This research was supported by the National Institute of Health Grant 1R03HD065036-01A and the National Science Foundation Grant 1628820 awarded to Tuppett M. Yates and Efrat Sher-Censor and the Herta and Paul Amir Faculty of Social Science, the University of Haifa, Israel. The author would like to thank Dr. Smadar Dolev for taking part in the film.

<ol>
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The author has nothing to disclose.

Four of our previous studies examined both the coherence and EE in parents&#39; FMSS (Davidovitch, M., 2018)29,30,32. Separate coding teams rated FMSS-Coherence and FMSS-EE. Three of these studies showed that FMSS-Coherence and the criticism component of FMSS-EE were significantly negatively correlated, although the associations were small to moderate (Davidovitch, M., 2018)29,32. The fourth study did not find a significant association between FMSS-Coherence and EE-criticism30. In addition, the four studies showed that FMSS-Coherence is not significantly associated with other components of FMSS-EE, namely, emotional overinvolvement and positive comments. Furthermore, FMSS-Coherence had a unique contribution to the explained variance of child adjustment indices. In one study, FMSS-EE was associated with mothers&#39; reports of preschoolers&#39; behavior problems while FMSS-Coherence was associated with observers&#39; reports of the preschoolers&#39; behavior problems32. In another study, only FMSS-Coherence and not FMSS-EE was associated with preschoolers&#39; descriptions of parents in play narratives29; Finally, in two studies FMSS-Coherence contributed to the explained variance of toddlers&#39;30 and school aged children&#39;s (Davidovitch, M., 2018) externalizing behavior problems, as reported by the mother, above and beyond the contribution of FMSS-EE. Taken together, these results suggest that FMSS-Coherence is distinct from FMSS-EE and point to the added value of assessing the coherence of parents&#39; FMSS in relation to the traditional EE coding.
Researchers who wish to use FMSS-Coherence should take into consideration the following. Administrating the FMSS as the first measure of the research procedure is vital, as any measure administered prior to the FMSS may color parents&#39; narratives. It is also important that the parent will be alone in the room with the interviewer, without the presence of other family members, to allow the parent to speak freely about the child.
Minimal interaction between the parent and the interviewer during the FMSS is critical. FMSS research suggests that the vast majority of parents are able to complete the task of speaking uninterruptedly about their child for 5 min. Yet, researchers of high risk families, such as homeless parents35 and mothers of twins who gave birth before the age of 2023 suggest to provide a series of standardized prompts when parents experience difficulties in narrating for 5 min (e.g., &#34;In what ways would you like your child to be different?&#34;; &#34;What is your child like in comparison with other children the same age?&#34; 23). These studies examined only FMSS-EE. As such prompts explicitly invite the parent to narrate about varied aspects of the child&#39;s characteristics, it may lead to higher scores in the elaboration and complexity components of coherence and influence the final coherence score. Research is required to compare results obtained with and without additional prompts. Such studies conducted with high- and low-risk families may indicate whether there are benefits in using such modified protocol for evaluating parents&#39; FMSS-Coherence, and if so, in which contexts.
Finally, coding the six subscales (focus, elaboration, separateness, concern, acceptance/rejection and complexity) before rating the final coherence score is warranted to improve coding quality. To date, studies have looked only at the final coherence score. Nevertheless, future research with large-scale samples may examine whether the profile of strengths and difficulties parents are showing in their FMSS, as reflected in their scores on the six subscales, are related to distinct parenting behaviors and child outcomes (e.g., parents who provide a meager FMSS versus parents who show a high level of concern). Such an approach may be particularity useful in clinical settings, as it may facilitate tailoring individualized interventions that meet the specific difficulties parents expressed in their FMSS36.
FMSS-Coherence is a promising method for research of the parent-child relationship and other close relationships. Nevertheless, two limitations should be noted. First, validation of the method in countries other than the United States and Israel is required. Second, as the FMSS includes only a single broad question, it can be easily adapted to different contexts. As shown above, FMSS-Coherence can be used not only for interviewing parents about their children, but also for interviewing them about their romantic partner (River, L., et al., 2019) and for interviewing adolescents about their parents34. However, extending the use of the FMSS-Coherence method to other relational contexts should be done with caution. For example, FMSS-Coherence may be less applicable for assessing the quality of relationships that do not involve caregiving. In addition, prior EE research documented the validity of the FMSS-EE and the TMSS-EE (i.e., Three-Minute Speech Sample-EE) for children aged 6 years and up, who were asked to narrate about their parents37 or siblings38. Narrative skills, and abstract and critical thinking, which are vital for narrating coherently, develop significantly during the transition from childhood to adolescence39,40. Thus, the FMSS-Coherence method may not be applicable to children younger than mid-adolescence.
Additional research is needed to address the following issues. The first future direction involves examining whether parents&#39; FMSS-Coherence is associated with parents&#39; sensitivity and child attachment, the main outcomes of parents&#39; narrative coherence examined in attachment research that used lengthy interview protocols12,14,15,16. Support for the link between FMSS-Coherence and mothers&#39; sensitivity comes from the study described above of mothers of children diagnosed with ASD31. Although the results of this study are promising, replication is needed with mothers of typically developing children. Second, although varied participants&#39; characteristics were examined in prior FMSS-Coherence research29,30,31,32,33,34, whether personality characteristics of parents shape the coherence of their FMSS awaits future research. Third, future studies would benefit from examining not only mothers&#39; but also fathers&#39; FMSS-Coherence and their association with paternal sensitivity and child socio-emotional adaptation. Fourth, most studies used the dichotomized coherent versus incoherent categories (e.g.31,32,33). This is in line with attachment research that typically uses a two-step coding procedure that begins with continuous scales and ends with classifying parents into categories that are used in data analyses12,13,14,15,16. The notion underlying this approach is that coherent narratives and incoherent narratives are qualitatively different4. However, growing evidence from attachment research41 as well as a few FMSS-Coherence studies30,34 suggest that the variation underlying FMSS-Coherence may be distributed continuously. Thus, additional studies are needed with large samples that would allow examination of individual differences among parents who narrate coherently and among parents who narrate incoherently and their associations with parenting quality and child&#39;s outcomes.

