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1.  Adults With Chronic Health Conditions Originating in Childhood: Inpatient Experience in Children's Hospitals 
Pediatrics  2011;128(1):5-13.
OBJECTIVE:
To describe the rate of increase of the population of adults seeking care as inpatients in children's hospitals over time.
PATIENTS AND METHODS:
We analyzed data from January 1, 1999, to December 31, 2008, from patients hospitalized at 30 academic children's hospitals, including growth rates according to age group (pediatric: aged <18 years; transitional: aged 18–21 years; or adult: aged >21 years) and disease.
RESULTS:
There were 3 343 194 hospital discharges for 2 143 696 patients. Transitional patients represented 2.0%, and adults represented 0.8%, totaling 59 974 patients older than 18 years. The number of unique patients, admissions, patient-days, and charges increased in all age groups over the study period and are projected to continue to increase. Resource use was disproportionately higher in the older ages. The growth of transitional patients exceeded that of others, with 6.9% average annual increase in discharges, 7.6% in patient-days, and 15% in charges. Chronic conditions occurred in 87% of adults compared with 48% of pediatric patients. Compared with pediatric patients, the rates of increase of inpatient-days increased significantly for transitional age patients with cystic fibrosis, malignant neoplasms, and epilepsy, and for adults with cerebral palsy. Annual growth rates of charges increased for transitional and adult patients for all diagnoses except cystic fibrosis and sickle cell disease.
CONCLUSIONS:
The population of adults with diseases originating in childhood who are hospitalized at children's hospitals is increasing, with varying disease-specific changes over time. Our findings underscore the need for proactive identification of strategies to care for adult survivors of pediatric diseases.
doi:10.1542/peds.2010-2037
PMCID: PMC3124106  PMID: 21708805
inpatients; hospitals; pediatric; congenital diseases; chronic conditions; adult patients; age groups
2.  The effects of bilingualism on stuttering during late childhood 
Objectives
To document distinct patterns of language use by bilingual children (use of an alternative language exclusively, LE, or along with English, BIL). To establish how these patterns affect onset of stuttering, school performance and recovery rate relative to monolingual speakers who stutter (MONO).
Design
Clinical referral sample with cases classified by speech-language therapists. Supplementary data obtained from speech recordings, interviews with child and family.
Setting
South-East England, 1999-2007.
Participants
Children aged 8-12 plus who stuttered (monolingual and bilingual) and fluent bilingual controls (FB).
Main outcome measures
Participants’ stuttering history, SATS scores, measures of recovery or persistence of stuttering.
Results
The sample of 317 children had 69 bilinguals (prevalence rate of bilingualism in the stuttering sample was 21.8%). 38 children used a language other than English primarily or exclusively in the home and 36 of these (94.7%) bilinguals who stuttered did so in both their languages. There were fewer LE than BIL stuttering children at time of first referral to clinic (of the bilinguals who stuttered, 15/38, 39.5%, were LE and 23/38, 60.5%, were BIL). The reverse was the case in the fluent control sample (of the bilinguals who did not stutter, 28/38, 73.7%, were LE and 10/38, 26.3%, were BIL). The association between stuttering and bilingual group (LE/BIL) was significant by χ2 and this is consistent with a higher chance of stuttering for BIL than LE speakers. For speakers who stuttered, age of stuttering onset for LE and BIL was similar to that reported for MONO groups (4 years 9 months, 4 years 10 months and 4 years 3 months for LE, BIL, MONO respectively) and males were affected in each of these groups to about the same extent (the male/female ratio was 4.1:1, 4.75:1 and 4.43:1 for LE, BIL and MONO respectively). For the 29 children who were old enough to complete the assessments, educational achievement at key stages one and two was not affected by either form of bilingualism relative to the MONO and fluent bilingual groups. For these same children, recovery rate for LE and MONO controls was significantly higher by χ2 than for those who were BIL since birth (recovery rate for LE and MONO together was 55%, and for BIL was 25%).
Conclusions
There was an increased chance of stuttering onset for BIL children. The chances of recovery from stuttering were lower for BIL speakers than for LE and MONO speakers.
doi:10.1136/adc.2007.134114
PMCID: PMC2597689  PMID: 18782846
Bilingualism; persistence; recovery; stuttering
3.  Late childhood stuttering 
Purpose
A longitudinal study was conducted on 76 children which examined risk factors that led children who stutter at around age eight to persist in the disorder when they reached age twelve.
Method
All children were verified as stuttering at the first assessment on the basis of a clinical referral and a further clinical assessment. When they reached twelve, they were classified as persistent or recovered on the basis of parent, child and researcher assessments. A range of measures was taken at the two age-points for determining risk factors for persistence/recovery.
Results
More males than females were affected. There was no evidence for persistence and recovery to run in families. At first referral all speakers who stuttered had high stuttering severity ratings and high proportions of dysfluencies in their speech (particularly those involving repetitions of whole words). At age 12 plus, the severity ratings of the recovered speakers and dysfluency counts dropped. The persistent speakers continued to have high severity ratings and produced more part-word dysfluencies. Temperament, measured at first assessment, differed between all stutterers and fluent controls and, when persistent and recovered speaker groups were examined separately, recovered speakers were less adaptable than persistent speakers; persistent speakers had more intense moods than controls; recovered speakers were less adaptable than controls. Detection of backward masking stimuli at 12 plus did not differ between all the children who stuttered and controls but when speakers who stuttered were differentiated by recovery group, persistent speakers had poorer backward masking thresholds than recovered speakers. Performance in motor tasks controlled by the cerebellum was assessed at 12 plus. There were indications of poor cerebellar control in speakers who persisted compared with the recovered speakers.
Conclusion
The tendency for more males than females to stutter was confirmed. Different patterns in speech were observed: Severity ratings of the recovered speakers dropped by age 12 plus. The severity ratings for the persistent speakers remained high at 12 plus and dysfluency types tended to change from whole to part words over time. Persistent and recovered speakers differed on temperamental performance at initial assessment, and performed differently on sensory and motor tasks at age 12 plus.
doi:10.1044/1092-4388(2008/048)
PMCID: PMC2405819  PMID: 18506043

Results 1-3 (3)