Peggy McCardle

Predicting, Explaining, and Preventing Children's Reading Difficulties

Several decades of research have made it clear that by the time children enter school they already vary widely in their reading-related knowledge and skills. How well do these differences predict differences in reading acquisition? What can they tell us about the causes of reading disabilities? How might these research findings be used to reduce the number of children who have difficulty learning to read? Answers to such questions are fundamental for designing early interventions for children at risk. In this paper, we summarize what has been learned so far, and discuss what directions need to be taken in future research so as to provide fuller answers.

Gastroenterology Workforce Modeling

OBJECTIVE To examine the current supply and distribution of gastroenterologists and project future supply under various scenarios to provide a paradigm for workforce reform. DESIGN An analysis of current practices and distribution of gastroenterologists and a demographic model, using the 1992 gastroenterology workforce as a baseline. MAIN OUTCOME MEASURE Comparison of current supply, distribution, and practice profiles with past data and future projections, using analyses of data from the 1993 Area Resource File, 1992 Medicare Part B file, age- and sex-specific death and retirement rates from the Bureau of Health Professions, managed care staffing patterns, the National Survey of Internal Medicine Manpower, and the Bureau of the Census. RESULTS Rapid growth in the number of US gastroenterologists has resulted in a gastroenterologist-to-population ratio double that used on average by health maintenance organizations. In addition, the work profile of gastroenterologists is shared significantly by primary care physicians and other specialists, with the exception of a few specific and uncommon procedures. CONCLUSIONS Empirical evidence suggests that, even in the absence of detailed models to describe the desired supply/need balance for gastroenterology, the US health care system and clinicians may benefit from a reduction in gastroenterology training programs. The Gastroenterology Leadership Council endorsed a goal of 25% to 50% reduction in trainee numbers over 5 years, and recent National Resident Matching Program data indicate that a voluntary downsizing process is in full force. This study illustrates a paradigm for workforce planning that could be useful for other medical specialties.

Advances and Remaining Challenges in Adult Literacy Research

Low literacy levels in adult learners pose an educational and public health challenge to practitioners and the scientific community. Increasing demands placed on literacy can limit opportunities in the workplace and access to health-related resources, negatively affecting public health. Current estimates from the National Center for Education Statistics suggest that more than 40 million adults in the United States possess only the most basic and concrete literacy skills. Despite the estimated number of learners possessing minimal literacy skills in English in the United States, there remains a paucity of research focused on adult learners to inform remediation efforts. This special issue of the Journal of Learning Disabilities represents an important step in highlighting the current scientific knowledge base and the implications for future directions and lines of inquiry with adult learners.

Language and development in FG syndrome with callosal agenesis

The FG syndrome is characterized by unusual facies, sudden infant death, developmental delay, and abnormalities of the cardiac, gastrointestinal, and central nervous systems. No longitudinal data on development in surviving patients are currently available. Serial evaluations of a patient with FG syndrome, whose sole central nervous system anomaly was agenesis of the corpus callosum, showed a consistent pattern over time. Specific language impairments in syntactic and pragmatic-semantic areas are emerging. These findings represent the first detailed data on which expectations for children with the FG syndrome can be based. The findings also fit theoretical constructs on the function of the corpus callosum and may therefore be generalized to provide expectations for other patients with isolated agenesis of the corpus callosum. Given the information gained from this case, it is clear that language intervention/consultation should be a pivotal service for such children, and that the speech-language pathologist should play a role in the development of an integrated educational services plan.

Executive function in preschool-age children: Integrating measurement, neurodevelopment, and translational research.

A primary aim of the neuropsychological revolution has been the mapping of what has come to be known as executive function (EF). This term encompasses a range of mental processes such as working memory, inhibitory control, and cognitive flexibility that, together, regulate our social behavior, and our emotional and cognitive well-being. In this book, top scientists from a variety of fields investigate executive function as it develops in early childhood. Because researchers differ in their conceptualizations of basic processes and even in how they define EF itself, contributors begin by discussing comparability and replicability, key issues which are of primary importance to those seeking to move the field to a new level of rigor. Next, they tackle the nuts-and-bolts of the development of EF in preschoolers, including the neurobiological mechanisms and circuitry that underlie EF development as well as the role of EF in assessing risk - and its counterpart, resilience. Finally, they highlight exciting new clinical applications of EF research, including the use of EF in contextualizing and assessing family risk, the impact of socioeconomic status on neurological development, and the promotion of EF development through early education programs.