Attachment theory suggests that the coherence of parents&#8217; narratives, namely the extent to which parents provide clear, consistent and multifaceted portrayals of their child, is of particular importance for learning about the emotional climate of the parent-child relationship1,2. According to this view, the coherence of parents&#8217; narratives captures the coherence of their internal representations (i.e., feelings, attributions and expectations) of the child. Parents&#8217; representations are defined as complex information processing rules that guide parents&#8217; interpretation of their child&#8217;s behavior as well as parents&#8217; behavior toward the child1,3, and consequently shape child adjustment.
Some parents process information regarding their child in a flexible manner. Their representations of the child are presumably undistorted and include strengths as well as challenging aspects of the child&#39;s characteristic and the parent-child relationship. When asked to narrate regarding the child, these parents would presumably provide multifaceted and integrated (i.e., coherent4) descriptions of the child and their relationship. Importantly, parents&#8217; coherent representations are thought to facilitate an accurate interpretation of the child&#8217;s signals as well as prompt and appropriate responses to the child (i.e., sensitive caregiving5). This in turn contributes to the child&#8217;s sense of security and competence as well as better self-regulation6,7.
Other parents process information regarding their child in a distorted way, and construct incoherent representations, which could take different forms, such as unilateral representations that are negative and overemphasize the child&#8217;s weaknesses, overwhelmed with concern, colored by difficulties in separateness from the child, idealizing or poorly integrated. Such representations are presumably mirrored in incoherent narratives that are unidimensional and/or inconsistent. Incoherent representations may hamper accurate interpretation of the child&#8217;s signals and lead to parents&#8217; insensitive caregiving in terms of emotional detachment, hostility, rigidity and harshness, or overprotectiveness and intrusiveness1,2,4. The child in turn, might internalize the incoherent representations of the parent8, construct negative expectations regarding close relationships, learn to restrict or exaggerate emotional expressions in relational contexts9, and experience poorer socio-emotional adjustment10,11.
Attachment research supports to these notions7,9,10,11. Yet, extant methods to assess the coherence of parents&#8217; narratives involve labor intensive semi-structured interviews12. These include the Adult Attachment Interview13, in which parents are asked to narrate about their early attachment experiences, and the Working Model of the Child Interview14, the Parent Developmental Interview15 and the Insightful Assessment16,17, in which parents are invited to narrate regarding their child. Due to their length and costs, the employment of these methods in large-scale research and practice with parents is relatively limited. To overcome this drawback, this paper introduces a new method for assessing the coherence of parents&#8217; short narratives elicited using the FMSS procedure.
The FMSS procedure was developed by the psychoanalyst and researcher Louis Gottschalk and his colleagues18,19. The researchers argued that although the procedure is brief, it maximizes the projection and expression of internal psychological states, response sets and attitudes as it requires narrating without the aid of prompts or responses from the interviewer18. Adult psychiatry researchers have embraced this procedure and have been using it to evaluate the quality of the relationships formed between mentally ill patients and their caregivers. In this context, a caregiver is invited to talk about the mentally ill relative and their relationship, and the FMSS is coded for expressed emotion (FMSS-EE20), namely caregivers&#8217; statements of criticism and emotional overinvolvement toward the relative. FMSS-EE is effective in indexing poor quality of caregiver-patient relationships and predicting patients&#8217; maladaptation and relapse risk21,22. Over the past three decades developmental and pediatric researchers have adopted the FMSS-EE method. The FMSS-EE coding was adapted to the context of parenting young children, for example, by adding the assessment of parents&#8217; positive comments regarding the child and the parent-child relationship (see references for examples23,24,25). Research on parents of children from infancy through adolescence have shown that FMSS-EE is related to parenting quality and is associated with and predicts the socio-emotional adjustment of the child26,27.
Attachment and FMSS-EE research have developed separately. Thus, EE research does not examine the coherence of the FMSS. To assess the coherence of parents&#8217; FMSS, the Insightful Assessment rating scales17 have been recently adapted to be used with the FMSS. This paper presents the protocol for collecting parents&#8217; FMSS and coding FMSS-Coherence. Results of studies that used the FMSS-Coherence method are described. Finally, directions for future research with FMSS-Coherence and issues that should be taken into consideration by researchers who plan to use FMSS-Coherence are discussed.

