Background and ObjectivesHeadache evaluation and treatment are believed to be influenced by race and ethnicity. Specific headache diagnosis assigned in the pediatric emergency department (ED) may compound disparities. We sought to investigate racial and ethnic disparities in the diagnosis, testing, and treatment of pediatric patients with headache presenting to the ED. MethodsWe performed a cross-sectional analysis of ED visits from 49 children's hospitals between 2016 and 2022 from the Pediatric Health Information System, an administrative database of ED and hospitalized encounters within children's hospitals in the United States. Index encounters in the ED from patients (aged 5-21 years, median age 13 [10-15]) with a primary diagnosis of migraine, headache, new daily persistent headache, or tension-type headache were included. Encounters with trauma, infection, and malignancy where secondary headache was possible were excluded. The primary outcomes were the rates of migraine diagnosis, testing, and treatment. We used generalized estimating equations to estimate associations between race and ethnicity and outcomes after adjusting for demographic factors, medical complexity, visit timing, and final headache diagnosis. ResultsA total of 309,678 encounters were included while 61,677 repeat visits, 81,821 visits with diagnoses suggestive of secondary headache, and 5,714 visits from 3 hospitals with sparse data on patient race/ethnicity were excluded. Of 160,466 eligible visits (59.8% female), 41% were by non-Hispanic White (NHW) children, 24.8% non-Hispanic Black (NHB), and 26.0% Hispanic/Latino (HL). NHW children were more frequently diagnosed with migraine (45.5% vs NHB 28.2% and HL 28.3%, p < 0.001). NHB and HL children compared with NHW children received less testing including brain MRI scans (adjusted odds ratio [aOR]: NHB 0.56 [95% CI 0.46-0.69] and HL 0.54 [0.36-0.82]). There was no difference in the proportion of visits without administration of headache-related medications (NHW 23.3% vs NHB 24.6% and HL 23.4%, p = 0.64). NHB and HL children were more likely to receive only oral medications (aOR: NHB 1.37 [1.2-1.56] and HL 1.54 [1.34-1.76]) and less likely to be admitted inpatient (aOR: NHB 0.8 [0.66-0.97] and HL 0.65 [0.44-0.94]). DiscussionNHB and HL children in the pediatric ED with headache receive fewer migraine diagnoses, less testing, and less intensive treatment compared with NHW children. Beyond affecting headache management, this inequity in migraine diagnosis requires further consideration to include children from marginalized racial and ethnic groups in future migraine research.

To test the efficacy of greater occipital nerve blocks with lidocaine in children/adolescents with acute migraine in a randomized control trial.

To identify socioeconomic factors associated with rates of outpatient evaluation after a pediatric emergency department (ED) visit for migraine applying natural language processing to identify migraine through clinical notes.

Color word learning is an important case study for the relationship between language and perception. While English color word learning is well-documented, there is relatively limited evidence on the developmental trajectory for color words, especially in languages from non-Western populations. We study color words and their acquisition in the Shipibo-Konibo (SK), an indigenous group within the Peruvian Amazon. In Study 1, we measure the color vocabulary in SK adults, updating findings from the World Color Survey. We then study receptive and productive knowledge of color words in children, conducted in both SK (Study 2) and Spanish (Study 3). Children learning the SK system show a protracted developmental trajectory towards adult-like color term knowledge compared to contemporary studies of English-speaking children. Further, when SK children lack precise color term knowledge, they appeared to follow different strategies for SK and Spanish, using Spanish vocabulary in SK and overgeneralizing in Spanish. For both children and adults, bilingual vocabulary is used adaptively to facilitate task performance, broadly supporting communicative views of color vocabulary.

