Study 1: Aims: Compare the uniaxial MTI/CSA accelerometer and the biaxial Actiwatch accelerometer against direct observation of total physical activity and minute-by-minute physical activity in 3-4 year olds. Methods: MTI/CSA-7164 and Actiwatch accelerometers simultaneously measured activity during 35-45 minute sessions of structured play in 78, 3-4 year olds. Rank order correlations between accelerometry and direct observation were used to assess the ability of the accelerometers to assess total activity. Within-child minute-by-minute correlations were calculated between accelerometry output and direct observation. Results: For assessment of total activity MTI/CSA output was significantly positively correlated with direct observation (r 0.72, p<0.001), Actiwatch was not (r 0.16, p>0.05). Conclusion: The present study suggests that for epidemiological assessment of total physical activity in young children the MTI/CSA-7164 provides greater accuracy than the Actiwatch. Study 2: Aim: To cross-validate the 1100 counts/ minute cut-off for the assessment of sedentary behaviour in an independent sample of young children using the MTI/CSA accelerometer. Methods: A previously developed cut-off for MTI-CSA accelerometry output (validation study) in 30 healthy Scottish 3-4 year olds, was cross-validated against direct observation in an independent sample of (n = 52) healthy Scottish 3-4 year olds. Results: In the cross-validation study sensitivity was 83%: 438/528 inactive minutes were correctly classified. Specificity was 82%: 1251/1526 non-inactive minutes were correctly classified using this cut-off. Conclusion: Sedentary behaviour can be quantified objectively in young children using accelerometry.

Diss. (sammanfattning) Linköping : Univ., 2002. / Härtill 5 uppsatser.

Thesis (M.S.P.H.)--University of Michigan, 1945.

Thesis (M.S.P.H.)--University of Michigan, 1936.

Thesis (M.S.P.H.)--University of Michigan, 1945.

Thesis (M.S.P.H.)--University of Michigan, 1936.

Autism is considered to be a chronic developmental disability that affects communication, relationships, emotional development and imagination (NAS, 2010). Prevalence rates for autism spectrum disorder (ASD) suggest that the rates have increased over time and recent research shows that 1 in 68 children are diagnosed with the disorder (Baio, 2014). These children’s difficulties in the areas of communication, social skills and restricted/repetitive behaviours and interests lead to the need of therapeutic support (APA, 2013) and often it falls to parents to find an appropriate treatment for their child (Marcus et al, 2005). Among recommended services to these children are speech and language therapy, occupational therapy (Johnson and Myer, 2007) and psychotherapy (Alvarez et al, 1999). There are a number of intervention approaches for children with autism that have been developed, however none have been universally accepted as being the most effective (Farrell et al, 2005). As a result, parents often find it difficult to know which is the most appropriate approach for their child. This study aims to explore the development of children with autism over time in the areas of social skill and communication, regardless of the kind of treatment (speech and language therapy, psychoanalytic/psychodynamic psychotherapy and occupational therapy) they are receiving and to investigate the association between therapy context and the patterns of developmental change. This thesis is designed as a cross-national study in order to examine the aspects of the disorder that differ in the UK and Greece along with the differences (if any) in the developmental patterns across countries. The significance of doing a cross-national study is to explore autism from a wider international perspective and to identify any differences and similarities across the two countries. Twenty children with autism who had completed one of two differing types of treatment in the UK (psychotherapy, n=10 and speech and language therapy, n=10) were recruited to be monitored post-therapy twice over a two-year period. Twenty children with autism who had received one of two types of treatment in Greece (occupational therapy, n=10 and speech and language therapy, n=10) were also recruited to be monitored post-therapy twice over a two-year period. The research found that all children changed significantly over time on all aspects of measurement. Furthermore, no significant differences were found in the children from the two different countries at the start of the study and they developed in a very similar way as well. The results suggested though that based on the ADOS-Social (p=0.008) and ADOS-Imagination (p=0.008) children in the UK improve faster in the areas of social skill, imagination and the CDI-no of words understood and produced (p=0.015) showed an increase in their ability to understand and say words compared to the children in Greece. However, the CDI-no of words understood (p=0.027) showed that the children in Greece improved faster in the area of comprehension. The children who received SLT are also mainly developing in a very similar way across the two countries. Most measures showed change over time, except for the SCQ (p=0.081), ADOS-Ster (p=0.050) and CDI-U (p=0.141|). Also, only the ADOS-Social (p=0.021) and the Social Communication Questionnaire (p=0.021) showed a significant interaction effect. Thus, the SLT group from the UK seems to improve faster in the area of social skills compared to the SLT group from Greece. Additionally, in regards to the effect of the therapy context on the developmental pattern of children with autism, there were no differences across intervention contexts at the beginning and there were mainly non-significant interactions in the rate of change across the differing types of intervention. The findings suggested that all measures showed change over time. Only the SCQ (p=0.041) and the ADOS-imagination (p=0.033) showed a significant interaction effect before adjusting for age. Therefore, the SLT group in the UK seems to improve faster in the social communication area and the Psychotherapy group in the UK improved faster in the area of imagination. Conclusively, the SLT groups showed more change on language and communication measures, whilst the psychotherapy and occupational therapy groups saw changes in other areas of autistic symptomatology not achieved in the SLT groups, such as imagination and stereotypical behaviour. In summary, the current study helps parents gain better insight in different therapy choices and raises awareness of other types of therapy that are available in terms of intervention. The findings of this study can help professionals who work with children with autism further their understanding of the disorder and how it manifests through time in order to provide appropriate services based on each child’s needs. Additionally, the cross-national approach was intended to give some suggestions about the manifestation of autism across countries and about the way childhood autism is treated in each country. In regards to the more specific changes that the analysis revealed, they seem to fit well with the intervention targets of each type of therapy. Thus, the analysis suggested that certain characteristics tend to be associated with specific treatment types, which leads us to believe that sometimes the most effective course of treatment is a combination of therapies depending on the individual needs of each family. Finally, the results of this study offer original findings with respect to the outcomes of psychodynamic/psychoanalytic psychotherapy for children with autism since there is a lack of rigorous research in this field.

