Vulnerability to Achievement Stressors: More Evidence That Students With Learning Disabilities Require Intensive Intervention.

In this article, we introduce the term , which refers to differentially low achievement when shifts in the educational environment "stress" or threaten the capacity of an individual or a group of individuals to make academic progress. We also introduce a methodological framework for assessing vulnerability to achievement stressors. Vulnerability to achievement stressors in students with learning disabilities (LD), relative to students without disabilities, is illustrated with two achievement stressors: (a) the shift in learning standards codified in Common Core State Standards, specifically the increase in complexity of the fourth-grade fractions curriculum, and (b) the COVID-19 pandemic, which decreased instructional structure by disrupting in-person teaching.

Increasing Caudal Block Utilization to Promote Opioid Stewardship in the NICU Population: A Quality Improvement Project.

Background: Regional anesthetic techniques are safe and effective in reducing pain and the need for opioid analgesia but may be underutilized in neonatal intensive care unit (NICU) patients. We developed an opioid stewardship pathway aimed at reducing the use of opioid analgesia in neonates by increasing caudal block utilization from a baseline of 50%-90% within 18 months.

Methods: We used control charts to track intra-operative opioid utilization in morphine milligram equivalents per kilogram (MME/kg) and immediate post-operative extubation rates.

Comorbid Word Reading and Mathematics Computation Difficulty at Start of First Grade.

The purpose of this analysis was to describe cognitive processes associated with comorbid difficulty between word reading (WR) and mathematics computation (MC) at the start of first grade among children selected for WR and MC delays. A sample of 234 children (mean age 6.50 years, = 0.

Modeling variability in treatment effects for cluster randomized controlled trials using by-variable smooth functions in a generalized additive mixed model.

Variability in treatment effects is common in intervention studies using cluster randomized controlled trial (C-RCT) designs. Such variability is often examined in multilevel modeling (MLM) to understand how treatment effects (TRT) differ based on the level of a covariate (COV), called TRT COV. In detecting TRT COV effects using MLM, relationships between covariates and outcomes are assumed to vary across clusters linearly.

Current Patterns of Probiotic Use in U.S. Neonatal Intensive Care Units: A Multi-Institution Survey.

Objective: Probiotic supplementation is associated with health benefits in preterm infants. The 2021 American Academy of Pediatrics (AAP) statement on probiotic use advised caution, citing heterogeneity and absence of federal regulation. We assessed the impact of the AAP statement and current institution-wide patterns of probiotic use across neonatal intensive care units (NICU) across the United States.

Antimicrobial Stewardship in Neonates with Necrotizing Enterocolitis: A Quality Improvement Initiative.

Background: Antibiotic overutilization in the neonatal intensive care unit (NICU) has many adverse effects, and necrotizing enterocolitis (NEC) is one of the most common indications for antibiotics in premature infants. Evidence for a preferred antibiotic regimen for NEC is lacking. This project aims to reduce piperacillin-tazobactam use and overall antibiotic duration in neonates with NEC through the implementation of an antibiotic stewardship pathway based on the modified Bell stage classification system.

Severe Pandemic Learning Loss and the Promise of Remotely Delivered Intervention in Students With Comorbid Reading and Mathematics Learning Difficulty.

Analyses were conducted with second graders, drawn from an ongoing multi-cohort randomized controlled trial (RCT), who had been identified for RCT entry based on comorbid reading comprehension and word-problem solving difficulty. To estimate pandemic learning loss, we contrasted fall performance for 3 cohorts: fall of 2019 (pre-pandemic; = 47), 2020 (early pandemic, when performance was affected by the truncated preceding school year; = 35), and 2021 (later pandemic, when performance was affected by the truncated 2019 to 2020 school year plus the subsequent year's ongoing interruptions; = 75). Across the 2 years, declines (standard deviations below expected growth) were approximately 3 times larger than those reported for the general population and for students in high-poverty schools.

Design and Analytic Features for Reducing Biases in Skill-Building Intervention Impact Forecasts.

Despite policy relevance, longer-term evaluations of educational interventions are relatively rare. A common approach to this problem has been to rely on longitudinal research to determine targets for intervention by looking at the correlation between children's early skills (e.g.

Predicting Risk for Comorbid Reading and Mathematics Disability Using Fluency-Based Screening Assessments.

