Parents of children with developmental disabilities seek out therapy in order to assist their child to reach full potential. In order to help parents understand where their child should be in comparison to a typically developing child, they must be provided with proper resources. While commercially available assessments are available to speech-language pathologists, parents only have access to checklists that provide minimal direction at certain age ranges. The purpose of this literature review is to discuss developmental domains important for the developing child, examine developmental milestone checklists available to parents as well as two commercially available assessments for speech-language pathologists, investigate available research on developmental milestones in the areas of language output, language comprehension, cognition, social-emotional skills, and motor development, and identify ages at which developmental milestones within the identified domains occur in typically developing children. The aim of this project will be to create developmental milestone checklists available for speech-language pathologists to provide to parents. / text

Pas de résumé / The thesis investigated the development of children’s global/local processing hierarchical patterns introduced by Navon (1977). The objectives were to understand more comprehensively the developmental characteristics of children’s perception through their global and local processing of hierarchical patterns, by considering the effects of age, stimuli properties, duration of exposure to the stimuli and gender in a perceptual task and a drawing task. These effects were tested in 3 different populations: typically developing children, children with mental retardation and early blind children. The results revealed that typically developing children attended to both the local and global level of processing but these modes of spatial information processing operated independently. In a first step, children before 4 years of age showed dominance of local processing and then a more global processing developed at 4 years of age, and at 5 years of age integrated responses began to emerge. Early blind children showed similar developmental characteristics, although there was a protracted period of local processing dominance. Indeed, these children mainly produced local responses at ages of between 6 and 10 years, and then developed more global responses at 11-12 years and continued to integrate the two levels of analysis at later ages. On the other hand, global dominance was shown in children with mental retardation and their development was affected more by mental age than by chronological age. Moreover, their responses were shown to be sensitive to the fact that meaningful object could be located at the local level, enhancing local processing in this case. These results need further confirmations as the studies of global/local processing in atypical children are not numerous. In particular, the effect of duration of exposure to the stimuli should be further analyzed, because this factor did not seem to have a great effect in our experiments while it seemed more powerful in other studies carried out with adults. Replication of the study with children with mental retardation appears also important to plan for future work, because we can have some doubt relatively the absence of modification through ages of the way these children perceive hierarchical patterns. Finally, defining more precisely what may underlie the gender differences seems also worth to explore since gender did not show a major effect in our results.

Sibling relationships and the interaction within these relationships play a central role in children’s general development and will therefore impact on functional outcomes of children with severe speech and language disabilities. Siblings of children with disabilities have often felt excluded from family interactions, possibly causing negative attitudes towards participation with their siblings, in turn impacting negatively on the functional outcomes of their siblings with disabilities. The main aim of this research is to determine the attitudes of typically-developing children towards participation with their younger siblings with severe speech and language disabilities in four everyday life situations, namely: play (major life areas), communication, activities of daily living as part of domestic life and interpersonal relationships (time and responsibility issues). Twenty-seven older, typically-developing siblings of children with severe speech and language disabilities were selected to complete the measuring instrument (SAS). The results indicated that the participants held the most positive attitudes towards participation in play (major life areas) but that they held less positive attitudes towards communication participation and that they were least positive about participation in interpersonal relationships (time and responsibility issues). This study succeeded in documenting attitudes of siblings towards participating in four everyday life situations with their younger sibling. It is envisaged that these results will provide tentative guidelines for how activity-based interventions can best be structured to support both the child with a disability and their sibling. Copyright / Dissertation (Master of Arts)--University of Pretoria, 2012. / Centre for Augmentative and Alternative Communication (CAAC) / unrestricted

