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Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/22
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Item Association of proximal elements of social disadvantage with children's language development at 2 years: An analysis of data from the Children in Focus (CiF) sample from the ALSPAC birth cohort(Wiley, 2018-11-27) Law, James; Clegg, Judy; Rush, Robert; Roulstone, Sue; Peters, Tim J.Background: An association between social disadvantage and early language development is commonly reported in the literature, but less attention has been paid to the way that different aspects of social disadvantage affect both expressive and receptive language in the first 2 years of life. Aims: To examine the contributions of gender, parental report of early language skills and proximal social variables (the amount of stimulation in the home, the resources available to the child and the attitudes/emotional status of the primary carer and the support available to him/her) controlling for distal social variables (family income and maternal education) to children's expressive and receptive language development at 2 years in a community ascertained population cohort. Methods & Procedures: Data from 1314 children in the Children in Focus (CiF) sample from the Avon Longitudinal Study of Parents and Children (ALSPAC) were analyzed. Multivariable regression models identified the contribution of proximal (what parents do with their children) measures of social disadvantage adjusting for more distal (e.g., family income and material wealth) measures as well as early language development at 15 months to the development of verbal comprehension, expressive vocabulary and expressive grammar (word combinations) at 2 years of age. Outcome & Results: In the final multivariable models gender, earlier language and proximal social factors, co‐varying for distal factors predicted 36% of the variance for expressive vocabulary, 22% for receptive language and 27% for word combinations at 2 years. Language development at 15 months remained a significant predictor of outcomes at 24 months. Environmental factors were associated with both expressive scales but the picture was rather more mixed for receptive language suggesting that there may be different mechanisms underlying the different processes. Conclusions & Implications: This study supports the argument that social advantage makes a strong contribution to children's language development in the early years. The results suggest that what parents/carers do with their children is critical even when structural aspects of social disadvantage such as family income and housing have been taken into consideration although this relationship varies for different aspects of language. This has the potential to inform the targeting of public health interventions focusing on early language and pre‐literacy skills on the one hand and home learning environments on the other and, potentially, the two in combination.Item Making sense in primary care: levelling the playing field for people with communication difficulties(Routledge, 2005-03) Law, James; Bunning, K.; Byng, S.; Farrelly, S.; Heyman, B.Primary care depends on the effective communication between service user and practitioner. This study proposes that people with communication difficulties serve as a litmus test for whether practitioners are truly sensitised to the impact of their own communication skills. It is based on interviews with service users and carers. Three key themes emerged, namely inclusion , the process of communication , and continuity . Inclusion is concerned with effective participation in society in general and access to health care in particular. The communication process describes the way in which health issues are raised and addressed. Continuity refers to the way in which time interacts with the relationship between user and provider. The paper concludes that effective communication is not simply a set of taught behaviours but reflects a set of values that create the conditions for improving both communication and clinical outcomesItem The Specificity of a Systematic Review Is the Key to Its Value: A Response to Johnston (2005)(2005-10-01) Law, James; Garret, Z.; Nye, ChadWe would like to thank the Editor for drawing to our attention Professor’s Johnston’s (2005) helpful commentary on our recent article in the Journal of Speech, Language, and Hearing Research titled ‘‘The Efficacy of Treatment for Children With Developmental Speech and Language Delay/Disorder: A Meta-Analysis’’ (Law, Garrett, & Nye, 2004). Johnston’s comments are most welcome because we need clinicians and researchers to engage in the evidence-based practice debate and to reflect on the nature of evidence that they and others are likely to accept for informing both policy and practice. We would like to address the most salient concerns raised.Item Grading study quality in systematic reviews(National Student Speech Language Hearing Association, 2006) Law, James; Plunckett, C.Item Early Years Centres for pre-school children with primary language difficulties: what do they cost, and are they cost-effective?