Music Lovers and Hearing Aids

Some people cannot imagine life without music - it relaxes, inspires, and for many, completes their lives. Music has a different meaning for each person, and there are individual preferences, but most would agree that music listening should be enjoyable. This seemingly simple task easily can be undermined when hearing loss is present, as listening to just a limited part of the dynamics, or a reduced frequency range of our favorite music could significantly reduce the enjoyment of the experience. Moreover, in several cases, this problem cannot be fixed with modern hearing aids.

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Music Lovers and Hearing Aids

Some people cannot imagine life without music - it relaxes, inspires, and for many, completes their lives. Music has a different meaning for each person, and there are individual preferences, but most would agree that music listening should be enjoyable. This seemingly simple task easily can be undermined when hearing loss is present, as listening to just a limited part of the dynamics, or a reduced frequency range of our favorite music could significantly reduce the enjoyment of the experience. Moreover, in several cases, this problem cannot be fixed with modern hearing aids.

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Music Lovers and Hearing Aids

Some people cannot imagine life without music - it relaxes, inspires, and for many, completes their lives. Music has a different meaning for each person, and there are individual preferences, but most would agree that music listening should be enjoyable. This seemingly simple task easily can be undermined when hearing loss is present, as listening to just a limited part of the dynamics, or a reduced frequency range of our favorite music could significantly reduce the enjoyment of the experience. Moreover, in several cases, this problem cannot be fixed with modern hearing aids.

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Efficacy of Multiple-Talker Phonetic Identification Training in Postlingually Deafened Cochlear Implant Listeners

Purpose

This study implemented a pretest-intervention-posttest design to examine whether multiple-talker identification training enhanced phonetic perception of the /ba/-/da/ and /wa/-/ja/ contrasts in adult listeners who were deafened postlingually and have cochlear implants (CIs).

Method

Nine CI recipients completed 8 hours of identification training using a custom-designed training package. Perception of speech produced by familiar talkers (talkers used during training) and unfamiliar talkers (talkers not used during training) was measured before and after training. Five additional untrained CI recipients completed identical pre- and posttests over the same time course as the trainees to control for procedural learning effects.

Results

Perception of the speech contrasts produced by the familiar talkers significantly improved for the trained CI listeners, and effects of perceptual learning transferred to unfamiliar talkers. Such training-induced significant changes were not observed in the control group.

Conclusion

The data provide initial evidence of the efficacy of the multiple-talker identification training paradigm for CI users who were deafened postlingually. This pattern of results is consistent with enhanced phonemic categorization of the trained speech sounds.

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English Language Learners' Nonword Repetition Performance: The Influence of Age, L2 Vocabulary Size, Length of L2 Exposure, and L1 Phonology

Purpose

This study examined individual differences in English language learners' (ELLs) nonword repetition (NWR) accuracy, focusing on the effects of age, English vocabulary size, length of exposure to English, and first-language (L1) phonology.

Method

Participants were 75 typically developing ELLs (mean age 5;8 [years;months]) whose exposure to English began on average at age 4;4. Children spoke either a Chinese language or South Asian language as an L1 and were given English standardized tests for NWR and receptive vocabulary.

Results

Although the majority of ELLs scored within or above the monolingual normal range (71%), 29% scored below. Mixed logistic regression modeling revealed that a larger English vocabulary, longer English exposure, South Asian L1, and older age all had significant and positive effects on ELLs' NWR accuracy. Error analyses revealed the following L1 effect: onset consonants were produced more accurately than codas overall, but this effect was stronger for the Chinese group whose L1s have a more limited coda inventory compared with English.

Conclusion

ELLs' NWR performance is influenced by a number of factors. Consideration of these factors is important in deciding whether monolingual norm referencing is appropriate for ELL children.

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Masking Release in Children and Adults With Hearing Loss When Using Amplification

Purpose

This study compared masking release for adults and children with normal hearing and hearing loss. For the participants with hearing loss, masking release using simulated hearing aid amplification with 2 different compression speeds (slow, fast) was compared.

Method

Sentence recognition in unmodulated noise was compared with recognition in modulated noise (masking release). Recognition was measured for participants with hearing loss using individualized amplification via the hearing-aid simulator.

Results

Adults with hearing loss showed greater masking release than the children with hearing loss. Average masking release was small (1 dB) and did not depend on hearing status. Masking release was comparable for slow and fast compression.

Conclusions

The use of amplification in this study contrasts with previous studies that did not use amplification. The results suggest that when differences in audibility are reduced, participants with hearing loss may be able to take advantage of dips in the noise levels, similar to participants with normal hearing. Although children required a more favorable signal-to-noise ratio than adults for both unmodulated and modulated noise, masking release was not statistically different. However, the ability to detect a difference may have been limited by the small amount of masking release observed.

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Sentence Recall by Children With SLI Across Two Nonmainstream Dialects of English

Purpose

The inability to accurately recall sentences has proven to be a clinical marker of specific language impairment (SLI); this task yields moderate-to-high levels of sensitivity and specificity. However, it is not yet known if these results hold for speakers of dialects whose nonmainstream grammatical productions overlap with those that are produced at high rates by children with SLI.

Method

Using matched groups of 70 African American English speakers and 36 Southern White English speakers and dialect-strategic scoring, we examined children's sentence recall abilities as a function of their dialect and clinical status (SLI vs. typically developing [TD]).

Results

For both dialects, the SLI group earned lower sentence recall scores than the TD group with sensitivity and specificity values ranging from .80 to .94, depending on the analysis. Children with SLI, as compared with TD controls, manifested lower levels of verbatim recall, more ungrammatical recalls when the recall was not exact, and higher levels of error on targeted functional categories, especially those marking tense.

Conclusion

When matched groups are examined and dialect-strategic scoring is used, sentence recall yields moderate-to-high levels of diagnostic accuracy to identify SLI within speakers of nonmainstream dialects of English.

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Efficacy of Multiple-Talker Phonetic Identification Training in Postlingually Deafened Cochlear Implant Listeners

Purpose

This study implemented a pretest-intervention-posttest design to examine whether multiple-talker identification training enhanced phonetic perception of the /ba/-/da/ and /wa/-/ja/ contrasts in adult listeners who were deafened postlingually and have cochlear implants (CIs).

