A Formant Range Profile for Singers

Publication date: Available online 28 October 2016
Source:Journal of Voice
Author(s): Ingo R. Titze, Lynn M. Maxfield, Megan C. Walker
Vowel selection is important in differentiating between singing styles. The timbre of the vocal instrument, which is related to its frequency spectrum, is governed by both the glottal sound source and the vowel choices made by singers. Consequently, the ability to modify the vowel space is a measure of how successfully a singer can maintain a desired timbre across a range of pitches. Formant range profiles were produced as a means of quantifying this ability. Seventy-seven subjects (including trained and untrained vocalists) participated, producing vowels with three intended mouth shapes: (1) neutral or speech-like, (2) megaphone-shaped (wide open mouth), and (3) inverted-megaphone-shaped (widened oropharynx with moderate mouth opening). The first and second formant frequencies (F1 and F2) were estimated with fry phonation for each shape and values were plotted in F1-F2 space. By taking four vowels of a quadrangle /i, æ, a, u/, the resulting area was quantified in kHz² (kHz squared) as a measure of the subject's ability to modify their vocal tract for spectral differences.



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Period for Normalization of Voice Acoustic Parameters in Indian Pediatric Cochlear Implantees

Publication date: Available online 28 October 2016
Source:Journal of Voice
Author(s): Jeena V. Joy, Shweta Deshpande, Dr. Neelam Vaid
ObjectiveThe purpose of this study was to investigate the duration required by children with cochlear implants to approximate the norms of voice acoustic parameters.Study DesignThe study design is retrospective.MethodsThirty children with cochlear implants (chronological ages ranging between 4.1 and 6.7 years) were divided into three groups, based on the postimplantation duration. Ten normal-hearing children (chronological ages ranging between 4 and 7 years) were selected as the control group. All implanted children underwent an objective voice analysis using Dr. Speech software (Tiger DRS, Inc., Seattle, WA, USA) at 6 months and at 1 and 2 years of implant use. Voice analysis was done for the children in the control group and means were derived for all the parameters analyzed to obtain the normal values. Habitual fundamental frequency (HFF), jitter (frequency variation), and shimmer (amplitude variation) were the voice acoustic parameters analyzed for the vowels |a|, |i|, and |u|. The obtained values of these parameters were then compared with the norms.ResultsHFF for the children with implant use for 6 months and 1 year did significantly differ from the control group. However, there was no significant difference (P > 0.5) observed in the children with implant use for 2 years, thus matching the norms. Jitter and shimmer showed a significant difference (P < 0.5) even at 2 years of implant use when compared with the control group.ConclusionsThe findings of the study divulge that children with cochlear implants approximate age-matched normal-hearing kids with respect to the voice acoustic parameter of HFF by 2 years of implant use. However, jitter and shimmer were not found to stabilize for the duration studied.



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Speech Adjustments for Room Acoustics and Their Effects on Vocal Effort

Publication date: Available online 28 October 2016
Source:Journal of Voice
Author(s): Pasquale Bottalico
ObjectivesThe aims of the present study are (1) to analyze the effects of the acoustical environment and the voice style on time dose (Dt_p) and fundamental frequency (mean f0 and standard deviation std_f0) while taking into account the effect of short-term vocal fatigue and (2) to predict the self-reported vocal effort from the voice acoustical parameters.MethodsTen male and ten female subjects were recorded while reading a text in normal and loud styles, in three rooms—anechoic, semi-reverberant, and reverberant—with and without acrylic glass panels 0.5 m from the mouth, which increased external auditory feedback. Subjects quantified how much effort was required to speak in each condition on a visual analogue scale after each task.Results(Aim1) In the loud style, Dt_p, f0, and std_f0 increased. The Dt_p was higher in the reverberant room compared to the other two rooms. Both genders tended to increase f0 in less reverberant environments, whereas a more monotonous speech was produced in rooms with greater reverberation. All three voice parameters increased with short-term vocal fatigue. (Aim2) A model of the vocal effort to acoustic vocal parameters is proposed. The sound pressure level contributed to 66% of the variance explained by the model, followed by the f0 (30%) and the modulation in amplitude (4%).ConclusionsThe results provide insight into how voice acoustical parameters can predict vocal effort. In particular, it increased when SPL and f0 increased and when the amplitude voice modulation decreased.