Test-retest reliability --- establishing that measurements remain consistent across multiple testing sessions --- is critical to measuring, understanding, and predicting individual differences in infant language development. However, previous attempts to establish measurement reliability in infant speech perception tasks are limited, and reliability of frequently-used infant measures is largely unknown. The current study investigated the test-retest reliability of infants' preference for infant-directed speech over adult-directed speech in a large sample (N=158) in the context of the ManyBabies1 collaborative research project (Frank et al., 2017; ManyBabies Consortium, 2020). Labs were asked to bring in participating infants for a second appointment retesting infants on their preference for infant-directed speech. This approach allowed us to estimate test-retest reliability across three different methods used to investigate preferential listening in infancy: the head-turn preference procedure, central fixation, and eye-tracking. Overall, we found no consistent evidence of test-retest reliability in measures of infants' speech preference (overall r=.09, 95% CI [-.06,.25]). While increasing the number of trials that infants needed to contribute for inclusion in the analysis revealed a numeric growth in test-retest reliability, it also considerably reduced the study's effective sample size. Therefore, future research on infant development should take into account that not all experimental measures may be appropriate for assessing individual differences between infants.

To examine racial/ethnic disparities in migraine diagnosis and management in the pediatric emergency department (ED) using a natural language processing model to identify migraine independent of billing diagnosis.

Objective: To assess agreement for migraine day between self-report and diagnostic guidelines for children and adolescents using a headache diary.Background: Trial guidelines recommend prospective collection of headache features and adoption of migraine day as an outcome measure, but there is no clear consensus on the definition of migraine day.Methods: This is a secondary analysis of data from two projects-a prospective cohort study validating a pediatric scale of treatment expectancy and a clinical trial of occipital nerve blocks to treat status migrainosus. Participants completed a text message-based diary for 4 or 12 weeks (depending on treatment), and a detailed headache assessment on a random 20% of headache days. Using this assessment, we determined whether a headache day qualified for migraine or probable migraine, based on the International Classification of Headache Disorders, 3rd edition (ICHD-3).Results: Of 122 enrolled children and adolescents, 106 (86.9%) completed =1 detailed headache assessment (438 entries). We found moderate agreement between self-reported and ICHDderived migraine day, with a Cohen's Kappa of 0.50 (positive predictive value [PPV]: 0.66; negative predictive value [NPV]: 0.85; correlation: 0.51). Allowing for ICHDderived probable migraine significantly increased PPV (0.66 vs. 0.94; 95% CI: 0.57- 0.74 vs. 0.90- 0.97), but decreased NPV (0.85 vs. 0.293; CI: 0.77- 0.90 vs. 0.199- 0.40), Cohen's Kappa (0.50 vs. 0.237; CI: 0. 389- 0.60 vs. 0.139- 0.352), and correlation (r = 0.51 vs. 0.302; CI: 0.41- 0.61 vs. 0.192- 0.41). Pain severity (OR: 5.7; CI: 2.39- 13.8), photophobia (OR: 4.1; CI: 1.02- 16.6), and phonophobia (OR: 7.5; CI: 1.95- 29.3) were significantly associated with participants' perception of migraine.Conclusion: We found only moderate agreement between self-reported and ICHD-derived migraine day, suggesting both measures are not equal but may represent overlapping aspects of migraine as a disease. This highlights the difficulty of applying ICHD criteria to individual attacks. We recommend greater methodological transparency in future research to avoid readers conflating both measures.

