Thesis (M.S.)--Boston University

Probiotics and lactoferrin are currently being used in neonatal intensive care units in the hopes of reducing rates of sepsis and necrotizing enterocolitis. While studies have shown that these measures can be clinically beneficial to premature babies, little is known about their effect at the level of the intestinal microbiome. We performed a prospective study describing the composition and evolution of the microbiota of premature babies receiving probiotics with and without lactoferrin supplementation. Furthermore, we compared our findings to a piglet model. We found that the addition of lactoferrin did not lead to a distinct microbiome using UniFrac analysis, nor increased diversity or richness as compared to probiotics alone. The relative abundance of probiotic bacterial strains was approximately 3%. At the phylum level Firmicutes and Proteobacteria predominated, while overall Enterobacteriaceae was the most abundant family. We remain the first to describe the microbiome of premature infants receiving lactoferrin.

Recognizing and learning one’s native language requires knowledge of the phonetic and rhythmical characteristics of the language. Few studies address the rich source of language information available in a speaker’s face. Solely visual speech permits language discrimination in adults (Soto-Faraco et al., 2007). This thesis tested infants and adults on their ability to use only information available in a speaker’s face to discriminate rhythmically dissimilar languages. Monolingual English infants discriminated French and English using only visual speech at 4 and 6 months old, but failed this task at 8 months old. To test the role of language experience, bilingual (English/French) 6 and 8-month-old infants were tested and successfully discriminated the languages. An optimal period for sensitivity to visual language information necessary for discriminating languages may exist in early life. To confirm an optimal period, adults who had acquired English as a second language were tested. If English was learned before age 6 years, adults discriminated English and French, but if English was learned after age 6, adults performed at chance. Experience with visual speech information in early childhood influences adult performance. To better understand the developmental trajectory of visual language discrimination, visual correlates of phonetic segments and rhythmical information were examined. When clips were manipulated to remove rhythmical information, infants used segmental visual phonetic cues to discriminate languages at 4, but not 8 months old. This suggests that a decline in non-native visual phonetic discrimination (similar to the decline seen for non-native auditory phonetic information; Werker & Tees, 1984), may be impairing language discrimination at 8 months. Infants as young as newborn use rhythmical auditory information to discriminate languages presented forward, but not backward (Mehler et al., 1988). This thesis showed that both 4 and 8-month-old infants could discriminate French from English when shown reversed language clips. Unlike auditory speech, reversed visual speech must conserve cues that permit language discrimination. Infants’ abilities to distinguish languages using visual speech parallel auditory speech findings, but also diverge to highlight unique characteristics of visual speech. Together, these studies further enrich our understanding of how infants come to recognize and learn their native language(s). / Medicine, Faculty of / Graduate