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Joint Engagement and Early Language in Young Children With Fragile X Syndrome

Purpose

In this study, we examine joint engagement (JE) in young children with fragile X syndrome (FXS) and its relationship to language abilities and autism spectrum disorder symptomatology at 24 to 36 months (toddler period) and 59 to 68 months (child period).

Method

Participants were 28 children with FXS (24 boys, four girls) and their mothers. Videotaped home observations were conducted during the toddler period and coded for JE. Language abilities were measured at both ages from a developmental assessment, a functional measure, and from a language sample. The Childhood Autism Rating Scale (Schopler, Reichler, & Renner, 1988) was completed at both ages.

Results

Children with FXS spent more time in supported JE than in coordinated JE. Using a weighted JE variable, we found that children with FXS who had higher weighted JE scores also had more advanced expressive language skills at both the toddler and child periods. Weighted JE was negatively related to autism symptomatology in the toddler period.

Conclusion

This study provides evidence that children with FXS who use more JE also have more advanced expressive language skills in early development. Therefore, existing early interventions that target JE behaviors may be effective for promoting language, social communication, and social interaction in this population.

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Epidemiology of Vocal Health in Young Adults Attending College in the United States

Purpose

The purpose of this study was to document typical vocal health characteristics (including voice-related activities, behaviors, and symptomatology) of young adults attending college and to determine lifetime and point prevalence rates of voice disorders.

Method

Undergraduates at University of Wisconsin–Madison completed an anonymous online survey detailing vocal use, symptomatology, impact, sociodemographics, and voice-related quality of life. Univariate analyses and multivariate regression models isolated risk factors for lifetime and point prevalence rates of a voice disorder.

Results

Vocal health and associated factors were analyzed for 652 students (predominantly 18–25 years of age). Lifetime prevalence rate of a voice disorder was 33.9% (point prevalence = 4.45%). Change in voice function (odds ratio [OR] = 2.77), seasonal or chronic postnasal drip (OR = 2.11), hoarseness (OR = 2.08), and restrictions to social activity (OR = 2.07; all p Conclusions

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Comprehension of Inferences in a Narrative in 3- to 6-Year-Old Children

Purpose

This study aimed to describe the development of inferential abilities of children age 3 to 6 years in a narrative using a dialogic reading task on an iPad.

Method

Participants were 121 typically developing children, divided into 3 groups according to age range (3–4 years old, 4–5 years old, 5–6 years old). Total score of inferential comprehension, subscores by causal inference type targeting elements of the story grammar, and quality of response were examined across groups.

Results

Inferential comprehension emerged early, from 3 to 4 years old, with considerable interindividual variability. Inferential comprehension scores increased significantly in relation to age, leading to developmental steps with regards to the type of causal inferences. The ability to infer the problem of the story, the internal response of a character, and predictions were easier starting at age 4 years. Then, the 5- to 6-year-olds were better able to infer the goal, the attempt to solve the problem, and the resolution. Last, between the ages of 3 and 6 years, children improved in terms of the quality of response they provided.

Conclusion

This study addresses important gaps in our knowledge of inferential comprehension in young children and has implications for planning of early education in this realm.

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An Item Analysis of the French Version of the Test for Reception of Grammar Among Children and Adolescents With Down Syndrome or Intellectual Disability of Undifferentiated Etiology

Purpose

An item analysis of Bishop's (1983) Test for Reception of Grammar (TROG) in its French version (F-TROG; Lecocq, 1996) was conducted to determine whether the difficulty of items is similar for participants with or without intellectual disability (ID).