Method

Nine CI recipients completed 8 hours of identification training using a custom-designed training package. Perception of speech produced by familiar talkers (talkers used during training) and unfamiliar talkers (talkers not used during training) was measured before and after training. Five additional untrained CI recipients completed identical pre- and posttests over the same time course as the trainees to control for procedural learning effects.

Results

Perception of the speech contrasts produced by the familiar talkers significantly improved for the trained CI listeners, and effects of perceptual learning transferred to unfamiliar talkers. Such training-induced significant changes were not observed in the control group.

Conclusion

The data provide initial evidence of the efficacy of the multiple-talker identification training paradigm for CI users who were deafened postlingually. This pattern of results is consistent with enhanced phonemic categorization of the trained speech sounds.

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English Language Learners' Nonword Repetition Performance: The Influence of Age, L2 Vocabulary Size, Length of L2 Exposure, and L1 Phonology

Purpose

This study examined individual differences in English language learners' (ELLs) nonword repetition (NWR) accuracy, focusing on the effects of age, English vocabulary size, length of exposure to English, and first-language (L1) phonology.

Method

Participants were 75 typically developing ELLs (mean age 5;8 [years;months]) whose exposure to English began on average at age 4;4. Children spoke either a Chinese language or South Asian language as an L1 and were given English standardized tests for NWR and receptive vocabulary.

Results

Although the majority of ELLs scored within or above the monolingual normal range (71%), 29% scored below. Mixed logistic regression modeling revealed that a larger English vocabulary, longer English exposure, South Asian L1, and older age all had significant and positive effects on ELLs' NWR accuracy. Error analyses revealed the following L1 effect: onset consonants were produced more accurately than codas overall, but this effect was stronger for the Chinese group whose L1s have a more limited coda inventory compared with English.

Conclusion

ELLs' NWR performance is influenced by a number of factors. Consideration of these factors is important in deciding whether monolingual norm referencing is appropriate for ELL children.

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Masking Release in Children and Adults With Hearing Loss When Using Amplification

Purpose

This study compared masking release for adults and children with normal hearing and hearing loss. For the participants with hearing loss, masking release using simulated hearing aid amplification with 2 different compression speeds (slow, fast) was compared.

Method

Sentence recognition in unmodulated noise was compared with recognition in modulated noise (masking release). Recognition was measured for participants with hearing loss using individualized amplification via the hearing-aid simulator.

Results

Adults with hearing loss showed greater masking release than the children with hearing loss. Average masking release was small (1 dB) and did not depend on hearing status. Masking release was comparable for slow and fast compression.

Conclusions

The use of amplification in this study contrasts with previous studies that did not use amplification. The results suggest that when differences in audibility are reduced, participants with hearing loss may be able to take advantage of dips in the noise levels, similar to participants with normal hearing. Although children required a more favorable signal-to-noise ratio than adults for both unmodulated and modulated noise, masking release was not statistically different. However, the ability to detect a difference may have been limited by the small amount of masking release observed.

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Sentence Recall by Children With SLI Across Two Nonmainstream Dialects of English

Purpose

The inability to accurately recall sentences has proven to be a clinical marker of specific language impairment (SLI); this task yields moderate-to-high levels of sensitivity and specificity. However, it is not yet known if these results hold for speakers of dialects whose nonmainstream grammatical productions overlap with those that are produced at high rates by children with SLI.

Method

Using matched groups of 70 African American English speakers and 36 Southern White English speakers and dialect-strategic scoring, we examined children's sentence recall abilities as a function of their dialect and clinical status (SLI vs. typically developing [TD]).

Results

For both dialects, the SLI group earned lower sentence recall scores than the TD group with sensitivity and specificity values ranging from .80 to .94, depending on the analysis. Children with SLI, as compared with TD controls, manifested lower levels of verbatim recall, more ungrammatical recalls when the recall was not exact, and higher levels of error on targeted functional categories, especially those marking tense.

Conclusion

When matched groups are examined and dialect-strategic scoring is used, sentence recall yields moderate-to-high levels of diagnostic accuracy to identify SLI within speakers of nonmainstream dialects of English.

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Specific Language Impairment, Nonverbal IQ, Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Cochlear Implants, Bilingualism, and Dialectal Variants: Defining the Boundaries, Clarifying Clinical Conditions, and Sorting Out Causes

Purpose

The purpose of this research forum article is to provide an overview of a collection of invited articles on the topic “specific language impairment (SLI) in children with concomitant health conditions or nonmainstream language backgrounds.” Topics include SLI, attention-deficit/hyperactivity disorder, autism spectrum disorder, cochlear implants, bilingualism, and dialectal language learning contexts.

Method

The topic is timely due to current debates about the diagnosis of SLI. An overarching comparative conceptual framework is provided for comparisons of SLI with other clinical conditions. Comparisons of SLI in children with low-normal or normal nonverbal IQ illustrate the unexpected outcomes of 2 × 2 comparison designs.

Results

Comparative studies reveal unexpected relationships among speech, language, cognitive, and social dimensions of children's development as well as precise ways to identify children with SLI who are bilingual or dialect speakers.

Conclusions

The diagnosis of SLI is essential for elucidating possible causal pathways of language impairments, risks for language impairments, assessments for identification of language impairments, linguistic dimensions of language impairments, and long-term outcomes. Although children's language acquisition is robust under high levels of risk, unexplained individual variations in language acquisition lead to persistent language impairments.

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Language Impairment in the Attention-Deficit/Hyperactivity Disorder Context

Purpose

Attention-deficit/hyperactivity disorder (ADHD) is a ubiquitous designation that affects the identification, assessment, treatment, and study of pediatric language impairments (LIs).

Method

Current literature is reviewed in 4 areas: (a) the capacity of psycholinguistic, neuropsychological, and socioemotional behavioral indices to differentiate cases of LI from ADHD; (b) the impact of co-occurring ADHD on children's LI; (c) cross-etiology comparisons of the nonlinguistic abilities of children with ADHD and specific LI (SLI); and (d) the extent to which ADHD contributes to educational and health disparities among individuals with LI.

Results

Evidence is presented demonstrating the value of using adjusted parent ratings of ADHD symptoms and targeted assessments of children's tense marking, nonword repetition, and sentence recall for differential diagnosis and the identification of comorbidity. Reports suggest that the presence of ADHD does not aggravate children's LI. The potential value of cross-etiology comparisons testing the necessity and sufficiency of proposed nonlinguistic contributors to the etiology of SLI is demonstrated through key studies. Reports suggest that children with comorbid ADHD+LI receive speech-language services at a higher rate than children with SLI.

