Jane Orton

Do early intervention programmes improve cognitive and motor outcomes for preterm infants after discharge? A systematic review

Aim  The aim of this study was to review the effects of early developmental intervention after discharge from hospital on motor and cognitive development in preterm infants.

Cerebral palsy and developmental coordination disorder in children born preterm.

Children born early (<37 weeks of gestation) are at high risk of a range of motor impairments due to a variety of biological and environmental risk factors. Cerebral palsy occurs more frequently in those children born preterm, with the risk increasing with decreasing gestational age. Mild and moderate motor impairments, consistent with developmental coordination disorder, occur in almost half of those children born preterm and include difficulties with balance, manual dexterity and ball skills. All forms of motor impairment are associated with comorbidities, which may have a greater effect on quality of life, academic achievement and participation in extracurricular activities than the motor impairment itself. Infants at risk of motor impairment can be identified in early infancy with a combination of clinical assessment tools and perinatal risk factors. However, the reliable diagnosis of motor impairment requires follow-up into early childhood and it is important to ensure that the appropriate intervention is implemented.

Challenges of neurodevelopmental follow-up for extremely preterm infants at two years

AIM This study examined the rates of follow-up for a cohort of extremely preterm (EP -<28weeks gestation) and/or extremely low birthweight (ELBW -<1000g) children at two years with related perinatal and geographical factors. The secondary aim was to determine the rates of developmental delay and disability. METHODS A retrospective review of two year follow-up data for all EP and/or ELBW infants born in a large tertiary neonatal hospital over a two year period was undertaken. Neurodevelopmental outcome was assessed using the Bayley Scales of Infant and Toddler Development Scale - 3rd edition (Bayley-III) and neurosensory disability was assessed by a paediatrician using a standard proforma. Rates of delay (composite score≥1SD below mean) were determined using the Bayley-III test norms and a local cohort normative group. Attrition rates and reasons for loss to follow-up were determined. RESULTS Only 50% (109/219) of eligible children participated in the follow-up. The follow-up rate for children engaged in an ongoing research project was excellent at 98% (58/59), however it was only 32% (51/160) for children following the clinical pathway. The main reason for not attending the follow-up was loss of contact. Factors associated with attendance included a lower gestation, sepsis and living in the metropolitan areas. The rates of delay in this cohort were greater with reference to local cohort normative data compared to Bayley-III test norms with an overall rate of delay of 72% (95%CI, 63% to 81%) compared to 38% (95%CI, 29% to 50%). CONCLUSIONS Follow-up of EP/ELBW infants to two years is an important part of clinical care, however the high rate of attrition in routine clinical follow-up and consequent difficulty in accurately determining rates of delay highlight challenges for centres providing ongoing care.

Responses to Chinese speakers of English

Abstract In the verbal linguistic systems, the target for English learners in China is educated native speaker accuracy. The target for more socially embedded interchange is yet to be established. Its basis needs to be formed from “what members of the target culture consider appropriate for foreigners and attitudes of learners themselves” (Sieloff Magnan and Walz 2002: 32). Seeking this information, the responses of 10 Chinese (CSE) and 10 native (NSE) English language academics to 20 video clips of Chinese students speaking English were examined. Results show a common CSE-NSE threshold for appropriate self-presentation with respect to many features. In the kinesic domain, however, findings strongly suggest many Chinese may be confronted in their exchanges with native English speakers by the dilemma that to express themselves to first language cultural comfort runs a high risk of being found inappropriate, even irritating, by their interlocutors. Establishing a pedagogical norm for social interaction will require negotiation of this dilemma.

Principles and Innovation Design: CLIL Units in Chinese

Achieving a command of Chinese is challenging due to difficulties in acquiring even the fundamentals: tones, characters, and a lexicon with no cognates. Chinese requires more time on task than other languages and to provide that and maintain motivation, the content needs to be engaging. Content and Language Integrated Learning (CLIL), a fusion of language learning with school subject learning, offers a meaningful option. Due to the same inherent challenges, however, deciding when explicit attention to form is necessary and how the unique features of Chinese can be mastered, is complex.

Developing Chinese oral skills – A research base for practice

One of the central contributions of the book is that each paper brings together theory and practice. Thus the book is recommended to both researchers and language practitioners.

NICU Graduates: The Role of the Allied Health Team in Follow-Up

Infants who graduate from the neonatal intensive care unit, including those infants born preterm and/or with brain injury, are at increased risk of long-term neurodevelopmental impairments. The developmental allied health team, consisting of physical therapy, occupational therapy, and speech pathology, is crucial in early evaluation of gross motor, fine motor, feeding, and language development. Surveillance of neurodevelopment in the first year of life is essential to ensure early detection of specific developmental delays and impairments, and to ensure timely referral for early intervention. Early intervention is not only important in optimizing long-term outcomes for the child, but it also plays an important role in enhancing the parent-child relationship and parental well-being. In this review, we discuss the role of the developmental allied health team in the follow-up of high-risk infants, identify key assessment tools used in early neurodevelopmental surveillance, and provide recommendations regarding referral to intervention programs to optimize child and family outcomes. [Pediatr Ann. 2018;47(4):e165-e171.].

Issues in Chinese Language Teaching in Australian Schools

Abstract The teaching of Chinese in Australian primary and secondary schools has a history of more than 40 years, but it has only been in the past two decades that it has become widespread. Nonetheless, until the last year, of the six most taught languages in schools, Chinese has had by far the smallest number of students. Several factors contribute to maintaining this situation, key among which are the greater time it takes students to master Chinese compared to other languages; the still underdeveloped pedagogy and resources for making learning Chinese an intellectually stimulating educational experience; and the impossibility of achieving good exam results due to the overwhelming number of students of Chinese background already proficient in the language. The result has been a uniform 95% drop out rate from early on. The factors involved in creating this situation are explained and concrete proposals made for improving the situation which take account of newly created gains and advocate collaborative work between those involved in teaching Chinese as an international language inside and outside China in helping to close the gaps.