Objective: To identify racial/ethnic disparities in testing, treatment, and diagnosis of headache and migraine in the pediatric ED. Background: Diagnostic workup and treatment for headache or migraine in the pediatric emergency department (ED) may vary by race and ethnicity. Prior social disparities research has not explored differences in pediatric headache diagnosis in this setting which could impact care. Design/Methods: We identified ED visits with a primary diagnosis of headache or migraine from the Pediatric Health Information Systems database between 2016–2021, excluding diagnoses suggesting secondary headache. We compared rates of diagnosis, testing, and treatment between non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic/Latino (HL) children and adolescents. Results: Across 142,250 visits (60% female), NHW children comprised 41.1% of visits, NHB 24.2%, and HL 27.4%. Migraine was diagnosed more often in NHW (45.5%) compared to NHB (28.4%) and HL (28.5%) children; NHB (67.3%) and HL (67.5%) were disproportionately diagnosed with non-specific headache (NHW: 52.3%; p<.001). Adjusting for diagnosis, insurance, and other demographic traits, NHW children received more MRI scans (6.7% [95% CI: 4.7–9.4%] vs. NHB 4.0% [2.8–5.6%] and HL 3.7% [2.8–4.9%]; p=0.005), blood tests (25.0% [20.5–30.2%] vs. NHB 21.2% [18.4–24.3%] and HL 21.9% [19.6–24.4%]; p=.013), and intravenous medications (54.2% [50.2–58.1%] vs. NHB 44.2% [40.9–47.6%] and HL 43.7% [39.0–48.5%]; p<.001). Conclusions: NHW children were more likely to receive testing and intravenous medications compared to children of color during ED headache visits. Race and ethnicity appear strongly associated with diagnosis of migraine vs. unspecified headache which could point to healthcare access or diagnostic biases among other factors. This likely impacts interpretation of research centered on visits with a migraine diagnosis. Such disparities in disease management may contribute to overall undertreatment and underdiagnosis of pediatric headache, particularly for children of color. Future research should investigate the validity of using diagnostic codes to select children with migraine compared to alternative methods. Disclosure: The institution of Ms. Kellier has received research support from National Institute of Neurological Disorders and Stroke. Dr. Anto has nothing to disclose. Dr. Hall has received personal compensation for serving as an employee of Children's Hospital Association. The institution of Dr. Szperka has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Allergan. Dr. Szperka has received research support from Pfizer. Dr. Szperka has received research support from FDA. Dr. Nash has nothing to disclose. Dr. Hutchinson has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Katz, Korin, Cunningham Attorneys At Law. The institution of Dr. Wells has received research support from National Institute of Allergy and Infectious Diseases. Dr. Moharir has nothing to disclose. Dr. Abend has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Epilepsy Foundation. The institution of Dr. Abend has received research support from NIH. The institution of Dr. Abend has received research support from PCORI. Dr. Abend has received publishing royalties from a publication relating to health care. Dr. Messer has nothing to disclose. Dr. Palaganas has nothing to disclose. Dr. Piantino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Applied Cognition. Dr. Press has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Marinus Pharmaceuticals. Dr. Press has received research support from Marinus Pharmaceuticals.

Pragmatic reasoning – the ability to infer the intended meaning of an utterance in context – is one of the core aspects of language comprehension. Yet classic linguistic accounts of pragmatics may not apply as consistently in non-WEIRD (western, educated, industrialized, rich, democratic) contexts. Children’s ability to reason pragmatically increases across childhood in U.S. and European communities. Ad hoc (contextual) implicatures tend to emerge around age four, but this pattern has not been studied cross-culturally. We conducted a study of the development of ad-hoc implicatures in Shipibo-Konibo communities in the Peruvian Amazon – a culture with a holistic orientation that might be expected to lead to a decrease in the felicity of implicatures, inferences which typically lead to restrictions on context. While 8–10 year-olds successfully made these implicatures, younger children did not, despite successfully understanding control trials. These findings suggest that ad-hoc implicatures are available interpretations, even in a community with different cultural expectations, but that their development may be more protracted.

To determine the predictive validity of pediatric adaptations of expectancy scale/questions in a cohort of youth treated for headache.