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			<td height="20" style="height:20px;width:183px;">A voice recorder</td>
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			<td height="21" style="height:21px;">A stop-watch</td>
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			<td height="20" style="height:20px;">A word processing software</td>
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assessing the coherence of parents' short narratives regarding their child using the five-minute speech sample procedure

Valid and efficient measures for assessing the quality of parent-child relationships are needed to facilitate research and evidence-based practice with parents. This paper focuses on such a method, namely Five-Minute Speech Sample-Coherence (FMSS-Coherence). In this method, a parent is asked to speak for five uninterrupted minutes about her/his child and their relationship. The resulted narrative is coded for coherence, namely the extent to which the parent provides&#160;in the narrative&#160;a clear, consistent, multidimensional and well-supported portrayal of the child. FMSS-Coherence is based on attachment research that shows that the coherence of parents&#8217; narratives is indicative of the quality of the parent-child relationship and child adjustment. It overcomes the limitations of attachment narrative measures which are typically labor intensive. FMSS-Coherence is less nuanced than extant attachment narrative measures. Yet, studies of families from different cultural backgrounds, across different child ages and in the context of typically developing children as well as children with special needs suggest that coherence can be reliably evaluated using the FMSS procedure. Furthermore, parents&#8217; FMSS-Coherence is associated with parenting quality and children&#8217;s socio-emotional adjustment. Thus, it holds promise for researchers and practitioners who seek a relatively time- and cost-effective method for assessing the coherence of parents&#8217; narratives regarding their child.