Method

In Study 1, responses to the 92 F-TROG items by 55 participants with Down syndrome (DS), 55 with ID of undifferentiated etiology (UND), and 55 typical children (TYP) matched on their F-TROG total score were compared using the transformed item difficulties method, a statistical approach designed to detect differential item functioning (DIF) between groups. In Study 2, an additional comparison involving 526 TYP participants and 526 participants with UND was conducted to increase the statistical power of the analysis.

Results

The difficulty of items was highly similar whatever the sample size or clinical status of participants. Fewer than 3.5% of the items were flagged as showing DIF.

Conclusions

Tests such as the TROG can be used with confidence in clinical practice as well as in research studies comparing participants with or without ID. Methods designed for investigating potential internal test bias—such as done here—should be more regularly employed in the developmental disability field to affirm the absence of DIF.

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Towards a Theory of Learning for Naming Rehabilitation: Retrieval Practice and Spacing Effects

Purpose

The purpose of this article was to examine how different types of learning experiences affect naming impairment in aphasia.

Methods

In 4 people with aphasia with naming impairment, we compared the benefits of naming treatment that emphasized retrieval practice (practice retrieving target names from long-term memory) with errorless learning (repetition training, which preempts retrieval practice) according to different schedules of learning. The design was within subjects. Items were administered for multiple training trials for retrieval practice or repetition in a spaced schedule (an item's trials were separated by multiple unrelated trials) or massed schedule (1 trial intervened between an item's trials). In the spaced condition, we studied 3 magnitudes of spacing to evaluate the impact of effortful retrieval during training on the ultimate benefits conferred by retrieval practice naming treatment. The primary outcome was performance on a retention test of naming after 1 day, with a follow-up test after 1 week.

Results

Group analyses revealed that retrieval practice outperformed errorless learning, and spaced learning outperformed massed learning at retention test and at follow-up. Increases in spacing in the retrieval practice condition yielded more robust learning of retrieved information.

Conclusion

This study delineates the importance of retrieval practice and spacing for treating naming impairment in aphasia.

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Short-Term Memory Performance in 7- and 8-Year-Old Children: The Relationship Between Phonological and Pitch Processing

Purpose

The relationship between short-term memory for phonology and pitch was explored by examining accuracy scores for typically developing children for 5 experimental tasks: immediate nonword repetition (NWR), nonword repetition with an 8-s silent interference (NWRS), pitch discrimination (PD), pitch discrimination with an 8-s silent interference (PDS), and pitch matching (PM).

Method

Thirty-six 7- and 8-year-old children (21 girls, 15 boys) with normal hearing, language, and cognition were asked to listen to and repeat nonsense words (NWR, NWRS), make a same versus different decision between 2 tones (PD, PDS), and listen to and then vocally reproduce a tone (PM).

Results

Results showed no significant correlations between tasks of phonological memory and tests of pitch memory, that participants scored significantly better on nonword repetition tasks than PD and PM tasks, and that participants performed significantly better on tasks with no silent interference.

Discussion

These findings suggest that, for typically developing children, pitch may be stored and rehearsed in a separate location than phonological information. Because of fundamental task differences, further research is needed to corroborate these data and determine the presence of developmental effects and neuroanatomical locations where a potential language/music overlap is occurring in children.

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Automated Proposition Density Analysis for Discourse in Aphasia

Purpose

This study evaluates how proposition density can differentiate between persons with aphasia (PWA) and individuals in a control group, as well as among subtypes of aphasia, on the basis of procedural discourse and personal narratives collected from large samples of participants.

Method

Participants were 195 PWA and 168 individuals in a control group from the AphasiaBank database. PWA represented 6 aphasia types on the basis of the Western Aphasia Battery–Revised (Kertesz, 2006). Narrative samples were stroke stories for PWA and illness or injury stories for individuals in the control group. Procedural samples were from the peanut-butter-and-jelly-sandwich task. Language samples were transcribed using Codes for the Human Analysis of Transcripts (MacWhinney, 2000) and analyzed using Computerized Language Analysis (MacWhinney, 2000), which automatically computes proposition density (PD) using rules developed for automatic PD measurement by the Computerized Propositional Idea Density Rater program (Brown, Snodgrass, & Covington, 2007; Covington, 2007).