La paralysie cérébrale (PC) est un trouble non progressif causé par une lésion cérébrale. La PC survient tôt dans la vie et présente une atteinte hétérogène et une altération fonctionnelle. Chez les personnes atteintes de PC, les modifications du Contrôle neuronal et des muscles entraînent des modifications permanentes de la fonction motrice, entraînant des déficits de mouvement. L'une des raisons des patrons de marche atypiques chez les enfants atteints de PC est l'altération l'activation musculaire. Un niveau anormal d'activation simultanée des muscles agonistes et antagonistes des muscles agonistes et antagonistes entourant une même articulation la même articulation empêche une performance de marche optimale chez les enfants atteints de PC. Ce phénomène est connu sous le nom de co-contraction musculaire (CoM) ou de co-activation musculaire (CaM) dans toutes les études. L'identification des schémas musculaires les plus détériorés, à savoir CoM/CaM, chez les enfants atteints de PC est essentielle pour une rééducation efficace de la marche. L'objectif de ce projet de maîtrise était donc de distinguer CoM/CaM chez les enfants atteints de PC de leurs pairs en développement typique (DT) pendant la marche. Cet objectif a été atteint en deux étapes ; Premièrement, nous avons décrit la CoM/CaM chez les personnes atteintes de PC via la réalisation d'une revue de littérature ; Ensuite, nous avons appliqué nos résultats de la première étape à une étude transversale pour comparer CoM/CaM pendant la marche entre des enfants atteints de CP et de DT. Une revue de littérature suivant la méthodologie en 6 étapes du Joanna Briggs Institute a été effectué. Les bases de données ont été consultées à l'aide de mots-clés pertinents. Toutes les études publiées sur CoM/CaM chez les personnes atteintes de PC pendant la marche ont été recueillies. Après un examen de la pertinence des titres et des résumés, un deuxième examen des textes intégraux des sources par deux examinateurs a été appliqué. Enfin, les données ont été extraites des articles inclus (n=21). Ensuite, à l'étape suivante, les principales méthodes utilisées pour quantifier la MCa identifiées à l'étape précédente ont été codées dans Matlab (The Mathworks Inc., Natick, États-Unis) et appliquées à nos données de 12 enfants atteints de CP et 23 enfants TD. Nous avons comparé le CaM moyen de deux groupes de muscles de la cuisse et de la jambe (Rectus Femoris (RF)/Semitendinosus (ST) et Tibialis Anterior (TA)/Lateral gastrocnemius (LG), respectivement) via des tests t non appariés (ou son équivalent non paramétrique). La revue de littérature a suggéré une CaM plus élevée chez les personnes atteintes de PC par rapport à leurs pairs en bonne santé dans toutes les études. Bien qu'il y ait eu une terminologie et des approches méthodologiques incohérentes, nous avons pu discriminer les terminologies (c'est-à-dire CoM et CaM) en fonction des méthodologies de calcul (c'est-à-dire moment et EMG) utilisées par les études. En outre, cette étude nous a permis de résumer les modèles de CaM chez les individus atteints de PC et d'identifier la relation entre certains des paramètres de marche avec CaM. Enfin, les résultats de cette étude ont révélé des informations précieuses concernant les lacunes de la recherche dans ce domaine. La deuxième étude a identifié une augmentation de la CaM pendant la marche (la foulée entière, la phase d’appuie et la phase oscillante) chez les enfants atteints de PC par rapport à leurs pairs TD. Cette augmentation n'a été observée que dans les muscles de la jambe (pendant la phase d’appuie et la phase oscillante) et dans les muscles de la cuisse (pendant la phase oscillante) lorsque nous avons normalisé les signaux d'électromyographie. Les groupes CP et DT n'avaient pas de CaM différent en utilisant l'EMG normalisé pour l'ensemble de la foulée. Cette différence met en évidence l'effet de la normalisation EMG sur les valeurs de CaM. De plus, les enfants avec le niveau II du système de classification de la fonction motrice globale (SCFMG) avaient un CaM plus élevé dans les muscles de la cuisse pendant le swing que ceux avec le niveau I. Dans l'ensemble, ce projet de maîtrise révèle de nouvelles preuves soutenant une plus grande CaM chez les enfants atteints de PC par rapport à DT pendant la marche. Néanmoins, il est important d'étudier la CaM dans différentes phases de marche car elle affecte la comparaison entre les groupes. En outre, ce projet justifie l'importance de la méthodologie (par exemple, le traitement EMG et le calcul CaM) dans les études CaM. Plus précisément, il est fort probable que les résultats changent avec différentes approches de normalisation EMG. De plus, les enfants atteints de SCFMG I et II peuvent éprouver différents niveaux de CaM pendant la phase oscillante. Davantage de comparaisons dans des recherches futures, telles qu'entre les SCFMG I, II et III dans la PC hémiplégique et diplégique pendant les sous-phases de la marche (le contact initial, le « mid-stance »), peuvent fournir de meilleures informations sur les modèles de CaM dans cette population. / Cerebral palsy (CP) is a nonprogressive disorder caused by a brain injury. CP occurs early in life, before, during, or after birth, and has heterogeneous involvement and functional impairment. In individuals with CP, changes in neural drive and muscles lead to lifelong changes in motor function, leading to movement deficits. One of the reasons for atypical gait patterns in children with CP is altered muscle activation patterns. An abnormal level of simultaneous activation of agonist and antagonist muscles crossing the same joint prevents optimal gait performance in children with CP. This phenomenon is known as muscle co-contraction (MCo) or muscle co-activation (MCa) across studies. Identification of the most deteriorated muscular patterns, namely, MCo/MCa, in children with CP is vital for effective gait rehabilitation. The objective of this master’s project, therefore, was to distinguish MCo/MCa in children with CP from their typically developing (TD) peers during gait. This objective was achieved through two studies; first, we described MCo/MCa in individuals with CP via the conduction of a scoping review; then, we applied our findings to inform a cross-sectional study to compare MCo/MCa during gait between children with CP and TD. A scoping review following the 6-stage Joanna Briggs Institute methodology was conducted. Databases were searched using relevant keywords. All published studies on MCo/MCa in individuals with CP during gait were collected. After title and abstract relevance screening, a second screening for the full texts of the sources by two reviewers was applied. Finally, data were extracted from the included articles (n=21). Then, leading methods used to quantify MCa identified from the previous study were coded in Matlab (The Mathworks Inc., Natick, USA) and applied to our data from 12 children with CP and 23 TD children. We compared the average MCa of two thigh and shank muscle groups Rectus Femoris (RF)/Semitendinosus (ST) and Tibialis Anterior (TA)/Lateral gastrocnemius (LG), respectively, via unpaired t-tests (or its non-parametric equivalent). According to our scoping review, higher MCa in individuals with CP compared to healthy peers across studies was found. Although there were inconsistent terminology and methodological approaches, we could discriminate terminologies (i.e., MCo and MCa) according to the methodologies in the calculation (i.e., moment and EMG) used by studies. Also, this study enabled us to summarize MCa patterns within individuals with CP and identify the effect of the some of the gait parameters on MCa. Finally, the findings of this study revealed valuable information regarding the research gaps in this area. The second study identified increased MCa around the knee and ankle joints for the following muscles (i.e., RF/ST and TA/LG, respectively) during walking (i.e., entire stride, stance, and swing) in children with CP compared to their TD peers. This increase was seen only in shank muscles (i.e., during stance and swing) and in thigh muscles (i.e., during the swing) when we normalized electromyography (EMG) signals. CP and TD groups did not have different MCa using normalized EMG for the entire stride. This difference highlights the effect of EMG normalization on MCa values. Also, children with Gross Motor Function Classification System (GMFCS) level II had higher MCa around the knee during swing than those with level I. Overall, this master’s project reveals new evidence supporting greater MCa in children with CP compared to TD peers during walking. Nevertheless, it is recommended to investigate MCa within different gait phases as it affects the comparison across groups. Also, this project justifies the importance of methodology (e.g., EMG processing and MCa calculation) in MCa studies. More specifically, it is likely that the results alter with different EMG normalization approaches. Moreover, children with GMFCS I and II can experience various levels of MCa during the swing phase. More comparisons in future research, such as between GMFCS I, II, and III in hemiplegic and diplegic CP during gait sub-phases (i.e., initial stance, mid-stance), can provide better information regarding MCa patterns in this population.

