In today’s news, I was able to find two really great articles about the diagnosis and treatment of particular special needs conditions. The first article comes from Medial News Today and looks at a new study examining children with specific language impairments (SLI). The data from this study, which examined around 600 children, is going to be used to help in the future diagnosis and treatment of similar language impairments. Language acquisition is a major issue facing children with ADHD and autism. The next medical article looks at the treatment of anxiety disorders in children. Another co-symptom for many ADHD and autistic children, looking at the treatment of anxiety through the use of computer-based applications pairs nicely with the overall trend of technology in education across the spectrum. Finally, the last article deviates somewhat from our typical content, but seems significant nonetheless. A report from ABC News on the University of California system’s new request for students to declare their sexual orientation upon admissions acceptance can have wide-ranging implications for all students. Like declaring race or gender, the sexual orientation question will be used for statistical purposes as well as a means to offer services to self-identified LGBT students. In the wake of the Tyler Clementi trial, should these types of questions be used to help determine roommate assignments? Where is the line? Seeking Better Ways to Diagnose Young Children with Language Impairments From Medical News Today Dr. Christine Dollaghan, a professor at the Callier Center for Communication Disorders and the School of Behavioral and Brain Sciences, is author of a paper in the Journal of Speech, Language, and Hearing Research. The study evaluated data collected from a large sample of about 600 children. Some of the participants had specific language impairments, or SLI. She wanted to deterimine whether SLI should be regarded as a discrete diagnostic category. "One of the most basic and long-standing questions about SLI is whether children with the disorder have language skills that differ qualitatively and nonarbitrarily from those of other children or whether their language skills simply fall at the lower end of a continuous distribution, below some arbitrary threshold but not otherwise unique," she wrote in the October article titled "Taxometric Analyses of Specific Language Impairment in 6-Year-Old Children." Dollaghan previously reported on this sample of children when they were 3 and 4 years old. The new study included some test results that were not available at the earlier ages. She focused on four common indicators of SLI - receptive vocabulary, expressive utterance length, expressive vocabulary diversity and nonsense word repetition. As in the earlier investigation, she found the 6-year-olds with SLI did not represent a distinct group with unique characteristics Instead, they fell at the lower end of a continuous distribution of language skills. The results of the study could help in developing diagnostic protocols for children with language impairment and tailoring treatments to the characteristics of individual children. Dollaghan said the categorical-continuous question is being examined by investigators interested in many other diagnostic categories, including autism, schizophrenia and ADHD. Dollaghan also co-authored an article in the November edition of Artificial Intelligence in Medicine with colleagues from UT Dallas' Erik Jonsson School of Engineering and Computer Science, including lead author Keyur Gabani, Yang Liu and Khairun-nisa Hassanali. The team examined the use of automated machine learning and natural language processing methods for diagnosing language impairment in children based on samples of their language. In "Exploring a corpus-based approach for detecting language impairment in monolingual English-speaking children," the team reported that automated methods performed well. The findings suggested future collaborations between researchers in computer science and communication disorders will likely be useful, Dollaghan said. Computer-Based Treatment Eases Anxiety Symptoms in Children: Small Clinical Trial Supports Larger Scale Testing From the National Institutes of Mental Health A computer-based training method that teaches a person with anxiety to shift attention away from threatening images reduced symptoms of anxiety in a small clinical trial in children with the condition. The results of this first randomized clinical trial of the therapy in children with anxiety suggest that the approach warrants more extensive testing as a promising therapy. Background As many as a quarter of 13- to 18-year-olds have met the criteria for an anxiety disorder at some point. Currently available treatments—including cognitive behavioral therapy and medication—relieve symptoms of anxiety in about 70 percent of children treated. Most children with clinical anxiety do not receive treatment, partly because of difficulties in access to care, including distance and financial resources. Scientists are searching for additional approaches, including therapies that do not involve medication with its associated side effects. A treatment called attention bias modification (ABM) has emerged from the observation that people with anxiety unconsciously pay more attention than others to anything that seems threatening. One way of detecting such a bias is a dot probe test. In the test, people view a computer screen on which angry and neutral faces are flashed briefly, adjacent to each other. After the faces disappear, a test image of dots appears where either one or the other face was, and the person has to respond by pushing a button. People with anxiety consistently respond more quickly to dots that appear where the angry face was located. ABM presents patients