Browsing by Person "Rush, R."

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Children's language ability and psychosocial development: a 29-year follow-up study.
(2010) Schoon, I.; Parsons, S.; Rush, R.; Law, J.
OBJECTIVES: Little is known on the psychosocial adult outcomes of children's early language skills or intervening circumstances. The aim of this study was to assess the longitudinal trajectory linking childhood receptive language skills to psychosocial outcomes in later life. METHODS: The study comprised 6941 men and women who participated in a nationally representative Birth Cohort Study. Direct assessment of language skills were made at age 5. The sample was studied again at age 34 to assess psychosocial outcomes and levels of adult mental health. Characteristics of the family environment, individual adjustment, and social adaptation in the transition to adulthood were assessed as potential moderating factors linking early language skills to adult mental health. RESULTS: In early childhood, cohort members with poor receptive language experienced more disadvantaged socioeconomic circumstances than cohort members with normal language skills and showed more behavior and psychosocial adjustment problems in the transition to adulthood. At age 34, cohort members with poor early language skills reported lower levels of mental health than cohort members with normal language. After adjustment for family background and experiences of social adaptation, early language skills maintained a significant and independent impact in predicting adult mental health. CONCLUSIONS: Early receptive language skills are significantly associated with adult mental health as well as psychosocial adjustment during early childhood and in later life. The needs of children with language problems are complex and call for early and continuing provision of educational support and services.
Communication skills in a population of primary school-aged children raised in an area of pronounced social disadvantage
(Informa Healthcare, 2011-11) Law, J.; McBean, K.; Rush, R.
Background: Previous studies have highlighted the level of communication difficulty experienced by children from socially disadvantaged backgrounds, but the pattern of difficulties remains unclear. Aims: The study asks whether the performance of a community sample of children from one of the most socially disadvantaged neighbourhoods in Scotland is best characterized by a general delay in all areas of development, by difficulties across the more formal structural aspects of language or in phonological skills. Methods & Procedures: The study included 138 monolingual English-speaking children: 63 (45.7%) boys and 75 (54.3%) girls aged between 5 and 12 years. All children were assessed blind to educational attainment in the school. Outcomes & Results: Nearly 40% of children had delayed language development with 10% having severe difficulties. The children presented with an uneven profile with much lower structural language scores than reading, general communication skills or non-verbal performance. Although service use was high in the group as a whole, the proportion who met criteria for specific language impairment on discrepancy criteria were not those who were being referred to speech and language therapy. Conclusions & Implications: Although many children were performing well within the normal range, a substantial proportion were not, having considerable implications for the way that services are delivered to these children. Given the high prevalence of delayed structural language difficulties in this group, there is a clear need for a more universal population-based approaches to service delivery.
How evidence-based is an 'evidence-based parenting programme'? A PRISMA systematic review and meta-analysis of Triple P
(BioMed Central, 2012-11-02) Wilson, P.; Rush, R.; Hussey, S.; Puckering, C.; Sim, F.; Allely, C.; Doku, P.; McConnachie, A.; Gillberg, C.
Background Interventions to promote positive parenting are often reported to offer good outcomes for children but they can consume substantial resources and they require rigorous appraisal. Methods Evaluations of the Triple P parenting program were subjected to systematic review and meta-analysis with analysis of biases. PsychInfo, Embase and Ovid Medline were used as data sources. We selected published articles reporting any child-based outcome in which any variant of Triple P was evaluated in relation to a comparison condition. Unpublished data, papers in languages other than English and some book chapters were not examined. Studies reporting Eyberg Child Behavior Inventory or Child Behavior Checklist scores as outcomes were used in the meta-analysis. Results A total of 33 eligible studies was identified, most involving media-recruited families. Thirty-one of these 33 studies compared Triple P interventions with waiting list or no-treatment comparison groups. Most papers only reported maternal assessments of child behavior. Twenty-three papers were incorporated in the meta-analysis. No studies involved children younger than two-years old and comparisons of intervention and control groups beyond the duration of the intervention were only possible in five studies. For maternally-reported outcomes the summary effect size was 0.61 (95%CI 0.42, 0.79). Paternally-reported outcomes following Triple P intervention were smaller and did not differ significantly from the control condition (effect size 0.42 (95%CI -0.02, 0.87)). The two studies involving an active control group showed no between-group differences. There was limited evidence of publication bias, but there was substantial selective reporting bias, and preferential reporting of positive results in article abstracts. Thirty-two of the 33 eligible studies were authored by Triple-P affiliated personnel. No trials were registered and only two papers contained conflict of interest statements. Conclusions In volunteer populations over the short term, mothers generally report that Triple P group interventions are better than no intervention, but there is concern about these results given the high risk of bias, poor reporting and potential conflicts of interest. We found no convincing evidence that Triple P interventions work across the whole population or that any benefits are long-term. Given the substantial cost implications, commissioners should apply to parenting programs the standards used in assessing pharmaceutical interventions.