Conclusion

The ADHD context is multifaceted and provides the management and study of LI with both opportunities and obstacles.

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Visual Speech Perception in Children With Language Learning Impairments

Purpose

The purpose of the study was to assess the ability of children with developmental language learning impairments (LLIs) to use visual speech cues from the talking face.

Method

In this cross-sectional study, 41 typically developing children (mean age: 8 years 0 months, range: 4 years 5 months to 11 years 10 months) and 27 children with diagnosed LLI (mean age: 8 years 10 months, range: 5 years 2 months to 11 years 6 months) completed a silent speechreading task and a speech-in-noise task with and without visual support from the talking face. The speech-in-noise task involved the identification of a target word in a carrier sentence with a single competing speaker as a masker.

Results

Children in the LLI group showed a deficit in speechreading when compared with their typically developing peers. Beyond the single-word level, this deficit became more apparent in older children. On the speech-in-noise task, a substantial benefit of visual cues was found regardless of age or group membership, although the LLI group showed an overall developmental delay in speech perception.

Conclusion

Although children with LLI were less accurate than their peers on the speechreading and speech-in noise-tasks, both groups were able to make equivalent use of visual cues to boost performance accuracy when listening in noise.

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Risk Factors Associated With Language in Autism Spectrum Disorder: Clues to Underlying Mechanisms

Purpose

Identifying risk factors associated with neurodevelopmental disorders is an important line of research, as it will lead to earlier identification of children who could benefit from interventions that support optimal developmental outcomes. The primary goal of this review was to summarize research on risk factors associated with autism spectrum disorder (ASD).

Method

The review focused on studies of infants who have older siblings with ASD, with particular emphasis on risk factors associated with language impairment that affects the majority of children with ASD. Findings from this body of work were compared to the literature on specific language impairment.

Results

A wide range of risk factors has been found for ASD, including demographic (e.g., male, family history), behavioral (e.g., gesture, motor) and neural risk markers (e.g., atypical lateralization for speech and reduced functional connectivity). Environmental factors, such as caregiver interaction, have not been found to predict language outcomes. Many of the risk markers for ASD are also found in studies of risk for specific language impairment, including demographic, behavioral, and neural factors.

Conclusions

There are significant gaps in the literature and limitations in the current research that preclude direct cross-syndrome comparisons. Future research directions are outlined that could address these limitations.

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Racial Variations in Velopharyngeal and Craniometric Morphology in Children: An Imaging Study

Purpose

The purpose of this study is to examine craniometric and velopharyngeal anatomy among young children (4–8 years of age) with normal anatomy across Black and White racial groups.

Method

Thirty-two healthy children (16 White and 16 Black) with normal velopharyngeal anatomy participated and successfully completed the magnetic resonance imaging scans. Measurements included 11 craniofacial and 9 velopharyngeal measures.

Results

Two-way analysis of covariance was used to determine the effects of race and sex on velopharyngeal measures and all craniometric measures except head circumference. Head circumference was included as a covariate to control for overall cranial size. Sex did not have a significant effect on any of the craniometric measures. Significant racial differences were demonstrated for face height. A significant race effect was also observed for mean velar length, velar thickness, and velopharyngeal ratio.

Conclusion

The present study provides separate craniofacial and velopharyngeal values for young Black and White children. Data from this study can be used to examine morphological variations with respect to race and sex.

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An Optimal Set of Flesh Points on Tongue and Lips for Speech-Movement Classification

Purpose

The authors sought to determine an optimal set of flesh points on the tongue and lips for classifying speech movements.

Method

The authors used electromagnetic articulographs (Carstens AG500 and NDI Wave) to record tongue and lip movements from 13 healthy talkers who articulated 8 vowels, 11 consonants, a phonetically balanced set of words, and a set of short phrases during the recording. We used a machine-learning classifier (support-vector machine) to classify the speech stimuli on the basis of articulatory movements. We then compared classification accuracies of the flesh-point combinations to determine an optimal set of sensors.

Results

When data from the 4 sensors (T1: the vicinity between the tongue tip and tongue blade; T4: the tongue-body back; UL: the upper lip; and LL: the lower lip) were combined, phoneme and word classifications were most accurate and were comparable with the full set (including T2: the tongue-body front; and T3: the tongue-body front).

Conclusion

We identified a 4-sensor set—that is, T1, T4, UL, LL—that yielded a classification accuracy (91%–95%) equivalent to that using all 6 sensors. These findings provide an empirical basis for selecting sensors and their locations for scientific and emerging clinical applications that incorporate articulatory movements.

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Pragmatic Language Features of Mothers With the FMR1 Premutation Are Associated With the Language Outcomes of Adolescents and Young Adults With Fragile X Syndrome

Purpose

Pragmatic language difficulties have been documented as part of the FMR1 premutation phenotype, yet the interplay between these features in mothers and the language outcomes of their children with fragile X syndrome is unknown. This study aimed to determine whether pragmatic language difficulties in mothers with the FMR1 premutation are related to the language development of their children.

Method

Twenty-seven mothers with the FMR1 premutation and their adolescent/young adult sons with fragile X syndrome participated. Maternal pragmatic language violations were rated from conversational samples using the Pragmatic Rating Scale (Landa et al., 1992). Children completed standardized assessments of vocabulary, syntax, and reading.

Results

Maternal pragmatic language difficulties were significantly associated with poorer child receptive vocabulary and expressive syntax skills, with medium effect sizes.

Conclusions

This work contributes to knowledge of the FMR1 premutation phenotype and its consequences at the family level, with the goal of identifying modifiable aspects of the child's language-learning environment that may promote the selection of treatments targeting the specific needs of families affected by fragile X. Findings contribute to our understanding of the multifaceted environment in which children with fragile X syndrome learn language and highlight the importance of family-centered intervention practices for this group.

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Persistent Language Delay Versus Late Language Emergence in Children With Early Cochlear Implantation

Purpose

The purpose of the present investigation is to differentiate children using cochlear implants (CIs) who did or did not achieve age-appropriate language scores by midelementary grades and to identify risk factors for persistent language delay following early cochlear implantation.