Results

Participants in the control group scored significantly higher than PWA on both tasks. PD scores were significantly different among the aphasia types for both tasks. Pairwise comparisons for both discourse tasks revealed that PD scores for the Broca's group were significantly lower than those for all groups except Transcortical Motor. No significant quadratic or linear association between PD and severity was found.

Conclusion

Proposition density is differentially sensitive to aphasia type and most clearly differentiates individuals with Broca's aphasia from the other groups.

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Exploring the Clinical Utility of Relative Fundamental Frequency as an Objective Measure of Vocal Hyperfunction

Purpose

Vocal hyperfunction, related to abnormal laryngeal muscle activity, is considered the proximal cause of primary muscle tension dysphonia (pMTD). Relative fundamental frequency (RFF) has been proposed as an objective acoustic marker of vocal hyperfunction. This study examined (a) the ability of RFF to track changes in vocal hyperfunction after treatment for pMTD and (b) the influence of dysphonia severity, among other factors, on the feasibility of RFF computation.

Method

RFF calculations and dysphonia severity ratings were derived from pre- and posttreatment recordings from 111 women with pMTD and 20 healthy controls. Three vowel–voiceless consonant–vowel stimuli were analyzed.

Results

RFF onset slope consistently varied as a function of group (pMTD vs. controls) and time (pretherapy vs. posttherapy). Significant correlations between RFF onset cycle 1 and dysphonia severity were observed. However, in many samples, RFF could not be computed, and adjusted odds ratios revealed that these unanalyzable data were linked to dysphonia severity, phonetic (vowel–voiceless consonant–vowel) context, and group (pMTD vs. control).

Conclusions

RFF onset appears to be sensitive to the presence and degree of suspected vocal hyperfunction before and after therapy. The large number of unanalyzable samples (related especially to dysphonia severity in the pMTD group) represents an important limitation.

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Objective Measure of Nasal Air Emission Using Nasal Accelerometry

Purpose

This article describes the development and initial validation of an objective measure of nasal air emission (NAE) using nasal accelerometry.

Method

Nasal acceleration and nasal airflow signals were simultaneously recorded while an expert speech language pathologist modeled NAEs at a variety of severity levels. In addition, microphone and nasal accelerometer signals were collected during the production of /pɑpɑpɑpɑ/ speech utterances by 25 children with and without cleft palate. Fourteen inexperienced raters listened to the microphone signals from the pediatric speakers and rated the samples for the severity of NAE using direct magnitude estimation. Mean listener ratings were compared to a novel quantitative measurement of NAE derived from the nasal acceleration signals.

Results

Correlation between the nasal acceleration energy measure and the measured nasal airflow was high (r = .87). Correlation between the measure and auditory-perceptual ratings was moderate (r = .49).

Conclusion

The measure presented here is quantitative and noninvasive, and the required hardware is inexpensive ($150). Future studies will include speakers with a wider range of NAE severity and etiology, including cleft palate, hearing impairment, or dysarthria. Further development will also involve validation of the measure against airflow measures across subjects.

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Dyslexia Limits the Ability to Categorize Talker Dialect

Purpose

The purpose of this study was to determine whether the underlying phonological impairment in dyslexia is associated with a deficit in categorizing regional dialects.

Method

Twenty adults with dyslexia, 20 school-age children with dyslexia, and 40 corresponding control listeners with average reading ability listened to sentences produced by multiple talkers (both sexes) representing two dialects: Midland dialect in Ohio (same as listeners' dialect) and Southern dialect in Western North Carolina. Participants' responses were analyzed using signal detection theory.

Results

Listeners with dyslexia were less sensitive to talker dialect than listeners with average reading ability. Children were less sensitive to dialect than adults. Under stimulus uncertainty, listeners with average reading ability were biased toward Ohio dialect, whereas listeners with dyslexia were unbiased in their responses. Talker sex interacted with sensitivity and bias differently for listeners with dyslexia than for listeners with average reading ability. The correlations between dialect sensitivity and phonological memory scores were strongest for adults with dyslexia.