The first purpose of this study was to examine the prevalence of risk for comorbid reading and mathematics disabilities (RMD) at start of first grade, when measured in a representative sample of 3,062 students with first-grade fluency measures (word reading; computation). The second purpose was to examine the utility of these measures for predicting RMD status within a sample of 577 students when RMD status was assessed at the end of second grade in terms of reading and math accuracy. When set at or below the 16 percentile, first-grade risk for RMD was two times more common than chance; at or below the 7 percentile, it was five times more common.

Gastrostomy Tube Use in Pediatrics: A Systematic Review.

Context: Despite frequency of gastrostomy placement procedures in children, there remains considerable variability in preoperative work-up and procedural technique of gastrostomy placement and a paucity of literature regarding patient-centric outcomes.

Objectives: This review summarizes existing literature and provides consensus-driven guidelines for patients throughout the enteral access decision-making process.

Data Sources: PubMed, Google Scholar, Medline, and Scopus.

The Effects of Language Instruction on Math Development.

How does language shape mathematical development? In this article, we consider this question by reviewing findings from cross-sectional and longitudinal research. In this literature, we find that differences in the structures of languages and individual variation in language ability are associated with mathematical performance in both obvious and unexpected ways. We then consider the causal nature of these relations, with a focus on experimental studies that have tested the effects of language instruction on mathematical outcomes.

Modelling multilevel nonlinear treatment-by-covariate interactions in cluster randomized controlled trials using a generalized additive mixed model.

A cluster randomized controlled trial (C-RCT) is common in educational intervention studies. Multilevel modelling (MLM) is a dominant analytic method to evaluate treatment effects in a C-RCT. In most MLM applications intended to detect an interaction effect, a single interaction effect (called a conflated effect) is considered instead of level-specific interaction effects in a multilevel design (called unconflated multilevel interaction effects), and the linear interaction effect is modelled.

Connections between Mathematics and Reading Development: Numerical Cognition Mediates Relations between Foundational Competencies and Later Academic Outcomes.

We examined longitudinal relations between 1-grade cognitive predictors (early nonverbal reasoning, processing speed, listening comprehension, working memory, calculation skill, word-problem solving, word-reading fluency, attentive behavior, and numerical cognition) and 2-grade academic outcomes (calculations, word-problem solving, and word reading) in 370 children ( = 6.55 years, = 0.33 years at the start of the study) who were identified as at-risk or not-at-risk for mathematics disability.

Comorbidity in Reading Comprehension and Word-Problem Solving Difficulties: Exploring Shared Risk Factors and Their Impact on Language Minority Learners.

The purpose of this study was threefold: to examine unique and shared risk factors of comorbidity for reading comprehension and word-problem solving difficulties, to explore whether language minority (LM) learners are at increased risk of what we refer to as (reading comprehension and word-problem solving difficulties), and to examine the profiles of at-risk LM learners compared with at-risk non-LM learners. At-risk (LM = 70; non-LM = 89) and not-at-risk (LM = 44; non-LM = 114) students were evaluated on foundational academic (word reading, calculation), behavioral (behavioral attention), cognitive (working memory, processing speed, nonverbal reasoning), and language (vocabulary, listening comprehension) measures in English. Results indicated listening comprehension was the only shared risk factor for higher order comorbidity.

Bringing Data-Based Individualization to Scale: A Call for the Next-Generation Technology of Teacher Supports.

The purpose of this narrative synthesis of the curriculum-based measure (CBM) instructional utility literature is to deepen insight into the supports required to enrich teachers' instructional decision-making within curriculum-based measuredata-based individualization (CBM-DBI) in ways that enhance the learning outcomes of students with intensive intervention needs, including students with learning disabilities. We begin by summarizing a recent meta-analysis of CBM-DBI studies focused on academic outcomes. We then reconsider studies from that meta-analysis to further explore the supports required to enrich teachers' instructional decision-making within CBM-DBI and improve student learning.

Closing the Word-Problem Achievement Gap in First Grade: Schema-Based Word-Problem Intervention with Embedded Language Comprehension Instruction.

The main purpose of this study was to test the effects of word-problem intervention, with versus without embedded language comprehension instruction, on at-risk 1 graders' word-problem performance. We also isolated the need for a structured approach to word-problem intervention and tested the efficacy of schema-based instruction at 1 grade. Children (n=391; mean age = 6.