Materials and Method

Children receiving unilateral CIs at young ages (12–38 months) were tested longitudinally and classified with normal language emergence (n = 19), late language emergence (n = 22), or persistent language delay (n = 19) on the basis of their test scores at 4.5 and 10.5 years of age. Relative effects of demographic, audiological, linguistic, and academic characteristics on language emergence were determined.

Results

Age at CI was associated with normal language emergence but did not differentiate late emergence from persistent delay. Children with persistent delay were more likely to use left-ear implants and older speech processor technology. They experienced higher aided thresholds and lower speech perception scores. Persistent delay was foreshadowed by low morphosyntactic and phonological diversity in preschool. Logistic regression analysis predicted normal language emergence with 84% accuracy and persistent language delay with 74% accuracy.

Conclusion

CI characteristics had a strong effect on persistent versus resolving language delay, suggesting that right-ear (or bilateral) devices, technology upgrades, and improved audibility may positively influence long-term language outcomes.

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The Development of English as a Second Language With and Without Specific Language Impairment: Clinical Implications

Purpose

The purpose of this research forum article is to provide an overview of typical and atypical development of English as a second language (L2) and to present strategies for clinical assessment with English language learners (ELLs).

Method

A review of studies examining the lexical, morphological, narrative, and verbal memory abilities of ELLs is organized around 3 topics: timeframe and characteristics of typical English L2 development, comparison of the English L2 development of children with and without specific language impairment (SLI), and strategies for more effective assessment with ELLs.

Results

ELLs take longer than 3 years to converge on monolingual norms and approach monolingual norms asynchronously across linguistic subdomains. Individual variation is predicted by age, first language, language learning aptitude, length of exposure to English in school, maternal education, and richness of the English environment outside school. ELLs with SLI acquire English more slowly than ELLs with typical development; their morphological and nonword repetition abilities differentiate them the most. Use of strategies such as parent questionnaires on first language development and ELL norm referencing can result in accurate discrimination of ELLs with SLI.

Conclusions

Variability in the language abilities of ELLs presents challenges for clinical practice. Increased knowledge of English language learning development with and without SLI together with evidence-based alternative assessment strategies can assist in overcoming these challenges.

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Effects of Removing Low-Frequency Electric Information on Speech Perception With Bimodal Hearing

Purpose

The objective was to determine whether speech perception could be improved for bimodal listeners (those using a cochlear implant [CI] in one ear and hearing aid in the contralateral ear) by removing low-frequency information provided by the CI, thereby reducing acoustic–electric overlap.

Method

Subjects were adult CI subjects with at least 1 year of CI experience. Nine subjects were evaluated in the CI-only condition (control condition), and 26 subjects were evaluated in the bimodal condition. CIs were programmed with 4 experimental programs in which the low cutoff frequency (LCF) was progressively raised. Speech perception was evaluated using Consonant-Nucleus-Consonant words in quiet, AzBio sentences in background babble, and spondee words in background babble.

Results

The CI-only group showed decreased speech perception in both quiet and noise as the LCF was raised. Bimodal subjects with better hearing in the hearing aid ear ( 60 dB HL at 250 and 500 Hz) performed similarly to the CI-only group.

Conclusions

These findings suggest that reducing low-frequency overlap of the CI and contralateral hearing aid may improve performance in quiet for some bimodal listeners with better hearing.

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Efficacy of Multiple-Talker Phonetic Identification Training in Postlingually Deafened Cochlear Implant Listeners

Purpose

This study implemented a pretest-intervention-posttest design to examine whether multiple-talker identification training enhanced phonetic perception of the /ba/-/da/ and /wa/-/ja/ contrasts in adult listeners who were deafened postlingually and have cochlear implants (CIs).

Method

Nine CI recipients completed 8 hours of identification training using a custom-designed training package. Perception of speech produced by familiar talkers (talkers used during training) and unfamiliar talkers (talkers not used during training) was measured before and after training. Five additional untrained CI recipients completed identical pre- and posttests over the same time course as the trainees to control for procedural learning effects.

Results

Perception of the speech contrasts produced by the familiar talkers significantly improved for the trained CI listeners, and effects of perceptual learning transferred to unfamiliar talkers. Such training-induced significant changes were not observed in the control group.

Conclusion

The data provide initial evidence of the efficacy of the multiple-talker identification training paradigm for CI users who were deafened postlingually. This pattern of results is consistent with enhanced phonemic categorization of the trained speech sounds.

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English Language Learners' Nonword Repetition Performance: The Influence of Age, L2 Vocabulary Size, Length of L2 Exposure, and L1 Phonology

Purpose

This study examined individual differences in English language learners' (ELLs) nonword repetition (NWR) accuracy, focusing on the effects of age, English vocabulary size, length of exposure to English, and first-language (L1) phonology.

Method

Participants were 75 typically developing ELLs (mean age 5;8 [years;months]) whose exposure to English began on average at age 4;4. Children spoke either a Chinese language or South Asian language as an L1 and were given English standardized tests for NWR and receptive vocabulary.

Results

Although the majority of ELLs scored within or above the monolingual normal range (71%), 29% scored below. Mixed logistic regression modeling revealed that a larger English vocabulary, longer English exposure, South Asian L1, and older age all had significant and positive effects on ELLs' NWR accuracy. Error analyses revealed the following L1 effect: onset consonants were produced more accurately than codas overall, but this effect was stronger for the Chinese group whose L1s have a more limited coda inventory compared with English.

Conclusion

ELLs' NWR performance is influenced by a number of factors. Consideration of these factors is important in deciding whether monolingual norm referencing is appropriate for ELL children.

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Masking Release in Children and Adults With Hearing Loss When Using Amplification

Purpose

This study compared masking release for adults and children with normal hearing and hearing loss. For the participants with hearing loss, masking release using simulated hearing aid amplification with 2 different compression speeds (slow, fast) was compared.

Method

Sentence recognition in unmodulated noise was compared with recognition in modulated noise (masking release). Recognition was measured for participants with hearing loss using individualized amplification via the hearing-aid simulator.

Results

Adults with hearing loss showed greater masking release than the children with hearing loss. Average masking release was small (1 dB) and did not depend on hearing status. Masking release was comparable for slow and fast compression.