Long-term Outcomes for Children with Early Language Problems: Beating the Odds
(2011-05) Parsons, S.; Schoon, I.; Rush, R.; Law, J.
Using the 1970 British Cohort Study, this study examines factors promoting positive language development and subsequent successful education and employment transitions among children showing early receptive language problems (age 5). We find that 61 per cent of children with early receptive language problems develop into competent readers by age 10. Factors promoting positive language development include parental support and more importantly a good school environment, characterised by only few children receiving remedial help. Post-16 education and employment experiences indicated competent reading to be associated with a less challenging journey into adulthood. Findings are discussed in terms of their policy implications.
Modeling Developmental Language Difficulties From School Entry Into Adulthood: Literacy, Mental Health, and Employment Outcomes
(2009-12) Law, J.; Rush, R.; Schoon, I.; Parsons, S.
Purpose: Understanding the long-term outcomes of developmental language difficulties is key to knowing what significance to attach to them. To date, most prognostic studies have tended to be clinical rather than population-based, which necessarily affects the interpretation. This study sought to address this issue using data from a U.K. birth cohort of 17,196 children, following them from school entry to adulthood, examining literacy, mental health, and employment at 34 years of age. The study compared groups with specific language impairment (SLI), nonspecific language impairment (N-SLI), and typically developing language (TL). Method: Secondary data analysis of the imputed 5-year and 34-year data was carried using multivariate logistic regressions. Results: The results show strong associations for demographic and biological risk for both impairment groups. The associations are consistent for the N-SLI group but rather more mixed for the SLI group. Conclusions: The data indicate that both SLI and N-SLI represent significant risk factors for all the outcomes identified. There is a strong case for the identification of these children and the development of appropriate interventions. The results are discussed in terms of the measures used and the implications for practice. American Speech-Language-Hearing Association.
Predicting language change between three and five years and its implications for early identification
(2012-07) Law, J.; Rush, R.; Anandan, C.; Cox, M.; Woods, R.
BACKGROUND AND OBJECTIVE: Early language delays across the preschool period have important implications for children, parents, and services raising the significance of early identification. Screening tests are an appealing solution but have proved problematic. A combined risk model would seem promising but has yet to be tested. The goal of this study was to examine the factors that predict language change in a nationally representative sample of children between 3 and 5 years when most children are identified as being in need of services. METHODS: By using data from children (n = 13 016) in the Millennium Cohort Study (a national UK birth cohort), linear regression was used to predict 5-year performance from 3-year test performance data coupled with sociodemographic and within-child factors and indicators of parental concern. Patterns of change were identified and logistic regression was used to predict the difference between children for whom profiles change and those for whom they do not. RESULTS: The final model (predicting 32% of the variance) included maternal education, pattern construction, behavior, language concerns, and 3-year vocabulary. Four change patterns were identified: one consistently low (n = 201), one consistently high (n = 12 066), a group that is resilient (n = 572), and one with a declining profile (n = 177). The models accurately predicted 71% of the declining group and 99% of the resilient group. Maternal education (odds ratio: 0.49) and behavior (odds ratio: 0.9) were significant predictors for the former and maternal education (odds ratio: 0.6) and pattern construction (odds ratio: 1.03) the latter. CONCLUSIONS: Early identification of delayed language remains problematic but, once identified, there are key indicators that predict which children are likely to be more or less at risk across time. The implications are discussed in terms of policy and practice. Copyright 2012 by the American Academy of Pediatrics.
Predicting patterns of developmental change: language development into primary school
(2010) Law, J.; Rush, R.