with an exercise similar to the dot probe test, but the dots always appear where the neutral face was, and thus consistently draw the attention of the participant to this non-threatening image. A recent meta-analyses of ABM in adults by some of the same investigators who carried out this work suggested its potential as a treatment. This Study Researchers at Tel Aviv University (TAU) in Israel carried out a clinical trial on ABM as an outcome of a three-year collaboration with scientists at the National Institute of Mental Health and the University of Maryland, College Park, Maryland. Yair Bar-Haim of TAU led the study, which appears in the American Journal of Psychiatry. The study enrolled 40 children, 8 to 14 years old, who had sought help for anxiety. For children receiving ABM, after faces appeared on a screen, two dots appeared on the screen; children had to determine whether the dots were side by side, or one above the other. In every case, dots appeared only where the neutral face had been. There were also two control groups: in the first, dots appeared equally frequently where angry and neutral faces appeared; in the second, the only faces that appeared throughout were neutral, so the dots always appeared in the location of a neutral face. The object of the second control group was to help confirm that any therapeutic effect was from the ABM training, and not from desensitizing the children to threatening faces. Children in the study were randomly assigned to receive treatment, or to be in one of two control groups. All children had four training sessions over 4 weeks, with 480 dot-probe trials per session. Although the trial was small, there was a “reasonably robust” decrease in the severity of anxiety, according to the authors. Following ABM, both the number and severity of symptoms were reduced. Significance An important feature of ABM, says NIMH author Daniel Pine, is that it addresses the fundamental neurological function underlying anxiety: attention. Changes in attention happen very quickly—in milliseconds. “We know from neuroscience that if you want to change behaviors that happen very quickly, you have to practice. You can’t just tell someone how to drive, or throw a ball. You have to practice,” says Pine. Longitudinal studies that follow children into adulthood suggest that most chronic mood and anxiety disorders in adults begin as high levels of anxiety in children. In fact, childhood anxiety is as important in predicting adult depression as it is for adult anxiety. The ability to influence attention biases early in development might provide a powerful means of prevention for both of these disorders later in life. The approach requires no medication and in practical terms, the computer-based nature of ABM lends itself to large-scale dissemination, in a medium children are comfortable with. Larger-scale trials will be able to provide more information on the efficacy of the treatment in children and how it works to reduce symptoms of anxiety. College Freshmen in California Could Be Asked to Declare Sexual Orientation From ABC News College freshman entering the University of California system next year could be asked to identify themselves as gay, straight, bi, or transgender when they accept their admissions offer. The system’s Academic Senate initiated the proposal, which would add an additional question to the statements of intent students fill out when deciding to go to the University of California. The statements already include a host of identifiers such as race, gender, and ethnicity. The question will not be asked on applications to the schools because students may feel uncomfortable filling out the forms in front of their parents, according to Robert Anderson, chair of the senate. “Sexual orientation is a part of diversity and cannot be ignored,” Anderson said after the proposal was passed, according to the UCLA student newspaper, the Daily Bruin. “It’s past time for this,” he told ABC News. Collecting data on sexual orientation among undergraduates, graduate students, staff, and faculty could help the school ensure there are services in place for LGBT members of the community, he said. The senate was spurred to pass the bill by California state government, which already mandates that community colleges and California state universities collect information regarding students’ sexual orientation. It has been requested by the state that the UCs also collect this demographic information, Anderson said. Many LGBT students told the student newspaper they thought the proposal was a good idea and would help lead to more benefits for LGBT students. “The data may not be accurate, but something is better than nothing,” Marcus McRae, a senior who heads the student Queer Alliance, told the paper. McRae noted that UCLA’s LGBT center was very beneficial to him when he arrived on campus. Anderson was not sure whether the information would factor into roommate assignment decisions for incoming freshmen. The proposal comes at the same time that a college student from the opposite coast, at Rutgers University in New Jersey, is on trial for allegedly spying on and intimidating his roommate for having a gay sexual encounter. Dharun Ravi, who is accused of a hate crime, Tweeted messages about his suspicion over his roommate’s sexuality, “F**K MY LIFE/He’s gay,” and told friends that he “Saw my roommate kissing a dude. Yay!” The suicide of Ravi’s roommate, Tyler Clementi, and trial have sparked public outrage at gay-bullying among students. The proposed policy at the UC system will be decided by the school’s provost, Lawrence Pitts, who is assembling a group to study the ramifications of such a policy, according to the Daily Bruin. The system has not yet announced when Pitts will issue a decision.
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