Abstract:Findings from a longitudinal study of language acquisition in a group of autistic children are presented. Six autistic subjects and six children with Down syndrome, matched on age and MLU at the start of the study, were followed over a period of between 12 and 26 months. Language samples were collected in the children's homes while they interacted with their mothers. Samples of 100 spontaneous child utterances from the transcripts were analyzed using the following measures: MLU, Index of Productive Syntax, lexical diversity, and form class distribution. The results indicate that the majority of these autistic children followed the same general developmental path as the Down syndrome children in this study, and normal children reported in the literature, in the acquisition of grammatical and lexical aspects of language, and confirm previous findings suggesting that autism does not involve a fundamental impairment in formal aspects of language.

This study investigated communicative competence in autistic children. Six autistic boys were matched to six children with Down syndrome on age and language level. For each child four samples of spontaneous speech over the course of 1 year were analysed. Child utterances were coded for adjacency, contingency and various categories of contingent discourse that either did or did not add new information. Autistic children wer found to be more non-contingent, and to show no developmental change in their contingent discourse, especially in categories of contingent discourse that added new information.

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ContextCardiovascular diseases (CVD) are a leading cause of illness and death for Indigenous people in Canada and globally. Appropriate medication can significantly improve health outcomes for persons diagnosed with CVD or for those at high risk of CVD. Poor health literacy has been identified as a major barrier that interferes with client understanding and taking of CVD medication. Strengthening health literacy within health services is particularly relevant in Indigenous contexts, where there are systemic barriers to accessing literacy skills.ObjectiveThe aim of this study is to test the effect of a customized, structured health literacy educational program addressing CVD medications.MethodsPre-post-design involves health providers and Indigenous clients at the De dwa da dehs nye>s Aboriginal Health Centre (DAHC) in Ontario, Canada. Forty-seven Indigenous clients with or at high risk of CVD received three educational sessions delivered by a trained Indigenous nurse over a 4- to 7-week period. A tablet application, pill card and booklet supported the sessions. Primary outcomes were knowledge of CVD medications and health literacy practices, which were assessed before and after the programe.ResultsFollowing the program compared to before, mean medication knowledge scores were 3.3 to 6.1 times higher for the four included CVD medications. Participants were also more likely to refer to the customized pill card and booklet for information and answer questions from others regarding CVD.ConclusionsThis customized education program was highly effective in increasing medication knowledge and health literacy practice among Indigenous people with CVD or at risk of CVD attending the program at an urban Indigenous health centre.

Indigenous people make up more than 4% of the Canadian population, but less than 0.25% of the physicians. National initiatives are being undertaken to increase the representation of First Nations, Inuit, and Métis people in the medical workforce. This is a necessary step in developing a health care system that is culturally safe and responsive — one step towards equity in health for First Nations, Inuit, and Métis people. Initiatives focus on recruitment and retention of indigenous physicians, and development of a curriculum framework to ensure all physicians can provide culturally safe care.