BACKGROUND:International guidelines recommend diaries in migraine trials for prospective collection of headache symptoms. Studies in other patient populations suggest higher adherence with electronic diaries instead of pen-and-paper. This study examines the feasibility of a text message-based (texting) diary for children and adolescents with headache. METHODS:This is a secondary analysis of data from a study validating a pediatric scale of treatment expectancy. We developed a Health Insurance Portability and Accountability Act-compliant texting diary collecting headache characteristics, medication use, and disability with 3-5 core daily questions for 4 or 12 weeks depending on headache treatment. Adherence was incentivized. RESULTS:93 participants consented to the expectancy study. Five participants opted for a paper diary for follow-up. 88 participants chose the texting diary with 28 4-week and 60 12-week participants. Five participants did not complete the enrollment visit. Of those remaining 83, 89% of 4-week and 93% of 12-week participants responded on at least 80% of days. On average, participants fully completed 88% (4-week cohort) and 90% (12-week) of diary entries. CONCLUSIONS:Text messages are a promising method for collecting patient-reported data. Adherence was similar to that reported for paper diaries in other pediatric migraine trials, but time-stamped entries ensure real-time data collection.

Understanding the mechanisms that drive variation in children’s language acquisition requires large, population-representative datasets of children’s word learning across development. Parent report measures such as the MacArthur-Bates Communicative Development Inventories (CDI) are commonly used to collect such data, but the traditional paper-based forms make the curation of large datasets logistically challenging. Many CDI datasets are thus gathered using convenience samples, often recruited from communities in proximity to major research institutions. Here, we introduce Web-CDI, a web-based tool which allows researchers to collect CDI data online. Web-CDI contains functionality to collect and manage longitudinal data, share links to test administrations, and download vocabulary scores. To date, over 3,500 valid Web-CDI administrations have been completed. General trends found in past norming studies of the CDI are present in data collected from Web-CDI: scores of children’s productive vocabulary grow with age, female children show a slightly faster rate of vocabulary growth, and participants with higher levels of educational attainment report slightly higher vocabulary production scores than those with lower levels of education attainment. We also report results from an effort to oversample non-white, lower-education participants via online recruitment (N = 241). These data showed similar demographic trends to the full sample but this effort resulted in a high exclusion rate. We conclude by discussing implications and challenges for the collection of large, population-representative datasets.

Replications in psychological science sometimes fail to reproduce prior findings. If replications use methods that are unfaithful to the original study or ineffective in eliciting the phenomenon of interest, then a failure to replicate may be a failure of the protocol rather than a challenge to the original finding. Formal pre-data collection peer review by experts may address shortcomings and increase replicability rates. We selected 10 replications from the Reproducibility Project: Psychology (RP:P; Open Science Collaboration, 2015) in which the original authors had expressed concerns about the replication designs before data collection and only one of which was “statistically significant” (p < .05). Commenters suggested that lack of adherence to expert review and low-powered tests were the reasons that most of these RP:P studies failed to replicate (Gilbert et al., 2016). We revised the replication protocols and received formal peer review prior to conducting new replications. We administered the RP:P and Revised protocols in multiple laboratories (Median number of laboratories per original study = 6.5; Range 3 to 9; Median total sample = 1279.5; Range 276 to 3512) for high-powered tests of each original finding with both protocols. Overall, Revised protocols produced similar effect sizes as RP:P protocols following the preregistered analysis plan (Δr = .002 or .014, depending on analytic approach). The median effect size for Revised protocols (r = .05) was similar to RP:P protocols (r = .04) and the original RP:P replications (r = .11), and smaller than the original studies (r = .37). The cumulative evidence of original study and three replication attempts suggests that effect sizes for all 10 (median r = .07; range .00 to .15) are 78% smaller on average than original findings (median r = .37; range .19 to .50), with very precisely estimated effects.