Interrater reliability 
Interrater reliability of the FMSS-Coherence scores ranged from very good to excellent across prior studies. ICC of the continuous scores ranged between 0.86 and 0.95 29,30, and Kappa ranged between 0.83 and 1.0031,33.
FMSS-Coherence, observed parenting and child adjustment 
In support of the notion that parents&#39; coherent narratives are associated with more sensitive caregiving, a study of mothers and young children with ASD attending special education schools indicated that mothers who provided coherent FMSS showed higher emotional availability during observed play interaction with their child as compared with mothers who provided incoherent FMSS. In other words, mothers who provided coherent FMSS were more sensitive, provided more appropriate structuring, and were less intrusive when interacting with their child31&#160;(see Figure 1).
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/60025/60025fig1.jpg" /> 
Figure 1: Mothers&#39; mean emotional availability to their child with ASD by mothers&#39; FMSS-Coherence. Error bars represent standard errors of the mean (p &#60; 0.05). <a href="https://www.jove.com/files/ftp_upload/60025/60025fig1large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
In line with the notion offered by attachment researchers that parents&#39; representations are internalized by their children, preschool children whose mothers provided incoherent FMSS showed more negative depictions of the parent-child relationship in their play-narratives than children whose mothers provided coherent FMSS29. Finally, as expected, parents&#39; coherent FMSS are related to better socio-emotional adjustment of their children. The coherence of mothers&#39; FMSS is associated with fewer behavioral problems of their toddlers30, preschoolers32&#160;and school-aged children (Davidovitch, M., 2018). In addition, mothers&#39; FMSS-Coherence predicts a decrease in externalizing behavior problems, an increase in ego resiliency, and an increase in peer acceptance from preschool to first grade among children with self-regulation difficulties33.
Applying the FMSS-Coherence method to other relational contexts 
Recent findings point to the utility of FMSS-Coherence in research of other close relationships. A study in which pregnant mothers provided FMSS regarding the father-to-be found that lower coherence of the FMSS was associated with mothers&#39; childhood maltreatment experiences, and this link was mediated by mothers&#39; post-traumatic stress disorder (PTSD) symptoms (River, L., Castillo, M., Narayan, A., Sher-Censor, E., Lieberman, A., 2019). In another study in which adolescents provided FMSS regarding their mothers, adolescents&#39; coherent FMSS mediated the association between higher maternal sensitive guidance, observed during mother-adolescent dialogue on autobiographic emotional events, and fewer behavior problems of the adolescents, as reported by adolescents&#39; examiners34. This result is in line with attachment theory notion that when the child receives sensitive caregiving, she/he would construct coherent representations of the relationship with the caregiver, which in turn would facilitate better adjustment of the child8,9,10,11.
FMSS-Coherence and participants&#39; characteristics 
To support the notion that FMSS-Coherence captures quality of the relationship, FMSS-Coherence studies controlled for several participants&#39; characteristics. These included mother and child age29,30,31,32,33, birth order29,30,31,32,33, child gender29,30,31,32,33, marital status29,32,33, mothers&#39; and adolescents&#39; receptive vocabulary and/or education level29,30,31,32,33, family socioeconomic status29,30,32,33, maternal psychological distress, economic distress and health condition31, and adaptive behavior of children with ASD31. Of these characteristics, only mothers&#39; receptive vocabulary and education level&#160;were significantly related to mothers&#39; FMSS-Coherence and adolescent gender was related to adolescents&#39; FMSS-Coherence, with girls showing higher levels of coherence than boys. Notably, the associations of FMSS-Coherence with observed parenting and child socio-emotional adjustment were significant when controlling for these characteristics30,31,32,33. Finally, studies suggest that FMSS-Coherence is valid among ethnic minorities and immigrant families (in the US: Hispanic and Black32; in Israel: Arab-Israelis31; and immigrants from the Former Soviet Union and Western countries34).

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Assessing the Coherence of Parents' Short Narratives Regarding their Child Using the Five-Minute Speech Sample Procedure

This paper introduces a method for assessing the coherence of parents' short narratives regarding their child and their relationship using the five-minute speech sample procedure.

Valid and efficient measures for assessing the quality of parent-child relationships are needed to facilitate research and evidence-based practice with ...

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9.8K Views.  University of Haifa. This paper introduces a method for assessing the coherence of parents' short narratives regarding their child and their relationship using the five-minute speech sample procedure. 