(Taylor & Francis (Informa Healthcare), 2006-01) Law, James; Dockrell, J. E.; Castelnuovo, E.; Williams, K.; Seeff, B.; Normand, CharlesBackground: High levels of early language difficulties raise practical issues about the efficient and effective means of meeting children’s needs. Persistent language difficulties place significant financial pressures on health and education services. This has led to large investment in intervention in the early years; yet, little is known about the actual and relative costs of early years provision. Aims: To profile the different costs incurred by two Early Years Centres (EYCs) partially funded by the charity I CAN and children receiving what might be termed ‘routine’ NHS speech therapy to provide an analysis of cost efficiency and equity. Methods & Procedures: Costings for service provision for 91 children (mean age 2;9) were collected. The activity of staff at each site and the cost of staff allocated to services were computed. Data on other resources were also collected. Outcomes & Results: The cost per child per session was on average £12. Despite the longer course of intervention in the first centre (10 compared with 6 weeks), the cost of the course per child was of the same order (£245 compared with £253). The annual cost of the early years provision per child was higher relative to the costs of the NHS provision, £645 compared with £181 in one EYC (A) and £462 compared with £173 in the other (B). When the cost of standard nursery provision was factored in, the difference in annual costs was rather less, with £5298 for the early years provision (EYC A) relative to £4276 in the comparison group. By contrast, the annual cost of early provision rises to £5926 relative to £8861 in the comparison group (EYC B).Item The use of non-nutritive sucking to promote functional sucking skills in premature infants: an exploratory trial.(2006-11) Harding, C.; Law, James; Pring, T.Non-nutritive sucking appears to promote an infant's readiness to begin oral feeding. This small pilot study examined a non-nutritive sucking programme to facilitate the transition to full oral feeding in premature infants. The results suggest that the non-nutritive sucking programme implemented by a speech and language therapist positively benefited the feeding development of neonates. Issues raised by the pilot study should be investigated in a larger scale study.Item Measuring and understanding patterns of change in intervention studies with children: Implications for evidence-based practice(Taylor & Francis, 2007) Dockrell, J. E.; Law, JamesPurpose: Comparisons across studies of the effects of intervention are problematic. Such analyses raise both methodological and statistical challenges. A single data set was examined to investigate whether different established approaches to measuring change in children with specific language impairments alter the conclusions that can be drawn regarding the efficacy of an intervention. Methods: Measures of cognitive and language skills were collected at baseline and at six months following an intervention. Reliable and valid psychometric measures were used. Data from the intervention study were used to explore the patterns of results obtained using four different measures of change: change of diagnostic category, differential improvement across assessment measures, item specific changes and predictors of individual change. Results: Associations between different tests purporting to measure similar constructs were modest. The measures identified different children as impaired both at baseline and follow-up. No effect of intervention was evident when a categorical analysis of impairment was used. Both treatment and comparison children changed significantly across time on the majority of measures, providing evidence of development, but specific effects of the intensive intervention were evident using ANCOVAs. Item analysis indicated that one of the standardized language tests adopted in the evaluation was insensitive to change over a six month period. Change in individual children’s performance was predicted by language level on entry to the project. Conclusion: The implications of the results are discussed in terms of the range of analytic approaches available to intervention researchers and the need to consider combinations of methods when analysing outcome data.Item Behavioral stuttering treatments are effective but no one treatment approach is more effective over other treatment approaches(Taylor & Francis, 2007-01) Law, JamesData sources: Databases up to 2004, PsychINFO, ERIC, MEDLINE, CINHL, C2-SPECTR, Cochrane Central Register of Controlled Trials and Dissertation abstracts. Search terms used stutt*, stam*, therap*, intervene*, fluen*, dysfl*, disfl. Study selection and assessment: Studies were included if (a) the participants were diagnosed as persons who stutter, (b) the treatment method was behavioral, (c) there were outcomes of speech behavior, and (d) the participants were randomly assigned to an experimental and control (or comparison condition) before the intervention. In terms of quality assessment, the following data were extracted from each included study: (a) intervention implemented as described; (b) who administered the outcomes measure; (c) participant recruitment procedure; (d) subject assignment procedure; (e) method of random assignment; and (f) blinding. Two reviewers independently coded each study using separate copies of the article. Disagreements were resolved through discussion between the two raters. If the disagreements persisted, the article was given to a third reviewer until the disagreement was resolved. Participants: Participants diagnosed as people who stutter (PWS), the treatment methods were behavioral, outcomes were measured in terms of speech and participants were randomly assigned to an experimental