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Caroline Adams

Publications and source records attributed to Caroline Adams.

4 recordsLinked to original sources

High heritability of speech and language impairments in 6-year-old twins demonstrated using parent and teacher report.

Previous twin studies have demonstrated high heritability of specific language impairment (SLI) when the diagnosis is based on psychometric testing. The current study measured the effectiveness of parent and teacher ratings of communication skills in identifying heritable language impairment. The Children's Communication Checklist was completed by parents and teachers of 6-year-old twins recruited from a general population sample. One hundred and thirty twin pairs (65 MZ) were selected because at least one twin had low language skills at 4 years of age; a further 66 pairs (37 MZ) were a low risk group with no indication of language difficulties at 4 years. Internal consistency, inter-rater reliability, and validity in identifying language impairment were assessed for all CCC scales. CCC scales, especially those assessing structural language skills, were highly effective in identifying cases of language impairment, but agreement between parent and teacher ratings was modest. Genetic analysis revealed negligible environmental influence and substantial genetic influence on most scales. A rater-specific effects model was fit to the data to assess how far parents and teachers assess a common genetic factor on the CCC. Ratings of parents and teachers were influenced to some extent by the same child characteristics, but rater-specific effects were also evident, especially on scales measuring pragmatic aspects of communication. This study shows that there are strong genetic influences on both structural and pragmatic language impairments in children, and these can be detected using a simple checklist completed by parents or teachers.

Child↗

Measurement of cerebrovascular flow reserve in pediatric patients with sickle cell disease.

PURPOSE: To report a method for determining absolute percentage change in cerebral blood flow (measurement of cerebrovascular reserve) before and after acetylazolamide (Diamox) administration in children with sickle cell anemia. MATERIALS AND METHODS: Thirty-six symptomatic sickle cell disease patients (48 studies) were evaluated. After the injection of either Tc-99m bicisate ethyl cysteinate dimer (ECD) or hexamethyl propylene amine oxime (HMPAO), both whole body scans (with geometric mean correction) and single photon emission computed tomography (CT) were performed pre- and post-Diamox administration with calculation of percentage brain uptake on the whole body images for both examinations and determination of cerebrovascular reserve (percentage change in brain uptake post-Diamox). Evaluation for regional cerebral perfusion change was also performed. RESULTS: The cerebrovascular reserve measurement was 17.6% +/- 43.5% (mean +/- 1 SD). Thirty-three of 48 studies (69%) showed an abnormal cerebrovascular reserve, while only 6 of 48 studies (12.5%) showed Diamox-induced regional perfusion changes in the brain. No statistically significant relationship was found between the occurrence of a regional perfusion abnormality versus loss of cerebrovascular reserve (P = 0.75, Fisher exact test), suggesting that these are independent variables. The cerebrovascular reserve was reproducible, with an average standard deviation of +/-0.54%. CONCLUSION: A new, simple method for calculation of cerebrovascular reserve is presented; this method is reproducible and appears to be an independent variable in the evaluation of cerebrovascular status in sickle cell anemia patients. It should allow further characterization of this complex patient population, and possibly assist in detection of patients at risk for developing "silent" or overt stroke.

Acetazolamide↗