Video: Assessing the Coherence of Parents' Short Narratives Regarding their Child Using the Five-Minute Speech Sample Procedure

Assessing Forelimb Function after Unilateral Cervical SCI using Novel Tasks: Limb Step-alternation, Postural Instability and Pasta Handling

Cervical spinal cord injury (cSCI) can cause devastating neurological deficits, including impairment or loss of upper limb and hand function. A majority of the spinal cord injuries in humans occur at the cervical levels. Therefore, developing cervical injury models and developing relevant and sensitive behavioral tests is of great importance. Here we describe the use of a newly developed forelimb step-alternation test after cervical spinal cord injury in rats. In addition, we describe two behavioral tests that have not been used after spinal cord injury: a postural instability test (PIT), and a pasta-handling test. All three behavioral tests are highly sensitive to injury and are easy to use. Therefore, we feel that these behavioral tests can be instrumental in investigating therapeutic strategies after cSCI.

Three new behavioral tests (forelimb step-alternation, postural instability test, pasta handling test) for evaluating forelimb function after cervical spinal cord injury in rodents are described.

Cervical spinal cord injury (cSCI) can cause devastating neurological deficits, including impairment or loss of upper limb and hand function. A majority ...

Assessing Functional Performance in the Mdx Mouse Model

Duchenne muscular dystrophy (DMD) is a severe and progressive muscle wasting disorder for which no cure is available. Nevertheless, several potential pharmaceutical compounds and gene therapy approaches have progressed into clinical trials. With improvement in muscle function being the most important end point in these trials, a lot of emphasis has been placed on setting up reliable, reproducible, and easy to perform functional tests to pre clinically assess muscle function, strength, condition, and coordination in the mdx mouse model for DMD. Both invasive and noninvasive tests are available. Tests that do not exacerbate the disease can be used to determine the natural history of the disease and the effects of therapeutic interventions (e.g. forelimb grip strength test, two different hanging tests using either a wire or a grid and rotarod running). Alternatively, forced treadmill running can be used to enhance disease progression and/or assess protective effects of therapeutic interventions on disease pathology. We here describe how to perform these most commonly used functional tests in a reliable and reproducible manner. Using these protocols based on standard operating procedures enables comparison of data between different laboratories.

Assessing Functional Performance in the Mdx Mouse Model

The primary outcome measure in clinical trials for neuromuscular disorders is generally improved muscle function. Therefore, assessing the effect of potential therapeutic compounds on muscle performance pre clinically in mouse models is of great importance. We here describe several functional tests to address this.

Duchenne muscular dystrophy (DMD) is a severe and progressive muscle wasting disorder for which no cure is available. Nevertheless, several potential ...

The Use of the Puzzle Box as a Means of Assessing the Efficacy of Environmental Enrichment

Environmental enrichment can dramatically influence the development and function of neural circuits. Further, enrichment has been shown to successfully delay the onset of symptoms in models of Huntington&#8217;s disease 1-4, suggesting environmental factors can evoke a neuroprotective effect against the progressive, cellular level damage observed in neurodegenerative disorders. The ways in which an animal can be environmentally enriched, however, can vary considerably. Further, there is no straightforward manner in which the effects of environmental enrichment can be assessed: most methods require either fairly complicated behavioral paradigms and/or postmortem anatomical/physiological analyses. This protocol describes the use of a simple and inexpensive behavioral assay, the Puzzle Box 5-7 as a robust means of determining the efficacy of increased social, sensory and motor stimulation on mice compared to cohorts raised in standard laboratory conditions. This simple problem solving task takes advantage of a rodent&#8217;s innate desire to avoid open enclosures by seeking shelter. Cognitive ability is assessed by adding increasingly complex impediments to the shelter&#8217;s entrance. The time a given subject takes to successfully remove the obstructions and enter the shelter serves as the primary metric for task performance. This method could provide a reliable means of rapidly assessing the efficacy of different enrichment protocols on cognitive function, thus paving the way for systematically determining the role specific environmental factors play in delaying the onset of neurodevelopmental and neurodegenerative disease.