Conclusions

The use of amplification in this study contrasts with previous studies that did not use amplification. The results suggest that when differences in audibility are reduced, participants with hearing loss may be able to take advantage of dips in the noise levels, similar to participants with normal hearing. Although children required a more favorable signal-to-noise ratio than adults for both unmodulated and modulated noise, masking release was not statistically different. However, the ability to detect a difference may have been limited by the small amount of masking release observed.

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Sentence Recall by Children With SLI Across Two Nonmainstream Dialects of English

Purpose

The inability to accurately recall sentences has proven to be a clinical marker of specific language impairment (SLI); this task yields moderate-to-high levels of sensitivity and specificity. However, it is not yet known if these results hold for speakers of dialects whose nonmainstream grammatical productions overlap with those that are produced at high rates by children with SLI.

Method

Using matched groups of 70 African American English speakers and 36 Southern White English speakers and dialect-strategic scoring, we examined children's sentence recall abilities as a function of their dialect and clinical status (SLI vs. typically developing [TD]).

Results

For both dialects, the SLI group earned lower sentence recall scores than the TD group with sensitivity and specificity values ranging from .80 to .94, depending on the analysis. Children with SLI, as compared with TD controls, manifested lower levels of verbatim recall, more ungrammatical recalls when the recall was not exact, and higher levels of error on targeted functional categories, especially those marking tense.

Conclusion

When matched groups are examined and dialect-strategic scoring is used, sentence recall yields moderate-to-high levels of diagnostic accuracy to identify SLI within speakers of nonmainstream dialects of English.

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Specific Language Impairment, Nonverbal IQ, Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Cochlear Implants, Bilingualism, and Dialectal Variants: Defining the Boundaries, Clarifying Clinical Conditions, and Sorting Out Causes

Purpose

The purpose of this research forum article is to provide an overview of a collection of invited articles on the topic “specific language impairment (SLI) in children with concomitant health conditions or nonmainstream language backgrounds.” Topics include SLI, attention-deficit/hyperactivity disorder, autism spectrum disorder, cochlear implants, bilingualism, and dialectal language learning contexts.

Method

The topic is timely due to current debates about the diagnosis of SLI. An overarching comparative conceptual framework is provided for comparisons of SLI with other clinical conditions. Comparisons of SLI in children with low-normal or normal nonverbal IQ illustrate the unexpected outcomes of 2 × 2 comparison designs.

Results

Comparative studies reveal unexpected relationships among speech, language, cognitive, and social dimensions of children's development as well as precise ways to identify children with SLI who are bilingual or dialect speakers.

Conclusions

The diagnosis of SLI is essential for elucidating possible causal pathways of language impairments, risks for language impairments, assessments for identification of language impairments, linguistic dimensions of language impairments, and long-term outcomes. Although children's language acquisition is robust under high levels of risk, unexplained individual variations in language acquisition lead to persistent language impairments.

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Language Impairment in the Attention-Deficit/Hyperactivity Disorder Context

Purpose

Attention-deficit/hyperactivity disorder (ADHD) is a ubiquitous designation that affects the identification, assessment, treatment, and study of pediatric language impairments (LIs).

Method

Current literature is reviewed in 4 areas: (a) the capacity of psycholinguistic, neuropsychological, and socioemotional behavioral indices to differentiate cases of LI from ADHD; (b) the impact of co-occurring ADHD on children's LI; (c) cross-etiology comparisons of the nonlinguistic abilities of children with ADHD and specific LI (SLI); and (d) the extent to which ADHD contributes to educational and health disparities among individuals with LI.

Results

Evidence is presented demonstrating the value of using adjusted parent ratings of ADHD symptoms and targeted assessments of children's tense marking, nonword repetition, and sentence recall for differential diagnosis and the identification of comorbidity. Reports suggest that the presence of ADHD does not aggravate children's LI. The potential value of cross-etiology comparisons testing the necessity and sufficiency of proposed nonlinguistic contributors to the etiology of SLI is demonstrated through key studies. Reports suggest that children with comorbid ADHD+LI receive speech-language services at a higher rate than children with SLI.

Conclusion

The ADHD context is multifaceted and provides the management and study of LI with both opportunities and obstacles.

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Visual Speech Perception in Children With Language Learning Impairments

Purpose

The purpose of the study was to assess the ability of children with developmental language learning impairments (LLIs) to use visual speech cues from the talking face.

Method

In this cross-sectional study, 41 typically developing children (mean age: 8 years 0 months, range: 4 years 5 months to 11 years 10 months) and 27 children with diagnosed LLI (mean age: 8 years 10 months, range: 5 years 2 months to 11 years 6 months) completed a silent speechreading task and a speech-in-noise task with and without visual support from the talking face. The speech-in-noise task involved the identification of a target word in a carrier sentence with a single competing speaker as a masker.

Results

Children in the LLI group showed a deficit in speechreading when compared with their typically developing peers. Beyond the single-word level, this deficit became more apparent in older children. On the speech-in-noise task, a substantial benefit of visual cues was found regardless of age or group membership, although the LLI group showed an overall developmental delay in speech perception.

Conclusion

Although children with LLI were less accurate than their peers on the speechreading and speech-in noise-tasks, both groups were able to make equivalent use of visual cues to boost performance accuracy when listening in noise.

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Risk Factors Associated With Language in Autism Spectrum Disorder: Clues to Underlying Mechanisms

Purpose

Identifying risk factors associated with neurodevelopmental disorders is an important line of research, as it will lead to earlier identification of children who could benefit from interventions that support optimal developmental outcomes. The primary goal of this review was to summarize research on risk factors associated with autism spectrum disorder (ASD).

Method

The review focused on studies of infants who have older siblings with ASD, with particular emphasis on risk factors associated with language impairment that affects the majority of children with ASD. Findings from this body of work were compared to the literature on specific language impairment.

Results

A wide range of risk factors has been found for ASD, including demographic (e.g., male, family history), behavioral (e.g., gesture, motor) and neural risk markers (e.g., atypical lateralization for speech and reduced functional connectivity). Environmental factors, such as caregiver interaction, have not been found to predict language outcomes. Many of the risk markers for ASD are also found in studies of risk for specific language impairment, including demographic, behavioral, and neural factors.

Conclusions

There are significant gaps in the literature and limitations in the current research that preclude direct cross-syndrome comparisons. Future research directions are outlined that could address these limitations.

