Cara McComish

Analysis of Social Interaction Gestures in Infants with Autism.

This study analyzes the emergent use of gestures used among 9–12-month-old infants with autism and typical development using retrospective video analysis. The purpose of the present investigation was to examine the frequency, initiation, prompting, and diversity of types of gestures used for social interaction purposes. It was hypothesized that a restricted variety in type(s) of gestures as well as fewer child-initiated gestures and more prompted gestures would be associated with later diagnosis of autism. Logistic regression analysis found that decreased variety in type of gestures used was significantly associated with autism status. Neither number of total gestures nor initiation of gestures (child-initiated vs. prompted) was significantly associated with autism status.

The Pediatric Eating Assessment Tool: Factor Structure and Psychometric Properties

Objectives: The Pediatric Eating Assessment Tool (PediEAT) is a parent-report instrument developed to assess symptoms of feeding problems in children aged 6 months to 7 years. The purpose of this study was to identify the factor structure of the PediEAT and test its psychometric properties, including internal consistency reliability, temporal stability, and construct validity. Methods: Participants included 567 parents of children aged 6 months to 7 years. Fifty-four percent of the sample had parent report of a diagnosed feeding problem or feeding concerns. Exploratory factor-analysis techniques were used to remove redundant or non-endorsed items and identify the factor structure of the instrument. Construct validity was examined with 466 parents completing the Mealtime Behavior Questionnaire as a criterion standard. Known-groups validation was used to compare PediEAT scores between children with and without diagnosed feeding problems. Temporal stability of the PediEAT was examined with 97 parents repeating the PediEAT after 2 weeks. Results: Principal components factor analysis with varimax rotation supported a 4-factor model accounting for 39.4% of the total variance. The 4 subscales (Physiologic Symptoms, Problematic Mealtime Behaviors, Selective/Restrictive Eating, Oral Processing) demonstrated acceptable internal consistencies (coefficient alphas: 0.92, 0.91, 0.83, 0.83; respectively). Construct validity was supported in 2 ways. The PediEAT correlated with the Mealtime Behavior Questionnaire (r = 0.77, P < 0.001) and total score and subscale scores were significantly different between children with and without diagnosed feeding problem (P < 0.001). Temporal stability was demonstrated through test-retest reliability (r = 0.95, P < 0.001). Conclusions: Strong psychometric properties support the use of the PediEAT in research and clinical practice.

Interdisciplinary Feeding Team: A Medical, Motor, Behavioral Approach to Complex Pediatric Feeding Problems.

AbstractPediatric feeding difficulties are complex and multifactorial in nature. Children who need assessment and individualized treatment for complex feeding problems are best served by an interdisciplinary treatment team. The medical, motor, and behavioral approach to treating pediatric feeding problems is presented as an avenue to treatment. By necessity, this approach requires a well-functioning interdisciplinary team, including nurses, physicians, registered dietitians, and feeding therapists (speech-language pathologists, occupational and physical therapists). We describe a robust interdisciplinary feeding team that applies a medical, motor, and behavioral approach to treating pediatric feeding problems. Within this team, pediatric gastroenterology nurse practitioners, dietitians, and speech pathologists function as integral members of the team. Description of each team members expertise is provided and how they operate to support children with feeding problems and their families.

A Retrospective Video Analysis of Canonical Babbling and Volubility in Infants with Fragile X Syndrome at 9–12 Months of Age

An infant’s vocal capacity develops significantly during the first year of life. Research suggests early measures of pre-speech development, such as canonical babbling and volubility, can differentiate typical versus disordered development. This study offers a new contribution by comparing early vocal development in 10 infants with Fragile X syndrome and 14 with typical development. Results suggest infants with Fragile X syndrome produce fewer syllables and have significantly lower canonical babbling ratios compared to infants who are typically developing. Furthermore, the particular measures of babbling were strong predictors of group membership, adding evidence regarding the possible utility of these markers in early identification.

The Neonatal Eating Assessment Tool: Development and Content Validation

Abstract Purpose: To develop and content validate the Neonatal Eating Assessment Tool (NeoEAT), a parent-report measure of infant feeding. Design: The NeoEAT was developed in three phases. Phase 1: Items were generated from a literature review, available assessment tools, and parents’ descriptions of problematic feeding in infants. Phase 2: Professionals rated items for relevance and clarity. Content validity indices were calculated. Phase 3: Parent understanding was explored through cognitive interviews. Sample: Phase 1: Descriptions of infant feeding were obtained from 12 parents of children with diagnosed feeding problems and 29 parents of infants younger than seven months. Phase 2: Nine professionals rated items. Phase 3: Sixteen parents of infants younger than seven months completed the cognitive interview. Main Outcome Variable: Content validity of the NeoEAT. Results: Three versions were developed: NeoEAT Breastfeeding (72 items), NeoEAT Bottle Feeding (74 items), and NeoEAT Breastfeeding and Bottle Feeding (89 items).

Factor Structure and Psychometric Properties of the Neonatal Eating Assessment Tool–Breastfeeding

&NA; The purpose of this study was to identify the factor structure of the Neonatal Eating Assessment Tool–Breastfeeding (NeoEAT–Breastfeeding) and to assess its psychometric properties, including internal consistency reliability, test–retest reliability, and construct validity as measured by concurrent and known‐groups validity. Exploratory factor analysis conducted on responses from 402 parents of breastfeeding infants younger than 7 months old showed a 62‐item measure with seven subscales and acceptable internal consistency reliability (Cronbachs &agr; = .92). Test–retest reliability was also acceptable (r = .91). The NeoEAT–Breastfeeding has evidence of concurrent validity with the Infant Gastroesophageal Reflux Questionnaire (r = .69) and Infant Gastrointestinal Symptoms Questionnaire (r = .62). The NeoEAT–Breastfeeding total score and all subscale scores were higher in infants with feeding problems than in typically feeding infants (p < .001, known‐groups validity). The NeoEAT–Breastfeeding is a parent‐report assessment of breastfeeding in infants from birth to 7 months old with good initial evidence of reliability and validity.