Risen and Gilovich (2008) found that subjects believed that “tempting fate” would be punished with ironic bad outcomes (a main effect), and that this effect was magnified when subjects were under cognitive load (an interaction). A previous replication study (Frank & Mathur, 2016) that used an online implementation of the protocol on Amazon Mechanical Turk failed to replicate both the main effect and the interaction. Before this replication was run, the authors of the original study expressed concern that the cognitive-load manipulation may be less effective when implemented online than when implemented in the lab and that subjects recruited online may also respond differently to the specific experimental scenario chosen for the replication. A later, large replication project, Many Labs 2 (Klein et al. 2018), replicated the main effect (though the effect size was smaller than in the original study), but the interaction was not assessed. Attempting to replicate the interaction while addressing the original authors’ concerns regarding the protocol for the first replication study, we developed a new protocol in collaboration with the original authors. We used four university sites (N = 754) chosen for similarity to the site of the original study to conduct a high-powered, preregistered replication focused primarily on the interaction effect. Results from these sites did not support the interaction or the main effect and were comparable to results obtained at six additional universities that were less similar to the original site. Post hoc analyses did not provide strong evidence for statistical inconsistency between the original study’s estimates and our estimates; that is, the original study’s results would not have been extremely unlikely in the estimated distribution of population effects in our sites. We also collected data from a new Mechanical Turk sample under the first replication study’s protocol, and results were not meaningfully different from those obtained with the new protocol at universities similar to the original site. Secondary analyses failed to support proposed substantive mechanisms for the failure to replicate.

Psychological scientists have become increasingly concerned with issues related to methodology and replicability, and infancy researchers in particular face specific challenges related to replicability: For example, high-powered studies are difficult to conduct, testing conditions vary across labs, and different labs have access to different infant populations. Addressing these concerns, we report on a large-scale, multisite study aimed at (a) assessing the overall replicability of a single theoretically important phenomenon and (b) examining methodological, cultural, and developmental moderators. We focus on infants’ preference for infant-directed speech (IDS) over adult-directed speech (ADS). Stimuli of mothers speaking to their infants and to an adult in North American English were created using seminaturalistic laboratory-based audio recordings. Infants’ relative preference for IDS and ADS was assessed across 67 laboratories in North America, Europe, Australia, and Asia using the three common methods for measuring infants’ discrimination (head-turn preference, central fixation, and eye tracking). The overall meta-analytic effect size (Cohen’s d) was 0.35, 95% confidence interval = [0.29, 0.42], which was reliably above zero but smaller than the meta-analytic mean computed from previous literature (0.67). The IDS preference was significantly stronger in older children, in those children for whom the stimuli matched their native language and dialect, and in data from labs using the head-turn preference procedure. Together, these findings replicate the IDS preference but suggest that its magnitude is modulated by development, native-language experience, and testing procedure.

30 Risen & Gilovich (2008) found that subjects believe that “tempting fate” will be punished 31 with ironic bad outcomes (a main effect) and that this effect is magnified under cognitive 32 load (an interaction). A previous replication project (Open Science Collaboration, 2015) 33 failed to replicate both the main effect and the interaction in an online implementation of 34 the protocol that used Amazon Mechanical Turk. Before this replication was run, the 35 authors of the original study expressed concern that the cognitive load manipulation may be 36 less effective when implemented online and that subjects recruited online may respond 37 differently to the specific experimental scenario chosen for replication. A later, large 38 replication project (Many Labs 2) replicated the main effect (though the effect size was 39 smaller than in the original study), but did not test for an interaction. To attempt to 40 replicate the interaction while addressing the original authors’ concerns regarding the 2015 41 protocol, we developed a new protocol in collaboration with the original authors. We used 4 42 university sites (n = 754 total) chosen for similarity to the site of the original study to 43 conduct a high-powered, preregistered replication focused primarily on the interaction effect. 44 Results did not support the focus interaction or the main effect and were comparable in 6 45 additional universities that were less similar to the original site. Post hoc analyses did not 46 provide strong evidence for statistical inconsistency between the original study’s estimates 47 and the replications; that is, the original study’s results would not have been extremely 48 unlikely in the estimated distribution of the replications. We also collected a new Mechanical 49 Turk sample under the previous replication protocol, indicating that the updated protocol 50 (i.e., conducting the study in person and in universities similar to the original site) did not 51 meaningfully change replication results. Secondary analyses failed to support substantive 52 mechanisms for the failure to replicate. 53