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Racial Variations in Velopharyngeal and Craniometric Morphology in Children: An Imaging Study

Purpose

The purpose of this study is to examine craniometric and velopharyngeal anatomy among young children (4–8 years of age) with normal anatomy across Black and White racial groups.

Method

Thirty-two healthy children (16 White and 16 Black) with normal velopharyngeal anatomy participated and successfully completed the magnetic resonance imaging scans. Measurements included 11 craniofacial and 9 velopharyngeal measures.

Results

Two-way analysis of covariance was used to determine the effects of race and sex on velopharyngeal measures and all craniometric measures except head circumference. Head circumference was included as a covariate to control for overall cranial size. Sex did not have a significant effect on any of the craniometric measures. Significant racial differences were demonstrated for face height. A significant race effect was also observed for mean velar length, velar thickness, and velopharyngeal ratio.

Conclusion

The present study provides separate craniofacial and velopharyngeal values for young Black and White children. Data from this study can be used to examine morphological variations with respect to race and sex.

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An Optimal Set of Flesh Points on Tongue and Lips for Speech-Movement Classification

Purpose

The authors sought to determine an optimal set of flesh points on the tongue and lips for classifying speech movements.

Method

The authors used electromagnetic articulographs (Carstens AG500 and NDI Wave) to record tongue and lip movements from 13 healthy talkers who articulated 8 vowels, 11 consonants, a phonetically balanced set of words, and a set of short phrases during the recording. We used a machine-learning classifier (support-vector machine) to classify the speech stimuli on the basis of articulatory movements. We then compared classification accuracies of the flesh-point combinations to determine an optimal set of sensors.

Results

When data from the 4 sensors (T1: the vicinity between the tongue tip and tongue blade; T4: the tongue-body back; UL: the upper lip; and LL: the lower lip) were combined, phoneme and word classifications were most accurate and were comparable with the full set (including T2: the tongue-body front; and T3: the tongue-body front).

Conclusion

We identified a 4-sensor set—that is, T1, T4, UL, LL—that yielded a classification accuracy (91%–95%) equivalent to that using all 6 sensors. These findings provide an empirical basis for selecting sensors and their locations for scientific and emerging clinical applications that incorporate articulatory movements.

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Pragmatic Language Features of Mothers With the FMR1 Premutation Are Associated With the Language Outcomes of Adolescents and Young Adults With Fragile X Syndrome

Purpose

Pragmatic language difficulties have been documented as part of the FMR1 premutation phenotype, yet the interplay between these features in mothers and the language outcomes of their children with fragile X syndrome is unknown. This study aimed to determine whether pragmatic language difficulties in mothers with the FMR1 premutation are related to the language development of their children.

Method

Twenty-seven mothers with the FMR1 premutation and their adolescent/young adult sons with fragile X syndrome participated. Maternal pragmatic language violations were rated from conversational samples using the Pragmatic Rating Scale (Landa et al., 1992). Children completed standardized assessments of vocabulary, syntax, and reading.

Results

Maternal pragmatic language difficulties were significantly associated with poorer child receptive vocabulary and expressive syntax skills, with medium effect sizes.

Conclusions

This work contributes to knowledge of the FMR1 premutation phenotype and its consequences at the family level, with the goal of identifying modifiable aspects of the child's language-learning environment that may promote the selection of treatments targeting the specific needs of families affected by fragile X. Findings contribute to our understanding of the multifaceted environment in which children with fragile X syndrome learn language and highlight the importance of family-centered intervention practices for this group.

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Persistent Language Delay Versus Late Language Emergence in Children With Early Cochlear Implantation

Purpose

The purpose of the present investigation is to differentiate children using cochlear implants (CIs) who did or did not achieve age-appropriate language scores by midelementary grades and to identify risk factors for persistent language delay following early cochlear implantation.

Materials and Method

Children receiving unilateral CIs at young ages (12–38 months) were tested longitudinally and classified with normal language emergence (n = 19), late language emergence (n = 22), or persistent language delay (n = 19) on the basis of their test scores at 4.5 and 10.5 years of age. Relative effects of demographic, audiological, linguistic, and academic characteristics on language emergence were determined.

Results

Age at CI was associated with normal language emergence but did not differentiate late emergence from persistent delay. Children with persistent delay were more likely to use left-ear implants and older speech processor technology. They experienced higher aided thresholds and lower speech perception scores. Persistent delay was foreshadowed by low morphosyntactic and phonological diversity in preschool. Logistic regression analysis predicted normal language emergence with 84% accuracy and persistent language delay with 74% accuracy.

Conclusion

CI characteristics had a strong effect on persistent versus resolving language delay, suggesting that right-ear (or bilateral) devices, technology upgrades, and improved audibility may positively influence long-term language outcomes.

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The Development of English as a Second Language With and Without Specific Language Impairment: Clinical Implications

Purpose

The purpose of this research forum article is to provide an overview of typical and atypical development of English as a second language (L2) and to present strategies for clinical assessment with English language learners (ELLs).

Method

A review of studies examining the lexical, morphological, narrative, and verbal memory abilities of ELLs is organized around 3 topics: timeframe and characteristics of typical English L2 development, comparison of the English L2 development of children with and without specific language impairment (SLI), and strategies for more effective assessment with ELLs.

Results

ELLs take longer than 3 years to converge on monolingual norms and approach monolingual norms asynchronously across linguistic subdomains. Individual variation is predicted by age, first language, language learning aptitude, length of exposure to English in school, maternal education, and richness of the English environment outside school. ELLs with SLI acquire English more slowly than ELLs with typical development; their morphological and nonword repetition abilities differentiate them the most. Use of strategies such as parent questionnaires on first language development and ELL norm referencing can result in accurate discrimination of ELLs with SLI.

Conclusions

Variability in the language abilities of ELLs presents challenges for clinical practice. Increased knowledge of English language learning development with and without SLI together with evidence-based alternative assessment strategies can assist in overcoming these challenges.

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Specific Language Impairment, Nonverbal IQ, Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Cochlear Implants, Bilingualism, and Dialectal Variants: Defining the Boundaries, Clarifying Clinical Conditions, and Sorting Out Causes

Purpose

The purpose of this research forum article is to provide an overview of a collection of invited articles on the topic “specific language impairment (SLI) in children with concomitant health conditions or nonmainstream language backgrounds.” Topics include SLI, attention-deficit/hyperactivity disorder, autism spectrum disorder, cochlear implants, bilingualism, and dialectal language learning contexts.