No description available.

The thesis investigated the development of children's global/local processing hierarchical patterns introduced by Navon (1977). The objectives were to understand more comprehensively the developmental characteristics of children's perception through their global and local processing of hierarchical patterns, by considering the effects of age, stimuli properties, duration of exposure to the stimuli and gender in a perceptual task and a drawing task. These effects were tested in 3 different populations: typically developing children, children with mental retardation and early blind children. The results revealed that typically developing children attended to both the local and global level of processing but these modes of spatial information processing operated independently. In a first step, children before 4 years of age showed dominance of local processing and then a more global processing developed at 4 years of age, and at 5 years of age integrated responses began to emerge. Early blind children showed similar developmental characteristics, although there was a protracted period of local processing dominance. Indeed, these children mainly produced local responses at ages of between 6 and 10 years, and then developed more global responses at 11-12 years and continued to integrate the two levels of analysis at later ages. On the other hand, global dominance was shown in children with mental retardation and their development was affected more by mental age than by chronological age. Moreover, their responses were shown to be sensitive to the fact that meaningful object could be located at the local level, enhancing local processing in this case. These results need further confirmations as the studies of global/local processing in atypical children are not numerous. In particular, the effect of duration of exposure to the stimuli should be further analyzed, because this factor did not seem to have a great effect in our experiments while it seemed more powerful in other studies carried out with adults. Replication of the study with children with mental retardation appears also important to plan for future work, because we can have some doubt relatively the absence of modification through ages of the way these children perceive hierarchical patterns. Finally, defining more precisely what may underlie the gender differences seems also worth to explore since gender did not show a major effect in our results.

No description available.