Iron-deficiency anaemia (IDA) is considered to be the most common nutritional deficiency among infants and children worldwide. The consequences of IDA on the developing central nervous system may be irreversible; these may include delayed mental and motor development, and reduced school performance. Infants are particularly prone to develop IDA if given foods low in iron content or foods that contain iron of low bioavailability. Infants from low socioeconomic background and Asian, Black or Hispanic infants, are believed to be at higher risk for IDA than White infants. There are no published studies on iron status in relation to feeding history from British Columbia or other parts of Canada. The purpose of this study was to determine the prevalence of IDA and low iron status in 9 month old infants in Vancouver, British Columbia, and to determine which infants are at highest risk for IDA and low iron status based on their feeding history, economic and ethnic background. Infants who could participate in the study were identified from birth and death lists provided by the Vancouver Public Health Department. Eligibility criteria were that the infant was full term (gestational age a: 37-<42 weeks) with a birth weight of 2500-4500g and born between January 1st, and March 2nd, 1993, or between June 4th and August 7th, 1993 to parents resident in Vancouver, with an address to enable contact. Initial contact with parents of all eligible infants (n = 1813) was made through a letter. A subsequent telephone call was made to the parents to describe the study protocol and to arrange an appointment for parents interested in participating with their infant. All the appointments were made to coincide with the time when the infant would be 39 ± 1 weeks old. At the clinic appointment, blood samples were collected from the infants, parents completed questionnaires regarding their family background and their infant's nutritional history from birth to 9 months of age, and a visual recognition memory test (Fagan Test of Infant Intelligence) was administered to the infant. Because many tests used to diagnose iron-deficiency anaemia lack specificity, several tests were used in combination. IDA was classified as a Hgb ^101 g/L or Hgb <110 g/L with 2 or 3 abnormal biochemical tests from serum ferritin :S 10 //g/L, total iron binding capacity > 60 //mol/L, and zinc protoporphyrin >70 //mol ZPP/mol heme. Low iron status was classified as a serum ferritin ^10 //g/L without iron-deficiency anaemia. Four hundred and thirty four (434) 9 month old infants and their parents participated in the study, representing 23.9% of all the eligible infants. The prevalence of IDA and low iron status was 6.9% and 24.4%, respectively. A statistically significant association (p<0.0001) was found between the infants' iron status and the duration of breast-feeding. IDA and low iron status was found in 15.2% and 30.4%, respectively, in infants who had received breastmilk as their main source of milk for more than 8 months. In contrast, the prevalence of IDA and low iron status was 1.5% and 10.3%, respectively, among the group of infants who were never breast-fed. Feeding low iron milk (cows' milk, low iron infant formula or goat's milk) also showed a statistically significant (p < 0.05) association with the iron status of the infants. No statistically significant association was found between iron status and the age of introduction of specific solid foods (iron-fortified infant cereals, fruits, vegetables, legumes, egg yolk, tofu, meat, chicken, or fish), or fruit juice. No statistically significant association was found between the annual family income and iron status of the infants, when considering either the entire group of infants, or the infants from two parent households. However, a statistically significant association (p< 0.05) was found between iron status and family income for the group of infants (n = 30) from one parent families. Of note, only 7 of these infants were from families with an annual income of > $20,000. The low number of infants in this group limits the ability to predict the true prevalence of IDA and low iron status, or the association with income in the single parent families. No statistically significant association was found between the infants' iron status and the mothers' level of education. A higher prevalence of iron-deficiency anaemia and low iron status was found in infants of mothers born in Canada compared to infants of mothers not born in Canada. The difference was statistically significant (p<0.05) suggesting a higher risk for iron-deficiency anaemia and low iron status among infants' whose mother had been born in Canada. No statistically significant association was found between the infants' iron status and the number of years an immigrant mother had resided in Canada. Ethnic background as reported by the mother was significantly associated (p<0.05) with the iron status of the infants. Specifically, the prevalence of IDA was higher among infants of European and Canadian parentage than among infants of East Indian and Chinese parentage. No statistically significant differences were found between the scores on the visual recognition memory test of the infants with iron-deficiency anaemia, low iron status or normal iron status. In conclusion, the prevalence of iron-deficiency anaemia (6.9%) and low iron status (24.4%) among otherwise healthy 9 month old infants who participated in this study suggests the need to develop strategies for the prevention of iron-deficiency anaemia, or for early detection and treatment. The results of this study show that the infants at highest risk for iron-deficiency anaemia and low iron status in Vancouver, when defined by feeding history, are infants with a history of breast-feeding as the main source of milk for more than 8 months, and infants bottle-fed low iron milk (cows' milk, goat's milk or low iron infant formula). When defined by economic and ethnic background the infants at highest risk for iron-deficiency anaemia are infants of Caucasian mothers (European or Canadian). / Land and Food Systems, Faculty of / Graduate

Previous research indicates that for adults and children the perception of speech can be significantly influenced by watching a speaker's mouth movements. For example, hearing the syllable /bi/ while watching a speaker mouth the syllable /vi/ results in reports of a 'heard' /vi/. Some evidence suggests young infants also may be able to integrate heard and seen speech. One theory suggests that an innate link between perception and production (Liberman & Mattingly, 1985) accounts for this phenomenon while another theory suggests that experience (e.g., producing speech sounds) may be necessary into order to develop fully the underlying representation of visible speech (Desjardins, Rogers & Werker, in press; Meltzoff & Kuhl, 1994). My dissertation addresses the above controversy by examining whether the integration of heard and seen speech is obligatory for young infants as it is for adults. In Experiment 1, 4-month-old female infants habituated to audiovisual /bi/ showed renewed visual interest to an auditory /bi/-visual NM suggesting that they may have perceived the auditory /bi/-visual /vi/ as /vi/, as do adults. In Experiment 2, neither male nor female infants showed renewed visual interest to a dishabituation stimulus which represents only a change in mouth movements. In Experiment 3, male infants looked longer to an audiovisual /bi/ than to an audiovisual /vi/ following habituation to an audio /bi/-visual /vi/, while female infants tended to look only slightly longer to an audiovisual /vi/ than to an audiovisual /bi/. Taken together these experiments suggest that at least some infants are able to integrate heard and seen speech, but that they do not do so consistently. Although an innate mechanism may be responsible for integration, a role for experience is suggested as integration does not appear to be obligatory for young infants as it is for adults. / Arts, Faculty of / Psychology, Department of / Graduate