and control (comparison) condition. Studies with clutterers were excluded. Both children and adults were included. No pharmacological treatments were included. No restriction was imposed on intensity or duration of intervention. Only randomised controlled trials were included. Outcomes: Typically speech production specifically stuttered words or syllables per minute. Independent coding was completed for participant, outcome, treatment and design characteristics. Effect sizes were calculated by subtracting the post-test means of the intervention and control groups and dividing by the pooled standard deviation. Studies were weighted for sample size. The Q statistic was used to assess homogeneity. Sensitivity analyses were also carried out.Item Mapping practice onto theory: the speech and language practitioner's construction of receptive language impairment(Taylor & Francis, 2008-05) Law, James; Campbell, Craig; Roulstone, S.; Adams, C.; Boyle, JamesBackground: Receptive language impairment (RLI) is one of the most significant indicators of negative sequelae for children with speech and language disorders. Despite this, relatively little is known about the most effective treatments for these children in the primary school period. Aims: To explore the relationship between the reported practice of speech and language practitioners and the underlying rationales for the therapy that they provide. Methods & Procedures: A phenomenological approach was adopted, drawing on the experiences of speech and language practitioners. Practitioners completed a questionnaire relating to their practice for a single child with receptive language impairment within the 5-11 age range, providing details and rationales for three recent therapy activities. The responses of 56 participants were coded. All the children described experienced marked receptive language impairments, in the main associated with expressive language difficulties and/or social communication problems. Outcome & Results: The relative homogeneity of the presenting symptoms in terms of test performance was not reflected in the highly differentiated descriptions of intervention. One of the key determinants of how therapists described their practice was the child's age. As the child develops the therapists appeared to shift from a 'skills acquisition' orientation to a 'meta-cognitive' orientation, that is they move away from teaching specific linguistic behaviours towards teaching children strategies for thinking and using their language. A third of rationales refer to explicit theories but only half of these refer to the work of specific authors. Many of these were theories of practice rather than theories of deficit, and of those that do cite specific theories, no less than 29 different authors were cited many of whom might best be described as translators of existing theories rather than generators of novel theories. Conclusions: While theories of the deficit dominate the literature they appear to play a relatively small part in the eclectic practice of speech and language therapists. Theories of therapy may develop relatively independent of theories of deficit. While this may not present a problem for the practitioner, whose principal focus is remediation, it may present a problem for the researcher developing intervention efficacy studies, where the theory of the deficit will need to be well-defined in order to describe both the subgroup of children under investigation and the parameters of the deficit to be targeted in intervention. © 2008 Royal College of Speech & Language Therapists.Item What have birth cohort studies asked about genetic, pre- and perinatal exposures and child and adolescent onset mental health outcomes? A systematic review(Springer Verlag, 2010-01-01) Thompson, Lucy; Wilson, P.; Pritchett, P.; Minnis, H.; Toms-Whittle, L.; Puckering, C.; Law, James; Gillberg, C.Increased understanding of early neurobehavioural development is needed to prevent, identify, and treat childhood psychopathology most effectively at the earliest possible stage. Prospective birth cohorts can elucidate the association of genes, environment, and their interactions with neurobehavioural development. We conducted a systematic review of the birth cohort literature. On the basis of internet searches and 6,248 peer-reviewed references, 105 longitudinal epidemiological studies were identified. Twenty studies met inclusion criteria (prospectively recruited, population-based cohort studies, including at least one assessment before the end of the perinatal period and at least one assessment of behaviour, temperament/personality, neuropsychiatric or psychiatric status before 19 years of age), and their methodologies were reviewed in full. Whilst the birth cohort studies did examine some aspects of behaviour and neurodevelopment, observations in the early months and years were rare. Furthermore, aspects of sampling method, sample size, data collection, design, and breadth and depth of measurement in some studies made research questions about neurodevelopment difficult to answer. Existing birth cohort studies have yielded limited information on how pre- and perinatal factors and early neurodevelopment relate to child psychopathology. Further epidemiological research is required with a specific focus on early neurodevelopment. Studies are needed which include the measures of early childhood psychopathology and involve long-term follow-up. © 2009 Springer-Verlag.
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