Language-Related Longitudinal Predictors of Arithmetic Word Problem Solving: A Structural Equation Modeling Approach.

We investigated the longitudinal relations between cognitive skills, specifically language-related skills, and word-problem solving in 340 children (6.10 to 9.02 years).

Is "Response/No Response" Too Simple a Notion for RTI Frameworks? Exploring Multiple Response Types With Latent Profile Analysis.

We conducted a secondary analysis of data from a randomized control trial to explore this question: Does "response/no response" best characterize students' reactions to a generally efficacious first-grade reading program, or is a more nuanced characterization necessary? Data were collected on 265 at-risk readers' word reading prior to and immediately following program implementation in first grade and in spring of second grade. Pretreatment data were also obtained on domain-specific skills (letter knowledge, decoding, passage comprehension, language) and domain-general skills (working memory, non-verbal reasoning). Latent profile analysis of word reading across the three time points with controls as a local norm revealed a group ( = 45) with mean word-reading scores of 0.

Improving Language Comprehension to Enhance Word-Problem Solving.

The focus of this article is the role of language comprehension within word-problem solving (WPS). The role of the language comprehension in WPS is explained, and an overview of research illustrating language comprehension's contribution to WPS is described. Next, an innovative intervention that embeds WP-specific language comprehension instruction within a validated form of schema-based WP intervention is described, and the methods and results of a randomized controlled trial assessing the added value of embedding WP-specific language comprehension instruction are outlined.

Do the Processes Engaged During Mathematical Word-Problem Solving Differ Along the Distribution of Word-Problem Competence?

Conventional research methods for understanding sources of individual differences in word-problem solving (WPS) only permit estimation of average relations between component processes and outcomes. The purpose of the present study was instead to examine whether and if so how the component processes engaged in WPS differ along the spectrum of WPS performance. Second graders ( = 1,130) from 126 classrooms in 17 schools were assessed on component processes (reasoning, in-class attentive behavior, working memory, language comprehension, calculation fluency, word reading) and WPS.

Dynamic Assessment for Identifying Spanish-Speaking English Learners' Risk for Mathematics Disabilities: Does Language of Administration Matter?

We examined dynamic assessment's (DA's) added value over traditional assessments for identifying Spanish-speaking English learners' (ELs) risk for developing mathematics disabilities, as a function of the language of test administration (English vs. Spanish), type of math outcome, and EL's language dominance. At the start of first grade, ELs ( = 368) were randomly assigned to English-DA or Spanish-DA conditions, were assessed on static mathematics measures and domain-general (language, reasoning) measures in English, and completed DA in their assigned language condition.

Temporo-frontal activation during phonological processing predicts gains in arithmetic facts in young children.

Behavioral studies have shown discrepant results regarding the role of phonology in predicting math gains. The objective of this study was to use fMRI to study the role of activation during a rhyming judgment task in predicting behavioral gains on math fluency, multiplication, and subtraction skill. We focused within the left middle/superior temporal gyrus and left inferior frontal gyrus, brain areas associated with the storage of phonological representations and with their access, respectively.

The Mathematical Performance of At-Risk First Graders as a Function of Limited English Proficiency Status.

The purpose of this study was to explore interactions between limited English proficiency (LEP) status, as a function of risk status (low math performance at the start of the school year), on computation and word-problem solving performance. Among 260 1st-grade students, classified as at-risk (AR) or not at-risk (NAR) for math disability, we compared the performance of LEP students to native English-speaking peers. A series of 2-way ANOVAs were conducted on computation and word-problem solving skill at 2 time points, fall and spring of 1st-grade.

Cognitive Correlates of the Covariance in Reading and Arithmetic Fluency: Importance of Serial Retrieval Fluency.

This study examines the core predictors of the covariance in reading and arithmetic fluency and the domain-general cognitive skills that explain the core predictors and covariance. Seven-year-old Finnish children (N = 200) were assessed on rapid automatized naming (RAN), phonological awareness, letter knowledge, verbal counting, number writing, number comparison, memory skills, and processing and articulation speed in the spring of Grade 1 and on reading and arithmetic fluency in the fall of Grade 2. RAN and verbal counting were strongly associated, and a constructed latent factor, serial retrieval fluency (SRF), was the strongest unique predictor of the shared variance.