Robotics have advanced to include highly anthropomorphic (human-like) entities. A novel eye-tracking paradigm was developed to assess infants’ sensitivity to communicative gestures by human and robotic informants. Infants from two age groups (5-9 months, n = 25; 10-15 months, n = 9) viewed a robotic or human informant pointing to locations where events would occur during experimental trials. Trials consisted of three phases: gesture, prediction, and event. Duration of looking (ms) to two areas of interest, target location and non-target location, was extracted. A series of paired t-tests revealed that only older infants in the human condition looked significantly longer to the target location during the prediction phase (p = .036). Future research is needed to tease apart what components of the robotic hand infants respond to differentially, and whether a robotic hand can be manipulated to increase infants’ sensitivity to social communication gestures executed by said robotic hand. / Includes bibliography. / Thesis (MA)--Florida Atlantic University, 2021. / FAU Electronic Theses and Dissertations Collection

archives@tulane.edu / Making eye contact is one of the earliest, most important forms of communication. Newborns are sensitive to adults’ gaze direction (Farroni, Massaccesi, Pividori, & Johnson, 2004), and by 4 months infants learn more about an object that an adult has looked at (Reid & Striano, 2005). Emotional facial expressions influence infants’ scanning of adults’ eyes (Shepard & Spence, 2012), which may affect their sensitivity to eye gaze cues. In two experiments, we examined the effects of silent dynamic emotional messages on 6-month-old infants’ scanning of face features, as well as their sensitivity to and learning from eye gaze cues. In Experiment 1, infants completed a gaze cueing task in which speakers delivered silent approving, comforting, prohibition, and neutral messages and then shifted their eye gaze to a peripheral target. Although infants showed increased attention to the eyes during prohibition and comforting messages, all infants showed enhanced gaze cueing in the context of approving messages. Moreover, female infants showed trend-level gaze cueing following approving messages, whereas male infants showed trend-level gaze cueing following neutral messages. In Experiment 2, a separate group of infants completed a similar gaze cueing task that included a visual paired comparison test phase to examine learning of the gaze-cued and non-cued targets, based on the hypothesis that increased sensitivity to gaze cues would enhance learning of the cued targets. As in Experiment 1, infants showed increased attention to the eyes during comforting messages. However, we did not find any reliable gaze cueing effects. Infants spent more time looking at test targets following approving messages but did not show evidence of enhanced learning of cued targets. Overall, findings from both experiments suggest that 6-month-olds are more responsive to gaze cues in the context of approving messages, underscoring the significance of positive infant-directed interactions to the development of early joint attention. We conclude by discussing clinical implications, limitations (including a relevant error in Experiment 2), and future directions. / 1 / Claire Frances Noonan

A research report submitted in partial fulfillment of the requirements for the degree Master in Audiology, Department of Speech Pathology and Audiology Faculty of Humanities University of the Witwatersrand September 2018 / Newborn hearing screening (NHS) has been successfully implemented in developed countries such as the United States of America and the United Kingdom. This is however not the case in developing countries such as South Africa. The challenges impact on the implementation of such programmes include lack of suitably trained personnel, financial resources for staff and equipment, institutional support and political will. The lack of NHS programmes in South Africa has resulted in the late detection of hearing loss in infants and children and subsequently delayed intervention. In order to address the lack of NHS, a rural clinic-based NHS programme was implemented in July 2014 at three primary health care (PHC) clinics in the Limpopo Province. The main aim of the study was to describe the parental/caregiver perspectives regarding the effectiveness of this rural clinic-based NHS programme. The effectiveness of the programme was also evaluated in terms of meeting national (HPCSA, 2007) and international (JCIH, 2007) benchmarks. A retrospective review of 2 302 audiological records of babies who underwent NHS between July 2014 to June 2015 was conducted. Concurrently, 18 parents of infants who underwent hearing screening as part of the programme were purposefully selected and semistructured interviews were conducted to explore the parental perspectives regarding the programme. The results of the retrospective record review revealed that the mean age of the infants screened during the review period was 112 days (2 – 341; ± 40.26). The overall coverage rate was 87% and the referral rate, 7%. The overall follow-up return rate was 32% and only 15% the infants who failed both the initial and rescreening underwent comprehensive diagnostic assessment to confirm their hearing status. The overall prevalence rate for significant sensorineural hearing loss was 0.4/1000 and 7.8/1000 for middle ear effusion. The parents/caregivers confirmed the perceived effectiveness of the NHS programme. All the participants were satisfied with the programme and confirmed the credibility of the screening programme and screeners. Parents indicated that they were empowered with knowledge regarding the importance of early detection of hearing loss in infants and young children. Accessibility was both a facilitator and a barrier with travel distance and cost the most often cited obstacles to attending follow-up appointments. The findings indicate it is feasible to implement clinic-based NHS programmes that effectively meet the needs of parents/caregivers of infants residing in rural areas of South Africa. Although not all the benchmarks were met within the first year of implementation, the high coverage- and low referral rates are the first steps in improving the outcomes of the screening programme. The study highlight the importance of regular monitoring and evaluation of the NHS programmes to keep track of key outcomes and impacts related to the different components of the programme / MT 2019

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