Purpose The purpose of this research was to examine spatial and temporal aspects of articulatory control in children with apraxia of speech (CAS), children with speech delay characterized by an articulation/phonological impairment (SD) and typically developing controls (TD) during speech tasks that increase in word length. Method The participants included 33 children between three and seven years of age (11 CAS, 11 SD, and 11 TD). A motion capture system was used to track jaw, lower lip and upper lip movement during a naming task. Movement duration, velocity, displacement, and variability were measured from accurate word productions. Results Movement variability was significantly higher in the children with CAS as compared to participants in the SD and TD groups. Differences in temporal control were seen between both groups of speech-impaired children and the TD controls during accurate word productions. As word length increased, movement duration and variability differed between the CAS and SD children. Conclusions These findings provide evidence that movement variability distinguishes children with CAS from speakers with SD. Kinematic differences between the CAS and SD participants suggest that these groups respond differently to linguistic challenges.

In order to develop evidence-based rehabilitation protocols post-stroke, one must first reconcile the vast heterogeneity in the post-stroke population and develop protocols to facilitate motor learning in the various subgroups. The main purpose of this study is to show that auditory constraints interact with the stage of recovery post-stroke to influence motor learning. We characterized the stages of upper limb recovery using task-based kinematic measures in 20 subjects with chronic hemiparesis. We used a bimanual wrist extension task, performed with a custom-made wrist trainer, to facilitate learning of wrist extension in the paretic hand under four auditory conditions: (1) without auditory cueing; (2) to non-musical happy sounds; (3) to self-selected music; and (4) to a metronome beat set at a comfortable tempo. Two bimanual trials (15 s each) were followed by one unimanual trial with the paretic hand over six cycles under each condition. Clinical metrics, wrist and arm kinematics, and electromyographic activity were recorded. Hierarchical cluster analysis with the Mahalanobis metric based on baseline speed and extent of wrist movement stratified subjects into three distinct groups, which reflected their stage of recovery: spastic paresis, spastic co-contraction, and minimal paresis. In spastic paresis, the metronome beat increased wrist extension, but also increased muscle co-activation across the wrist. In contrast, in spastic co-contraction, no auditory stimulation increased wrist extension and reduced co-activation. In minimal paresis, wrist extension did not improve under any condition. The results suggest that auditory task constraints interact with stage of recovery during motor learning after stroke, perhaps due to recruitment of distinct neural substrates over the course of recovery. The findings advance our understanding of the mechanisms of progression of motor recovery and lay the foundation for personalized treatment algorithms post-stroke.

Spasticity, muscle stiffness and contracture cause severe disability after central nervous system injury. However, current treatment options for spasticity produce muscle weakness which can impede movement, and do not directly address muscle stiffness. Here we propose that the accumulation of hyaluronan within muscles promotes the development of muscle stiffness, and report that treatment with the enzyme hyaluronidase increases upper limb movement and reduces muscle stiffness without producing weakness. 20 patients with unilateral upper limb spasticity received multiple intramuscular injections of human recombinant hyaluronidase with saline at a single visit. The safety and efficacy of the injections, passive and active movement, and muscle stiffness at eight upper limb joints were assessed at four time points: pre-injection (T0), within 2 weeks (T1), within 4–6 weeks (T2), and within 3–5 months post-injection (T3). There were no clinically significant adverse effects from the injections. Passive movement at all joints, and active movement at most joints increased at T1, and persisted at T2 and T3 for most joints. The modified Ashworth scores also declined significantly over time post-injection. Hyaluronidase injections offer a safe and potentially efficacious treatment for muscle stiffness in neurologically impaired individuals. These results warrant confirmation in placebo-controlled clinical trials.

The New York City Department of Education (NYC DOE) gifted-and-talented programs aim to support all students of exceptional learning potential within the public school system. Using proprietary data made available to us by the NYC DOE, we show, however, that substantial disparities exist in the rates of gifted-and-talented admission test taking, the first step in the process of accessing these more challenging educational opportunities. While Black and Latino/a students take the test for gifted-and-talented admission at substantially lower rates than their White and Asian counterparts, we find the disparity to be significantly less for those enrolled in public prekindergarten programs. We likewise find similar results when comparing other subgroups defined by students' family, borough, and neighborhood characteristics. These results suggest that public prekindergarten gifted-and-talented attendance could have played a role in ameliorating the gaps in test taking by providing greater access to information about the gifted-and-talented programs across subgroups of students.Keywords: early childhood; educational policy; equity; gifted and talented education; gifted education; hierarchical linear modeling; preschool equity research; public pre-K; regression analyses; social stratification; urban education FEATURE ARTICLES JANUARY/FEBRUARY 2016 37 subject matter knowledge, and challenging coursework, which are known to be related to student learning (Goldhaber & Brewer, 1997;Meyer, 1999;Phillips, 1997;Phillips & Chin, 2004;Rivkin, Hanushek, & Kain, 1998;Tach & Farkas, 2006). In the interest of equity, these findings point to the importance of designing challenging educational opportunities and academic programs within the public school sector that are designed for students from all population subgroups. One answer to fostering academic equity among high achievers is the public availability of challenging educational programs for students with exceptional ability across all ethnic and social class backgrounds.Gifted-and-talented education programs emphasize identifying students as gifted and talented based on their learning potential through a psychometric assessment of the students' cognitive ability and school readiness at a young age and provide such students with specialized instruction so as to enable them to be educated to their full potential (Subotnik, Olszewski-Kubilius, & Worrell, 2011). Compared to programs that select students at later grades based on their achievement to date, by identifying students early on in elementary school, gifted-and-talented programs may hold even greater promise for promoting children from all backgrounds to reach their full academic potential and for shrinking the reported disparities that exist with respect to college application, enrollment, and graduation.As we show in this article, however, there is an equally compelling need to create a public awareness of such educational opportunities to ensure that students from all population subgroups have equitable access to them. Us...

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