Environmental enrichment provides a potential protective effect against neurodegenerative disorders. Currently, however, there is no easy way of determining the efficacy of enrichment procedures. This protocol describes a simple &#8220;Puzzle Box&#8221; method for assessing an animal&#8217;s cognitive function, in order to reveal the effectiveness of environmental enrichment.

Environmental enrichment can dramatically influence the development and function of neural circuits.  Further, enrichment has been shown to successfully ...

The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease

This protocol describes the administration of the 4 Mountains Test (4MT), a short test of spatial memory, in which memory for the topographical layout of four mountains within a computer-generated landscape is tested using a delayed match-to-sample paradigm. Allocentric spatial memory is assessed by altering the viewpoint, colors and textures between the initially presented and target images.
Allocentric spatial memory is a key function of the hippocampus, one of the earliest brain regions to be affected in Alzheimer&#39;s disease (AD) and impairment of hippocampal function predates the onset of dementia. It was hypothesized that performance on the 4MT would aid the diagnosis of predementia AD, which manifests clinically as Mild Cognitive Impairment (MCI).
The 4MT was applied to patients with MCI, stratified further based on cerebrospinal fluid (CSF) AD biomarker status (10 MCI biomarker positive, 9 MCI biomarker negative), and with mild AD dementia, as well as healthy controls. Comparator tests included tests of episodic memory and attention widely accepted as sensitive measures of early AD. Behavioral data were correlated with quantitative MRI measures of the hippocampus, precuneus and posterior cingulate gyrus.
4MT scores were significantly different between the two MCI groups (p = 0.001), with a test score of &#8804;8/15 associated with 100% sensitivity and 78% specificity for the classification of MCI with positive AD biomarkers, i.e., predementia AD. 4MT test scores correlated with hippocampal volume (r = 0.42) and cortical thickness of the precuneus (r = 0.55).
In conclusion, the 4MT is effective in identifying the early stages of AD. The short duration, easy application and scoring, and favorable psychometric properties of the 4MT fulfil the need for a simple but accurate diagnostic test for predementia AD.

This article describes the 4 Mountains Test (4MT), a hippocampus-dependent test of working allocentric spatial memory. The hippocampus is affected early in Alzheimer's disease (AD) and this article outlines the 4MT methodology and results of patient testing, which demonstrates the value of the 4MT in the diagnosis of pre-dementia AD.

This protocol describes the administration of the 4 Mountains Test (4MT), a short test of spatial memory, in which memory for the topographical layout of ...

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses

Collecting reliable behavioral data from toddlers and preschoolers is challenging. As a result, there are significant gaps in our understanding of human auditory development for these age groups. This paper describes an observer-based procedure for measuring hearing sensitivity with a two-interval, two-alternative forced-choice paradigm. Young children are trained to perform a play-based, motor response (e.g., putting a block in a bucket) whenever they hear a target signal. An experimenter observes the child&#39;s behavior and makes a judgment about whether the signal was presented during the first or second observation interval; the experimenter is blinded to the true signal interval, so this judgment is based solely on the child&#39;s behavior. These procedures were used to test 2 to 4 year-olds (n = 33) with no known hearing problems. The signal was a 1,000 Hz warble tone presented in quiet, and the signal level was adjusted to estimate a threshold corresponding to 71%-correct detection. A valid threshold was obtained for 82% of children. These results indicate that the two-interval procedure is both feasible and reliable for use with toddlers and preschoolers. The two-interval, observer-based procedure described in this paper is a powerful tool for evaluating hearing in young children because it guards against response bias on the part of the experimenter.

This paper describes a procedure for measuring hearing sensitivity in 2 to 4 year-old children. Children are trained to perform play-based responses when they hear a target signal. Thresholds are then estimated in a two-interval, two-alternative forced-choice paradigm, based on observations of the child&#39;s behaviors.

Collecting reliable behavioral data from toddlers and preschoolers is challenging. As a result, there are significant gaps in our understanding of human ...