Conclusions

The results imply that the phonological deficit in dyslexia arises from impaired access to intact phonological representations rather than from poorly specified representations. It can be presumed that the impeded access to implicit long-term memory representations for indexical (dialect) information is due to less efficient operations in working memory, including deficiencies in utilizing talker normalization processes.

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Effects of Biofeedback on Control and Generalization of Nasalization in Typical Speakers

Purpose

The purpose of this study was to determine the effects of biofeedback on control of nasalization in individuals with typical speech.

Method

Forty-eight individuals with typical speech attempted to increase and decrease vowel nasalization. During training, stimuli consisted of consonant-vowel-consonant (CVC) tokens with the center vowels /a/ or /i/ in either a nasal or nonnasal phonemic context (e.g., /mim/ vs. /bib/), depending on the participant’s training group. Half of the participants had access to augmentative visual feedback during training, which was based on a less-invasive acoustic, accelerometric measure of vowel nasalization—the Horii oral–nasal coupling (HONC) score. During pre- and posttraining assessments, acoustically based nasalance was also measured from the center vowels /a/, /i/, /æ/, and /u/ of CVCs in both nasal and nonnasal contexts.

Results

Linear regressions indicated that both phonemic contexts (nasal or nonnasal) and the presence of augmentative visual feedback during training were significant predictors for changes in nasalance scores from pre- to posttraining.

Conclusions

Participants were able to change the nasalization of their speech following a training period with HONC biofeedback. Future work is necessary to examine the effect of such training in individuals with velopharyngeal dysfunction.

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Effects of Noise on Speech Recognition and Listening Effort in Children With Normal Hearing and Children With Mild Bilateral or Unilateral Hearing Loss

Purpose

This study examined the effects of stimulus type and hearing status on speech recognition and listening effort in children with normal hearing (NH) and children with mild bilateral hearing loss (MBHL) or unilateral hearing loss (UHL).

Method

Children (5–12 years of age) with NH (Experiment 1) and children (8–12 years of age) with MBHL, UHL, or NH (Experiment 2) performed consonant identification and word and sentence recognition in background noise. Percentage correct performance and verbal response time (VRT) were assessed (onset time, total duration).

Results

In general, speech recognition improved as signal-to-noise ratio (SNR) increased both for children with NH and children with MBHL or UHL. The groups did not differ on measures of VRT. Onset times were longer for incorrect than for correct responses. For correct responses only, there was a general increase in VRT with decreasing SNR.

Conclusions

Findings indicate poorer sentence recognition in children with NH and MBHL or UHL as SNR decreases. VRT results suggest that greater effort was expended when processing stimuli that were incorrectly identified. Increasing VRT with decreasing SNR for correct responses also supports greater effort in poorer acoustic conditions. The absence of significant hearing status differences suggests that VRT was not differentially affected by MBHL, UHL, or NH for children in this study.

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Screening for Language Delay: Growth Trajectories of Language Ability in Low- and High-Performing Children

Purpose

This study investigated the stability and growth of preschool language skills and explores latent class analysis as an approach for identifying children at risk of language impairment.

Method

The authors present data from a large-scale 2-year longitudinal study, in which 600 children were assessed with a language-screening tool (LANGUAGE4) at age 4 years. A subsample (n = 206) was assessed on measures of sentence repetition, vocabulary, and grammatical knowledge at ages 4, 5, and 6 years.

Results

A global latent language factor showed a high degree of longitudinal stability in children between the ages of 4 to 6 years. A low-performing group showing a language deficit compared to their age peers at age 4 was identified on the basis of the LANGUAGE4. The growth-rates during this 2-year time period were parallel for the low-performing and 3 higher performing groups of children.

