An exploration of the positive and negative relationships associated with the development of asthma and atopic disorders in primary school children in Cork

Childhood asthma, allergic rhinitis and eczema are complex heterogenic chronic inflammatory allergic disorders which constitute a major burden to children, their families. The prevalence of childhood allergic disorders is increasing worldwide and merely rudimentary understanding exists regarding causality, or the influence of the environment on disease expression. Phase Three of the International Study of Asthma and Allergy in Childhood (ISAAC) reported that Irish adolescents had the 4th highest eczema and rhinoconjunctivitis prevalence and 3rd highest asthma prevalence in the world. There are no ISAAC data pertaining to young Irish children. In 2002, Sturley reported a high prevalence of current asthma in Cork primary school children aged 6-9 years. This thesis comprises of three cross-sectional studies which examined the prevalence of and associations with childhood allergy and a quasi-retrospective cohort study which observed the natural history of allergy from 6-9 until 11-13 years. Although not part of ISAAC, data was attained by parentally completed ISAAC-based questionnaires, using the ISAAC protocol. The prevalence, natural history and risk factors of childhood allergy in Ireland, as described in this thesis, echo those in worldwide allergy research. The variations of prevalence in different populations worldwide and the recurring themes of associations between childhood allergy and microbial exposures, from farming environments and/or gastrointestinal infections, as shown in this thesis, strengthen the mounting evidence that microbial exposure on GALT may hold the key to the mechanisms of allergy development. In this regard, probiotics may be an area of particular interest in allergy modification. Although their effects in relation to allergy, have been investigated now for several years, our knowledge of their diversity, complex functions and interactions with gut microflora, remain rudimentary. Birth cohort studies which include genomic and microbiomic research are recommended in order to examine the underlying mechanisms and the natural course of allergic diseases.

The effect of moderate gestational alcohol consumption during pregnancy on speech and language outcomes in children: a systematic review

Consensus has not been reached on safe alcohol consumption recommendations during pregnancy. The National Institutes for Care and Health Excellence (NICE) in the UK suggest that one to two drinks not more than twice per week is safe. However, the speech and language effects of even low levels of alcohol use among offspring are unknown. The aim of this study was to review systematically the evidence on studies of the effect of low to moderate levels of alcohol consumption during pregnancy (up to 70 grams of alcohol per week) compared to abstinence on speech and language outcomes in children.

Using parent report to assess early lexical production in children exposed to more than one language

Limited expressive vocabulary skills in young children are considered to be the first warning signs of a potential Specific Language Impairment (SLI) (Ellis & Thal, 2008). In bilingual language learning environments, the expressive vocabulary size in each of the child’s developing languages is usually smaller compared to the number of words produced by monolingual peers (e.g. De Houwer, 2009). Nonetheless, evidence shows children’s total productive lexicon size across both languages to be comparable to monolingual peers’ vocabularies (e.g. Pearson et al., 1993; Pearson & Fernandez, 1994). Since there is limited knowledge as to which level of bilingual vocabulary size should be considered as a risk factor for SLI, the effects of bilingualism and language-learning difficulties on early lexical production are often confounded. The compilation of profiles for early vocabulary production in children exposed to more than one language, and their comparison across language pairs, should enable more accurate identification of vocabulary delays that signal a risk for SLI in bilingual populations. These considerations prompted the design of a methodology for assessing early expressive vocabulary in children exposed to more than one language, which is described in the present chapter. The implementation of this methodological framework is then outlined by presenting the design of a study that measured the productive lexicons of children aged 24-36 months who were exposed to different language pairs, namely Maltese and English, Irish and English, Polish and English, French and Portuguese, Turkish and German as well as English and Hebrew. These studies were designed and coordinated in COST Action IS0804 Working Group 3 (WG3) and will be described in detail in a series of subsequent publications. Expressive vocabulary size was measured through parental report, by employing the vocabulary checklist of the MacArthur-Bates Communicative Development Inventory: Words and Sentences (CDI: WS) (Fenson et al., 1993, 2007) and its adaptations to the participants’ languages. Here we describe the novelty of the study’s methodological design, which lies in its attempt to harmonize the use of vocabulary checklist adaptations, together with parental questionnaires addressing language exposure and developmental history, across participant groups characterized by different language exposure variables. This chapter outlines the various methodological considerations that paved the way for meaningful cross-linguistic comparison of the participants’ expressive lexicon sizes. In so doing, it hopes to provide a template for and encourage further research directed at establishing a threshold for SLI risk in children exposed to more than one language.