Assessing Working Memory in Children: The Comprehensive Assessment Battery for Children &#8211; Working Memory (CABC-WM)

The Comprehensive Assessment Battery for Children - Working Memory (CABC-WM) is a computer-based battery designed to assess different components of working memory in young school-age children. Working memory deficits have been identified in children with language-based learning disabilities, including dyslexia1,2 and language impairment3,4, but it is not clear whether these children exhibit deficits in subcomponents of working memory, such as visuospatial or phonological working memory. The CABC-WM is administered on a desktop computer with a touchscreen interface and was specifically developed to be engaging and motivating for children. Although the long-term goal of the CABC-WM is to provide individualized working memory profiles in children, the present study focuses on the initial success and utility of the CABC-WM for measuring central executive, visuospatial, phonological loop, and binding constructs in children with typical development. Immediate next steps are to administer the CABC-WM to children with specific language impairment, dyslexia, and comorbid specific language impairment and dyslexia.

Working memory predicts a significant amount of variance for a variety of cognitive tasks, including speaking, reading, and writing. However, few tools are available to assess working memory in children. We present an innovative, computer-based battery that comprehensively assesses different components of working memory in school-age children.

The Comprehensive Assessment Battery for Children - Working Memory (CABC-WM) is a computer-based battery designed to assess different components of ...

Ultrasound Images of the Tongue: A Tutorial for Assessment and Remediation of Speech Sound Errors

Diagnostic ultrasound imaging has been a common tool in medical practice for several decades. It provides a safe and effective method for imaging structures internal to the body. There has been a recent increase in the use of ultrasound technology to visualize the shape and movements of the tongue during speech, both in typical speakers and in clinical populations. Ultrasound imaging of speech has greatly expanded our understanding of how sounds articulated with the tongue (lingual sounds) are produced. Such information can be particularly valuable for speech-language pathologists. Among other advantages, ultrasound images can be used during speech therapy to provide (1) illustrative models of typical (i.e.&#160;&#34;correct&#34;) tongue configurations for speech sounds, and (2) a source of insight into the articulatory nature of deviant productions. The images can also be used as an additional source of feedback for clinical populations learning to distinguish their better productions from their incorrect productions, en route to establishing more effective articulatory habits.
Ultrasound feedback is increasingly used by scientists and clinicians as both the expertise of the users increases and as the expense of the equipment declines. In this tutorial, procedures are presented for collecting ultrasound images of the tongue in a clinical context. We illustrate these procedures in an extended example featuring one common error sound, American English /r/. Images of correct and distorted /r/ are used to demonstrate (1) how to interpret ultrasound images, (2) how to assess tongue shape during production of speech sounds, (3), how to categorize tongue shape errors, and (4), how to provide visual feedback to elicit a more appropriate and functional tongue shape. We present a sample protocol for using real-time ultrasound images of the tongue for visual feedback to remediate speech sound errors. Additionally, example data are shown to illustrate outcomes with the procedure.

Ultrasound imaging can be used to display the shape and movements of the tongue in real time during speech. The images can be used to determine the nature of speech sound errors. Visual feedback of the tongue can be used to facilitate improvements in speech sound production in clinical populations.

Diagnostic ultrasound imaging has been a common tool in medical practice for several decades. It provides a safe and effective method for imaging ...

The Knob Supination Task: A Semi-automated Method for Assessing Forelimb Function in Rats

Tasks that accurately measure dexterity in animal models are critical to understand hand function. Current rat behavioral tasks that measure dexterity largely use video analysis of reaching or food manipulation. While these tasks are easy to implement and are robust across disease models, they are subjective and laborious for the experimenter. Automating traditional tasks or creating new automated tasks can make the tasks more efficient, objective, and quantitative. Since rats are less dexterous than primates, central nervous system (CNS) injury produces more subtle deficits in dexterity, however, supination is highly affected in rodents and crucial to hand function in primates. Therefore, we designed a semi-automated task that measures forelimb supination in rats. Rats are trained to reach and grasp a knob-shaped manipulandum and turn the manipulandum in supination to receive a reward. Rats can acquire the skill within 20 &plusmn; 5 days. While the early part of training is highly supervised, much of the training is done without direct supervision. The task reliably and reproducibly captures subtle deficits after injury and shows functional recovery that accurately reflects clinical recovery curves. Analysis of data is performed by specialized software through a graphical user interface that is designed to be intuitive. We also give solutions to common problems encountered during training, and show that minor corrections to behavior early in training produce reliable acquisition of supination. Thus, the knob supination task provides efficient and quantitative evaluation of a critical movement for dexterity in rats.

