BACKGROUND Following a diagnosis of a small unruptured intracranial aneurysm (sUIA), patients often experience psychological ailments which may be attributable to the neurovascular consultation, referral pathway, or long‐term imaging surveillance. Here, we aim to characterize the early sUIA patient journey and evaluate their psychosocial status. METHODS A mixed‐methods analysis of sUIA patients attending a large tertiary neurosciences center was performed. For patients presenting to the neurovascular service in 2020, this included: (i) a thematic analysis of patient perspectives extracted from semistructured telephone interviews, (ii) a quantitative assessment of psychological status using the Hospital Anxiety and Depression Scale and (iii) an evaluation of functional independence using a customized activity of daily living questionnaire. The relationship between service or clinical factors, and Hospital Anxiety and Depression Scale subscale scores was statistically tested. RESULTS The sUIA patient cohort (n=105) had a mean age of 56.8 years (SD=15.8, female=69). Thematic analysis of interview responses (n=33) identified 5 recurrent themes underpinning the sUIA patient experience: referral, diagnosis and information sharing, imaging surveillance, psychological impairment and coping strategies, and activities of daily living, all of which contributed to patient concerns. A total of 53.6% of patients achieved a Hospital Anxiety and Depression Scale score signifying at least mild anxiety and/or depression. Lifestyle changes most frequently affected after diagnosis included avoidance of straining‐intensive exercise, change in patterns of substance use, and work‐related performance. Multivariate analysis revealed no significant service or clinical predictors for anxiety or depression. CONCLUSION For some patients, an sUIA diagnosis appears to be associated, at least qualitatively, with a psychological burden. This is likely mediated through stressors related to the referral, diagnosis, neurosurgical consultation, and image surveillance. In the absence of evidence‐based guidelines regarding these aspects of the early patient journey, we offer suggestions aimed at improving both the neurovascular service and sUIA patient experience.

No abstract

We report a preregistered analysis to test whether children meeting diagnostic criteria for language disorder (LD) have higher self-reported and/or parent-reported mental health symptoms during the transition from primary to secondary education. Data are from a UK based longitudinal cohort study, The Surrey Communication and Language in Education Study (SCALES; Norbury et al 2016). SCALES oversampled children at risk of LD at school entry. Language was measured using a battery of standardised assessments in Year 1 (age 5-6 years, n = 529) and mental health symptoms were measured using self and parent report in Year 6 (age 10-11 years, n = 384) and Year 8 (age 12-13 years, n = 246). Social experiences were also measured using self-report measures in Year 6. Mental health symptoms were stable during the transition from primary to secondary school. Symptom rates did not differ between children with and without LD based on self-report, but children with language disorder had higher parent-reported mental health symptoms than their peers with typical language. Similarly, early language was negatively associated with parent-reported but not self-reported mental health symptoms. Early language was associated with fewer child-reported positive social experiences in Year 6, but social experiences did not mediate the association between language and mental health. We found poor agreement between parent and self-reported child mental health symptoms across language groups. Future studies should aim to determine sources of disagreement between parent and child report, particularly for children with communication difficulties who may struggle to accurately self-report mental health symptoms.

We report a preregistered analysis testing whether children that meet diagnostic criteria for language disorder (LD) have higher self-reported and/or parent-reported mental health symptoms during the transition from primary to secondary education. Data are from a longitudinal cohort study that oversampled children at risk of LD at school entry. Language was measured using a battery of standardised assessments in Year 1 (age 5-6 years, n = 529) and mental health symptoms were measured using self and parent report measures in Year 6 (age 10-11 years, n = 384) and Year 8 (age 12-13 years, n = 246). Social experiences were also measured using self-report measures in Year 6. Mental health symptoms were stable during the transition from primary to secondary school. Symptom rates did not differ between children with and without LD based on self-report, but children with language disorder did have higher parent-reported mental health symptoms than their peers with typical language. Similarly, early language was negatively associated with parent-reported but not self-reported mental health symptoms. Early language was also associated with fewer child-reported positive social experiences in Year 6, but social experiences did not mediate the association between language and mental health. We found poor agreement between parent and self-reported child mental health symptoms across language groups. Future studies should aim to determine sources of disagreement between parent and child report, particularly for children with communication difficulties who may struggle to accurately self-report mental health symptoms.

Background: English syntax acquisition is crucial for developing literacy but may be challenging for many children learning English as an Additional Language (EAL). This study longitudinally investigates syntactic complexity and diversity of stories retold by children with EAL and their monolingual peers as well as the relationship between syntax and vocabulary.Methods: Sixty-one children with EAL were matched to their monolingual peers on sex, age and teacher-rated language proficiency. Children’s narratives were collected in Year 1 (age 5-6) and Year 3 (age 7-8) and coded for clause type. Dependent variables included Mean Length of Utterance in words (MLUw) and Clausal Density (CD) as measures of syntactic complexity and Complex Syntax Type-Token Ratio (CS TTR) estimating syntactic diversity.Results: Children with EAL presented syntactically complex and diverse narratives equivalent to monolingual peers in Year 1 and Year 3. Growth rate in syntactic complexity was associated with English vocabulary in Year 1. Among children with low vocabulary, children with EAL developed syntactic complexity at a faster rate than monolingual peers, while the opposite was true in the high-vocabulary group. Children with average vocabulary progressed at parallel rates. Children with EAL and their monolingual peers used broadly the same complex structures but with varying frequency.Conclusions: In this longitudinal study comparing children with EAL and monolinguals on complex clauses, the interaction between emerging bilingualism and vocabulary knowledge in the societal language predicted different patterns of growth in syntactic complexity. Children with EAL might use language differently than their monolingual peers to achieve similar syntactic complexity and diversity. These findings demonstrate that in early primary school, children with EAL have syntactic skills comparable to their monolingual peers.