Children who have language disorder frequently have difficulties with vocabulary acquisition, and these difficulties often persist into adolescence. Language disorder is known to be associated with long-term influences on a range of academic, social, emotional, health, and employment outcomes. Phonological-semantic intervention has been shown to be effective in enhancing the vocabulary skills of children with language disorder in small-group or individual settings, but less is known about vocabulary interventions for adolescents with language disorder or interventions in whole-class models of delivery. This thesis undertook three strands of enquiry: a systematic review; a survey of teaching and speech and language therapy practice; and an experimental effectiveness study. The systematic review of the evidence regarding vocabulary intervention with adolescents confirmed that the use of a phonological-semantic approach in a universal model of delivery is under-researched in this age group. The survey of mainstream secondary school teachers and speech and language therapists showed that a phonological-semantic approach is frequently used by speech and language therapists but less often by teachers. The experimental study investigated the effectiveness of phonological-semantic vocabulary intervention, delivered by teachers and embedded into the secondary school curriculum in a whole-class model of delivery, for adolescents with language disorder. In the intervention study, 78 adolescents with language disorder aged 11 – 13 years were taught science curriculum words by teachers in class, under two conditions: 1) 10 words taught through usual teaching practice; and 2) 10 matched words taught using an experimental intervention incorporating phonological-semantic activities, embedded into the teaching of the syllabus. Ten matched control words received no intervention. Word knowledge was assessed at pre-intervention, post-intervention, and follow-up timepoints. The main findings of the study were that: the experimental classroom vocabulary intervention was more effective than usual teaching practice in increasing the word knowledge of participating students; there was a high degree of acceptability for the intervention activities amongst both students and teachers; and there were mixed preferences amongst students for whole-class, small-group, and individual models of intervention delivery. Clinical and teaching implications include the importance of intervening during the adolescent years, with classroom vocabulary intervention being a viable option for collaborative teacher and speech and language therapy practice.

This study was carried out following observation from health professionals in the paediatric intensive care community that the incidence of chylothorax development in infants and children in the United Kingdom was unknown. Furthermore, treatment strategies were based on limited international evidence from single centre, small scale, retrospective cohort studies or case series. The aim of this study was therefore to determine the size and extent of the problem by establishing the current incidence, patient profile, management strategies and discharge destination or outcome of infants and children who developed a chylothorax in the UK. Infants and children ≥ 24 weeks gestation to ≤ 16 years, who developed a chylothorax in the UK were prospectively reported through the British Paediatric Surveillance Unit (BPSU). Clinicians completed a questionnaire on the presentation, diagnosis, management and discharge destination or outcome of these children. Three further additional data sources were accessed to confirm this data. A total of 219 questionnaires were returned with 173 cases meeting the eligibility criteria for inclusion. The incidence in children in the UK was 1.4 in 100,000 (0.0014%), in infants ≤ 12 months 16 in 100,000 (0.016%) and for those developing a chylothorax following cardiac surgery it was 3.1% (3,100 in 100,000). The majority of chylothoraces were reported following cardiac surgery (65.3%). Chylothorax was most frequently confirmed by laboratory verification of triglyceride content of the pleural fluid ≥ 1.1 mmol/litre (66%). Although a variety of management strategies were employed, treatment with an intercostal pleural catheter (86.5%) and a Medium Chain Triglyceride (MCT) diet (89%) were most commonly reported. The majority of the children had a prolonged hospital stay (median 29.5 days), with a reported mortality of 12.5%. The results of this study indicate that the development of a chylothorax in infants and children in the UK is not common; although incidence is higher in children having cardiac surgery. The duration of hospital stay is lengthy and therefore the impact on the child, family and hospital resources are significant. Common management strategies exist, but the variation in these and the lack of an outcome based rationale suggest national guidance is required.

No description available.