Conclusions

There is strong stability in children's language skills between the ages of 4 and 6 years. The results demonstrate that a simple language screening measure can successfully identify a low-performing group of children who show persistent language weaknesses between the ages of 4 and 6 years.

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The Palin Parent Rating Scales: Parents' Perspectives of Childhood Stuttering and Its Impact

Purpose

The goal of this study is to explore the psychometric properties of the Parent Rating Scales–V1 (S. K. Millard, S. Edwards, & F. M. Cook, 2009), an assessment tool for parents of children who stutter, and to refine the measure accordingly.

Method

We included 259 scales completed prior to therapy. An exploratory factor analysis determined the test constructs and identified the items that had greatest loadings on those factors. Items that did not load on the factors were removed, and normative scores calculated.

Results

The resulting 19-item questionnaire measures three factors: (a) the impact of stuttering on the child; (b) the severity of stuttering and its impact on the parents; and (c) the parents' knowledge about stuttering and confidence in managing it. Reliability was demonstrated, norms established, and an automated online version constructed.

Conclusions

The Palin Parent Rating Scale is a valid and reliable tool, providing a method of exploring parents' perceptions of stuttering, the impact it has on the child and themselves, and the parents' knowledge of and confidence in managing the stuttering. This is an important addition to the existing range of assessments that may be used to evaluate stuttering in children up to age 14;6 (years;months) and allows the wider targets of parent-led therapy programs to be evaluated.

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Examining the Language Phenotype in Children With Typical Development, Specific Language Impairment, and Fragile X Syndrome

Purpose

One aspect of morphosyntax, finiteness marking, was compared in children with fragile X syndrome (FXS), specific language impairment (SLI), and typical development matched on mean length of utterance (MLU).

Method

Nineteen children with typical development (mean age = 3.3 years), 20 children with SLI (mean age = 4.9 years), and 17 boys with FXS (mean age = 11.9 years) completed the Test of Early Grammatical Impairment (TEGI; Rice & Wexler, 2001), and other cognitive and language assessments. Quantitative comparisons on finiteness marking and qualitative comparisons of unscorable (i.e., nontarget) TEGI responses were conducted.

Results

Children with typical development and FXS performed better on finiteness marking than children with SLI. Although unscorable responses were infrequent, boys with FXS produced more unscorable responses than children with typical development and SLI.

Conclusions

Although boys with FXS have language deficits, they performed similarly to MLU-matched typically developing children on finiteness marking. This language profile differs from children with SLI, who present with a delay-within-a-delay profile with finiteness marking delays that exceed delays in MLU. Unscorable responses produced by the boys with FXS may reflect pragmatic deficits, which are prominent in this population. Assessment procedures should be carefully considered when examining language in boys with FXS.

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Glimpsing Speech in the Presence of Nonsimultaneous Amplitude Modulations From a Competing Talker: Effect of Modulation Rate, Age, and Hearing Loss

Purpose

This study investigated how listeners process acoustic cues preserved during sentences interrupted by nonsimultaneous noise that was amplitude modulated by a competing talker.

Method

Younger adults with normal hearing and older adults with normal or impaired hearing listened to sentences with consonants or vowels replaced with noise amplitude modulated by a competing talker. Sentences were spectrally shaped according to individual audiograms or to the mean audiogram from the listeners with hearing impairment for a younger spectrally shaped control group. The modulation spectrum of the noise was low-pass filtered at different modulation cutoff frequencies. The effect of noise level was also examined.

Results

Performance declined when nonsimultaneous masker modulation included faster rates and was maximized when masker modulation matched the preserved primary speech modulation. Vowels resulted in better performance compared with consonants at slower modulation cutoff rates, likely due to suprasegmental features. Poorer overall performance was observed with increased age or hearing loss, and for listeners who received spectrally shaped speech.

Conclusions

Nonsimultaneous amplitude modulations from a competing talker significantly interacted with the preserved speech segment, and additional listener factors were observed for age and hearing loss. Importantly, listeners may obtain benefit from nonsimultaneous competing modulations when they match the preserved modulations of the sentence.