Method

The topic is timely due to current debates about the diagnosis of SLI. An overarching comparative conceptual framework is provided for comparisons of SLI with other clinical conditions. Comparisons of SLI in children with low-normal or normal nonverbal IQ illustrate the unexpected outcomes of 2 × 2 comparison designs.

Results

Comparative studies reveal unexpected relationships among speech, language, cognitive, and social dimensions of children's development as well as precise ways to identify children with SLI who are bilingual or dialect speakers.

Conclusions

The diagnosis of SLI is essential for elucidating possible causal pathways of language impairments, risks for language impairments, assessments for identification of language impairments, linguistic dimensions of language impairments, and long-term outcomes. Although children's language acquisition is robust under high levels of risk, unexplained individual variations in language acquisition lead to persistent language impairments.

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Effects of Removing Low-Frequency Electric Information on Speech Perception With Bimodal Hearing

Purpose

The objective was to determine whether speech perception could be improved for bimodal listeners (those using a cochlear implant [CI] in one ear and hearing aid in the contralateral ear) by removing low-frequency information provided by the CI, thereby reducing acoustic–electric overlap.

Method

Subjects were adult CI subjects with at least 1 year of CI experience. Nine subjects were evaluated in the CI-only condition (control condition), and 26 subjects were evaluated in the bimodal condition. CIs were programmed with 4 experimental programs in which the low cutoff frequency (LCF) was progressively raised. Speech perception was evaluated using Consonant-Nucleus-Consonant words in quiet, AzBio sentences in background babble, and spondee words in background babble.

Results

The CI-only group showed decreased speech perception in both quiet and noise as the LCF was raised. Bimodal subjects with better hearing in the hearing aid ear ( 60 dB HL at 250 and 500 Hz) performed similarly to the CI-only group.

Conclusions

These findings suggest that reducing low-frequency overlap of the CI and contralateral hearing aid may improve performance in quiet for some bimodal listeners with better hearing.

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Language Impairment in the Attention-Deficit/Hyperactivity Disorder Context

Purpose

Attention-deficit/hyperactivity disorder (ADHD) is a ubiquitous designation that affects the identification, assessment, treatment, and study of pediatric language impairments (LIs).

Method

Current literature is reviewed in 4 areas: (a) the capacity of psycholinguistic, neuropsychological, and socioemotional behavioral indices to differentiate cases of LI from ADHD; (b) the impact of co-occurring ADHD on children's LI; (c) cross-etiology comparisons of the nonlinguistic abilities of children with ADHD and specific LI (SLI); and (d) the extent to which ADHD contributes to educational and health disparities among individuals with LI.

Results

Evidence is presented demonstrating the value of using adjusted parent ratings of ADHD symptoms and targeted assessments of children's tense marking, nonword repetition, and sentence recall for differential diagnosis and the identification of comorbidity. Reports suggest that the presence of ADHD does not aggravate children's LI. The potential value of cross-etiology comparisons testing the necessity and sufficiency of proposed nonlinguistic contributors to the etiology of SLI is demonstrated through key studies. Reports suggest that children with comorbid ADHD+LI receive speech-language services at a higher rate than children with SLI.

Conclusion

The ADHD context is multifaceted and provides the management and study of LI with both opportunities and obstacles.

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via IFTTT

Visual Speech Perception in Children With Language Learning Impairments

Purpose

The purpose of the study was to assess the ability of children with developmental language learning impairments (LLIs) to use visual speech cues from the talking face.

Method

In this cross-sectional study, 41 typically developing children (mean age: 8 years 0 months, range: 4 years 5 months to 11 years 10 months) and 27 children with diagnosed LLI (mean age: 8 years 10 months, range: 5 years 2 months to 11 years 6 months) completed a silent speechreading task and a speech-in-noise task with and without visual support from the talking face. The speech-in-noise task involved the identification of a target word in a carrier sentence with a single competing speaker as a masker.

Results

Children in the LLI group showed a deficit in speechreading when compared with their typically developing peers. Beyond the single-word level, this deficit became more apparent in older children. On the speech-in-noise task, a substantial benefit of visual cues was found regardless of age or group membership, although the LLI group showed an overall developmental delay in speech perception.

Conclusion

Although children with LLI were less accurate than their peers on the speechreading and speech-in noise-tasks, both groups were able to make equivalent use of visual cues to boost performance accuracy when listening in noise.

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Risk Factors Associated With Language in Autism Spectrum Disorder: Clues to Underlying Mechanisms

Purpose

Identifying risk factors associated with neurodevelopmental disorders is an important line of research, as it will lead to earlier identification of children who could benefit from interventions that support optimal developmental outcomes. The primary goal of this review was to summarize research on risk factors associated with autism spectrum disorder (ASD).

Method

The review focused on studies of infants who have older siblings with ASD, with particular emphasis on risk factors associated with language impairment that affects the majority of children with ASD. Findings from this body of work were compared to the literature on specific language impairment.

Results

A wide range of risk factors has been found for ASD, including demographic (e.g., male, family history), behavioral (e.g., gesture, motor) and neural risk markers (e.g., atypical lateralization for speech and reduced functional connectivity). Environmental factors, such as caregiver interaction, have not been found to predict language outcomes. Many of the risk markers for ASD are also found in studies of risk for specific language impairment, including demographic, behavioral, and neural factors.

Conclusions

There are significant gaps in the literature and limitations in the current research that preclude direct cross-syndrome comparisons. Future research directions are outlined that could address these limitations.

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via IFTTT

Racial Variations in Velopharyngeal and Craniometric Morphology in Children: An Imaging Study

Purpose

The purpose of this study is to examine craniometric and velopharyngeal anatomy among young children (4–8 years of age) with normal anatomy across Black and White racial groups.

Method

Thirty-two healthy children (16 White and 16 Black) with normal velopharyngeal anatomy participated and successfully completed the magnetic resonance imaging scans. Measurements included 11 craniofacial and 9 velopharyngeal measures.

Results

Two-way analysis of covariance was used to determine the effects of race and sex on velopharyngeal measures and all craniometric measures except head circumference. Head circumference was included as a covariate to control for overall cranial size. Sex did not have a significant effect on any of the craniometric measures. Significant racial differences were demonstrated for face height. A significant race effect was also observed for mean velar length, velar thickness, and velopharyngeal ratio.