This manuscript describes a semi-automated task that quantifies supination in rats. Rats reach, grasp, and supinate a spherical manipulandum. The rat is rewarded with a pellet if the turn angle exceeds a criterion set by the user. This task increases throughput, sensitivity to injury, and objectivity compared to traditional tasks.

Tasks that accurately measure dexterity in animal models are critical to understand hand function. Current rat behavioral tasks that measure dexterity ...

An Objective and Child-friendly Assessment of Arm Function by Using a 3-D Sensor

Progressive and irreversible muscle atrophy characterizes Spinal Muscular Atrophy (SMA) and other similar muscle disorder diseases. Objective assessment of muscle functions is an essential and important, although challenging, prerequisite for successful clinical trials. Current clinical rating scales restrain the movement abnormalities to certain predefined coarse-grained individual items. The Kinect 3-D sensor has emerged as a low-cost and portable motion sensing technology used to capture and track people&#39;s movement in many medical and research fields. A novel approach using this 3-D sensor was developed and a game-like test was designed to objectively measure the upper limb function of patients with SMA. The prototype test targeted joint movement capability. While sitting in a virtual scene, the patient was instructed to extend, flex, and lift the whole arm in order to reach and place some objects. Both kinematic and spatiotemporal characteristics of upper limb movement were extracted and analyzed, e.g., elbow extension and flexion angles, hand velocity, and acceleration. The first study included a small cohort of 18 ambulant SMA patients and 19 age- and gender-matched healthy controls. A comprehensive analysis of arm movement was achieved; however, no significant difference between the groups were found due to the mismatch of patient&#39;s capability and the test difficulty. Based on this experience, a second version of the test consisting of a modified version of the first game with increased difficulties and a second game targeting muscle endurance were designed and implemented. The new test has not been conducted in any patient groups yet. Our work has demonstrated the potential capability of the 3-D sensor in assessing such muscle function and suggested an objective approach to complement the clinical rating scales.

An objective measure of muscle functions is challenging especially in children. Based on a commercially available digital 3-D sensor, a child-friendly gaming test was developed to assess upper limb function for clinical trials.

Progressive and irreversible muscle atrophy characterizes Spinal Muscular Atrophy (SMA) and other similar muscle disorder diseases. Objective assessment ...

Classical Short-Delay Eyeblink Conditioning in One-Year-Old Children

Classical eyeblink conditioning (EBC) refers to the learned association between a conditioned stimulus (an auditory tone) and an unconditioned stimulus (a puff of air to the cornea). Eyeblink conditioning is often used experimentally to detect abnormalities in cerebellar-dependent learning and memory that underlies this type of associative learning. While experiments in adults and older children are relatively simple to administer using commercial equipment, eyeblink conditioning in infants is more challenging due to their poor compliance, which makes correct positioning of the equipment difficult. To achieve conditioning in one-year-old infants, a custom-made or an adapted commercial system can be used to deliver the air puff to the infant's cornea. The main challenge lies in successfully detecting and classifying the behavioral responses. We report that automated blink detection methods are unreliable in this population, and that conditioning experiments should be analyzed using frame-by-frame analysis of supplementary video camera recordings. This method can be applied to study developmental changes in eyeblink conditioning and to examine whether this paradigm can detect children with neurological disorders.

This protocol describes an eyeblink conditioning paradigm appropriate for experiments with one-year-old infants. Commercial or custom-made equipment can be used to deliver the stimuli, and data collection and analysis should be performed on the video recordings.

Classical eyeblink conditioning (EBC) refers to the learned association between a conditioned stimulus (an auditory tone) and an unconditioned stimulus (a ...