A Public Health Approach to Improving the Lives of Adult Learners: Introduction to the Special Issue on Adult Literacy Interventions

Abstract Addressing the literacy needs of adult basic and secondary education learners must form a core part of a broader public health effort to increase educational and health outcomes for these individuals and their families. Adult learners constitute a significant proportion of the overall adult U.S. population and a proportion that impacts, directly and indirectly, on the physical and economic health of millions of families and society writ large. Enhancing the literacy skills of low-literate adults has proven difficult, hampered by the relative dearth of research data on struggling adult learners and effective intervention approaches, the contextual challenges of delivering intensive interventions, limited personal and systemic resources, and competing demands on learners’ time. We propose a systems-level view of adult low literacy as one that holds promise and provides a basic framework for providing coordinated, comprehensive, and integrated services but that requires additional research to support. Informed and coordinated efforts with the prekindergarten to 12th-grade education system and health and labor services sectors is needed if we are to improve the lives of these adults and their families.

The social neuroscience of human-animal interaction.

Humans are a fundamentally social species, preferring to live in dyads, families, groups, communities, and cultures (Cacioppo & Ortigue, 2011). As a species, we have a wonderful capacity to develop and engage in social interactions, both with other humans and with members of other species, most obviously companion animals such as dogs and cats. In fact, the latest figures indicate that 68% of U.S. households (American Pet Products Association, 2014; American Veterinary Medicine Association, 2007) and 46% of British households (Pet Food Manufacturers Association, 2014) include at least one companion animal. Pet ownership has also been shown to facilitate “social capital” in that the presence of pets tends to facilitate social contact and a sense of community (Wood, Giles-Corti, & Bulsara, 2005; Wood et al., 2015).

LANGUAGE AND DEVELOPMENT IN THE “FG” SYNDROME

The “FG” Syndrome is an X-linked syndrome characterized by unusual facial features, cardiac defects, mental retardation and gastrointestinal anomalies. Agenesis of the corpus callosum has also been noted in this syndrome. We report sequential language and developmental testing in a patient with “FG” syndrome, including callosal agenesis. J.B. is a 4 year 6 month old white male who has shown progressive delay in language and development. When first tested at 25 months of age, he had a 7 month receptive delay and an 11 month expressive delay. By 34 months of age, both were delayed by 14 months. At 54 months, his receptive skills were 21 months delayed and expressive skills were 24 months delayed and neither had shown measurable progression over the preceeding 10 months. He has abnormal articulation, word finding difficulty, and disordered syntax. This pattern of speech development is consistent with the language function defects reported in adults with callosal agenesis. His motor skills have been similarly delayed, and he has been consistently unable to anticipate his own manual adjustments. His skills on the Bayley and selected McCarthy subtests place him in the mildly mentally retarded range. Some of the deficits noted are consistent with a defect in interhemispheric communication. This pattern of progressive developmental and language delay has not been previously reported in the “FG” syndrome.

LANGUAGE DEVELOPMENT IN CHILDREN WITH ADVANCED PHYSICAL MATURATION

Differences in language development and function have long been noted between males and females. These are felt to result from the faster maturation rate in females, leading to increased bilateral language function in the brain (Waber, 1976). To test this, we examined language function in two groups with rapid maturation, using the Clinical Evaluation of Language Function. Patients, 5 to 12 years old, with idiopathic precocious puberty (n=12) or congenital adrenal hyperplasia (CAH) (n=14), were tested. We hypothesized that sex hormone exposure might be related to the observed differences, since they emerge in late childhood. Girls with CAH are exposed to androgens and represent a natural cross-over between genetic sex and hormone exposure. The cdmparison score (language processing vs production) was significantly lower in children with androgen exposure, both male and female (p<0.025). No differences were observed between diagnoses, sponsor rank (a measure of socio-economic status), or degree of physical advancement as measured by bone age. On subtest scores, estrogen exposed children scored better in oral directions and word series, while androgen exposed children scored better in confrontation naming accuracy and word associations. These results suggest hormonal exposure affects language development, and that current theories may be overly simple for this complex area.