Conclusion

The present study provides separate craniofacial and velopharyngeal values for young Black and White children. Data from this study can be used to examine morphological variations with respect to race and sex.

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via IFTTT

An Optimal Set of Flesh Points on Tongue and Lips for Speech-Movement Classification

Purpose

The authors sought to determine an optimal set of flesh points on the tongue and lips for classifying speech movements.

Method

The authors used electromagnetic articulographs (Carstens AG500 and NDI Wave) to record tongue and lip movements from 13 healthy talkers who articulated 8 vowels, 11 consonants, a phonetically balanced set of words, and a set of short phrases during the recording. We used a machine-learning classifier (support-vector machine) to classify the speech stimuli on the basis of articulatory movements. We then compared classification accuracies of the flesh-point combinations to determine an optimal set of sensors.

Results

When data from the 4 sensors (T1: the vicinity between the tongue tip and tongue blade; T4: the tongue-body back; UL: the upper lip; and LL: the lower lip) were combined, phoneme and word classifications were most accurate and were comparable with the full set (including T2: the tongue-body front; and T3: the tongue-body front).

Conclusion

We identified a 4-sensor set—that is, T1, T4, UL, LL—that yielded a classification accuracy (91%–95%) equivalent to that using all 6 sensors. These findings provide an empirical basis for selecting sensors and their locations for scientific and emerging clinical applications that incorporate articulatory movements.

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via IFTTT

Pragmatic Language Features of Mothers With the FMR1 Premutation Are Associated With the Language Outcomes of Adolescents and Young Adults With Fragile X Syndrome

Purpose

Pragmatic language difficulties have been documented as part of the FMR1 premutation phenotype, yet the interplay between these features in mothers and the language outcomes of their children with fragile X syndrome is unknown. This study aimed to determine whether pragmatic language difficulties in mothers with the FMR1 premutation are related to the language development of their children.

Method

Twenty-seven mothers with the FMR1 premutation and their adolescent/young adult sons with fragile X syndrome participated. Maternal pragmatic language violations were rated from conversational samples using the Pragmatic Rating Scale (Landa et al., 1992). Children completed standardized assessments of vocabulary, syntax, and reading.

Results

Maternal pragmatic language difficulties were significantly associated with poorer child receptive vocabulary and expressive syntax skills, with medium effect sizes.

Conclusions

This work contributes to knowledge of the FMR1 premutation phenotype and its consequences at the family level, with the goal of identifying modifiable aspects of the child's language-learning environment that may promote the selection of treatments targeting the specific needs of families affected by fragile X. Findings contribute to our understanding of the multifaceted environment in which children with fragile X syndrome learn language and highlight the importance of family-centered intervention practices for this group.

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via IFTTT

Persistent Language Delay Versus Late Language Emergence in Children With Early Cochlear Implantation

Purpose

The purpose of the present investigation is to differentiate children using cochlear implants (CIs) who did or did not achieve age-appropriate language scores by midelementary grades and to identify risk factors for persistent language delay following early cochlear implantation.

Materials and Method

Children receiving unilateral CIs at young ages (12–38 months) were tested longitudinally and classified with normal language emergence (n = 19), late language emergence (n = 22), or persistent language delay (n = 19) on the basis of their test scores at 4.5 and 10.5 years of age. Relative effects of demographic, audiological, linguistic, and academic characteristics on language emergence were determined.

Results

Age at CI was associated with normal language emergence but did not differentiate late emergence from persistent delay. Children with persistent delay were more likely to use left-ear implants and older speech processor technology. They experienced higher aided thresholds and lower speech perception scores. Persistent delay was foreshadowed by low morphosyntactic and phonological diversity in preschool. Logistic regression analysis predicted normal language emergence with 84% accuracy and persistent language delay with 74% accuracy.

Conclusion

CI characteristics had a strong effect on persistent versus resolving language delay, suggesting that right-ear (or bilateral) devices, technology upgrades, and improved audibility may positively influence long-term language outcomes.

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via IFTTT

The Development of English as a Second Language With and Without Specific Language Impairment: Clinical Implications

Purpose

The purpose of this research forum article is to provide an overview of typical and atypical development of English as a second language (L2) and to present strategies for clinical assessment with English language learners (ELLs).

Method

A review of studies examining the lexical, morphological, narrative, and verbal memory abilities of ELLs is organized around 3 topics: timeframe and characteristics of typical English L2 development, comparison of the English L2 development of children with and without specific language impairment (SLI), and strategies for more effective assessment with ELLs.

Results

ELLs take longer than 3 years to converge on monolingual norms and approach monolingual norms asynchronously across linguistic subdomains. Individual variation is predicted by age, first language, language learning aptitude, length of exposure to English in school, maternal education, and richness of the English environment outside school. ELLs with SLI acquire English more slowly than ELLs with typical development; their morphological and nonword repetition abilities differentiate them the most. Use of strategies such as parent questionnaires on first language development and ELL norm referencing can result in accurate discrimination of ELLs with SLI.

Conclusions

Variability in the language abilities of ELLs presents challenges for clinical practice. Increased knowledge of English language learning development with and without SLI together with evidence-based alternative assessment strategies can assist in overcoming these challenges.

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via IFTTT

Effects of Removing Low-Frequency Electric Information on Speech Perception With Bimodal Hearing

Purpose

The objective was to determine whether speech perception could be improved for bimodal listeners (those using a cochlear implant [CI] in one ear and hearing aid in the contralateral ear) by removing low-frequency information provided by the CI, thereby reducing acoustic–electric overlap.

Method

Subjects were adult CI subjects with at least 1 year of CI experience. Nine subjects were evaluated in the CI-only condition (control condition), and 26 subjects were evaluated in the bimodal condition. CIs were programmed with 4 experimental programs in which the low cutoff frequency (LCF) was progressively raised. Speech perception was evaluated using Consonant-Nucleus-Consonant words in quiet, AzBio sentences in background babble, and spondee words in background babble.

Results

The CI-only group showed decreased speech perception in both quiet and noise as the LCF was raised. Bimodal subjects with better hearing in the hearing aid ear ( 60 dB HL at 250 and 500 Hz) performed similarly to the CI-only group.

Conclusions

These findings suggest that reducing low-frequency overlap of the CI and contralateral hearing aid may improve performance in quiet for some bimodal listeners with better hearing.

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