Objectives: Although it is possible to examine population subgroups using test cut point it is preferable to examine the performance of such groups across time if measures allow. This analysis will compare the profile of childrens language development between three and five years drawing on data (n=11788) in the UKs Millennium Cohort Study. Methods: Following clinical convention, the threshold for caseness was set at -1.5 standard deviations below the mean on the British Ability Scales, a well recognized standardized assessment of language development. We identified four groups based on their profiles across time on the British Abilities Scales. Group 1 comprised those whose scores fell 1.5 SD below the mean at both time points (n=199), Group 2 made up those whose scores deteriorated across time i.e. starting within normal limits and falling outside the normal range at five years (n=234), Group 3 comprised those who appeared to be resilient i.e. starting below the norm and improving across time (n=257) Group 4 comprised those whose scores remained within normal limits between 3 and 5 (n=11098). Multinomial regression was employed to assess the influence of these variables on the first three groups relative to the fourth. Potential predictors included gender, whether the child was small for dates, whether they had been in a special care baby unit, had long term health conditions, report of parental concern about hearing at nine months, attachment and developmental performance at nine months. Conclusion: The findings will be discussed in terms of their implications for our understanding of developmental change which has tended to emphasise continuities rather than discontinuities in child development. We will also interpret the data in terms of current health and educational policy and the popular desire to implement early screening procedures to identify at risk children. We argue that risk itself is not sufficient to warrant universal procedures which tend not to be very strong predictors even across such a narrow age span and using identical measures.
The incidence of cases of aphasia following first stroke referred to speech and language therapy services in Scotland
(2009) Law, J.; Rush, R.; Pringle, A.; Irving, A.; Huby, G.; Smith, M.; Conochie, D.; Haworth, C.; Burston, A.
Background: Key to the provision of appropriate services is an understanding of the number of cases in a given population. This study examined the incidence of aphasia following first ever stroke. It was part of a larger study, the Aphasia in Scotland Study, which examined the provision of services for people with aphasia in Scotland. Aims: The present study examines the incidence of aphasia referred to speech and language therapy services in people who have experienced their first ever stroke. The specific questions addressed were: What is the incidence of aphasia following first ever stroke? What is the percentage of aphasia following first ever stroke? What are the crude figures for aphasia following first ever stroke by age? What are the crude figures for aphasia following first ever stroke by gender? What are the crude figures for aphasia following first ever stroke by severity? Methods & Procedures: All 14 health boards in Scotland were approached but only 3, NHS Borders, Orkney, and Shetland, were able to provide the level of information required. Respondents were asked to provide information about the age and gender and level of communication need of referred cases over a given year. Outcomes & Results: Results suggested that the incidence of aphasia following first ever stroke was found to be 54, 57, and 77.5 per 100,000, for NHS Borders, Orkney, and Shetland respectively. This is slightly higher than in other comparable studies. The percentage of new cases of aphasia following a first ever stroke across NHS Borders, Orkney, and Shetland was 19, 22, and 34% respectively. The variability across the three sites is probably a function of the potential effect of small changes in the relatively low numbers. The majority of cases were, unsurprisingly, over 65 years of age but a substantial minority-17% (Shetland), 26% (Borders) and 36% (Orkney)-were below 65 years of age. One third of new cases resulted in severe aphasia. Although the proportions of men and women with aphasia were similar, women tended to be older at the point at which they experienced their first stroke. Conclusions: The results are discussed in terms the practicalities of this sort of data collection exercise and the implications of the results for service delivery. There is a need for comparable local data collection exercises tied in to current epidemiological studies.
Validation of an item bank for detecting and assessing psychological distress in cancer patients.
(2009) Smith, A.; Rush, R.; Wright, P.; Stark, D.; Velikova, G.; Sharpe, M.
Objective: To validate an item bank for assessing and detecting psychological distress in cancer patients by (1) identifying whether additional items are required in the full item bank; (2) identifying any item bias in the existing item bank; (3) linking levels of distress against thresholds derived from gold-standard psychiatric interviews (PSE/SCAN/SCID). Method: A Rasch analysis was conducted on a heterogeneous sample of cancer patients (n=4919) who had completed a combination of eight psychological distress screening instruments. A subset of patients had completed a psychiatric interview along with the HADS (n=381) or PHQ-9 (n=440). Item thresholds were plotted along the latent trait. Furthermore, items were assessed for differential item functioning (DIF) by age and gender. Finally, optimum thresholds were derived for the HADS and PHQ-9 and plotted along the latent trait distribution for the entire item bank. Result: Item thresholds exceeded the range of person measures, although a gap was still present along the latent trait. No DIF was observed for either age or gender. Putative cut-offs were derived for the item bank detecting moderate to severe levels of psychological distress. Conclusion: The item bank covers the majority of levels of emotional distress reported by cancer patients. Additionally, initial thresholds have been derived on the item bank, which correspond to a formal psychiatric assessment. Further work is required to ascertain the stability of the item bank over time and by diagnosis and stage of disease, as well as to determine additional thresholds for levels of distress.