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Longitudinal Effects on Early Adolescent Language: A Twin Study

Purpose

We evaluated genetic and environmental contributions to individual differences in language skills during early adolescence, measured by both language sampling and standardized tests, and examined the extent to which these genetic and environmental effects are stable across time.

Method

We used structural equation modeling on latent factors to estimate additive genetic, shared environmental, and nonshared environmental effects on variance in standardized language skills (i.e., Formal Language) and productive language-sample measures (i.e., Productive Language) in a sample of 527 twins across 3 time points (mean ages 10–12 years).

Results

Individual differences in the Formal Language factor were influenced primarily by genetic factors at each age, whereas individual differences in the Productive Language factor were primarily due to nonshared environmental influences. For the Formal Language factor, the stability of genetic effects was high across all 3 time points. For the Productive Language factor, nonshared environmental effects showed low but statistically significant stability across adjacent time points.

Conclusions

The etiology of language outcomes may differ substantially depending on assessment context. In addition, the potential mechanisms for nonshared environmental influences on language development warrant further investigation.

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Patient-Reported Measures of Hearing Loss and Tinnitus in Pediatric Cancer and Hematopoietic Stem Cell Transplantation: A Systematic Review

Purpose

We identified studies that described use of any patient-reported outcome scale for hearing loss or tinnitus among children and adolescents and young adults (AYAs) with cancer or hematopoietic stem cell transplantation (HSCT) recipients.

Method

In this systematic review, we performed electronic searches of OvidSP MEDLINE, EMBASE, and PsycINFO to August 2015. We included studies if they used any patient-reported scale of hearing loss or tinnitus among children and AYAs with cancer or HSCT recipients. Only English language publications were included. Two reviewers identified studies and abstracted data.

Results

There were 953 studies screened; 6 met eligibility criteria. All studies administered hearing patient-reported outcomes only once, after therapy completion. None of the studies described the psychometric properties of the hearing-specific component. Three instruments (among 6 studies) were used: Health Utilities Index (Barr et al., 2000; Fu et al., 2006; Kennedy et al., 2014), Hearing Measurement Scales (Einar-Jon et al., 2011; Einarsson et al., 2011), and the Tinnitus Questionnaire for Auditory Brainstem Implant (Soussi & Otto, 1994). All had limitations, precluding routine use for hearing assessment in this population.

Conclusions

We identified few studies that included hearing patient-reported measures for children and AYA cancer and HSCT patients. None are ideal to take forward into future studies. Future work should focus on the creation of a new psychometrically sound instrument for hearing outcomes in this population.

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Executive Functions in Children With Specific Language Impairment: A Meta-Analysis

Purpose

Mounting evidence demonstrates deficits in children with specific language impairment (SLI) beyond the linguistic domain. Using meta-analysis, this study examined differences in children with and without SLI on tasks measuring inhibition and cognitive flexibility.

Method

Databases were searched for articles comparing children (4–14 years) with and without SLI on behavioral measures of inhibition or cognitive flexibility. Weighted average effect size was calculated using multilevel modeling to measure potential group differences.

Results

The analysis included 46 studies. Of those, 34 included inhibitory control measures and 22 included cognitive flexibility tasks. Children with SLI performed below same-aged peers on both inhibitory control tasks (g = −.56) and cognitive flexibility tasks (g = −.27). Moderator analyses showed no effect of linguistic task demands, participant age, or severity of language impairment on the degree of difference between children with SLI and controls on measures of inhibitory control.

Conclusion

Reliable differences between children with and without SLI were found on inhibition and cognitive flexibility tasks. A moderate group effect was found for inhibition tasks, but there was only a small effect for cognitive flexibility tasks. Results of moderator analyses suggest that these deficits are present throughout development despite task demands or severity of linguistic impairment.

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Lidcombe Program Webcam Treatment for Early Stuttering: A Randomized Controlled Trial

Purpose

Webcam treatment is potentially useful for health care in cases of early stuttering in which clients are isolated from specialized treatment services for geographic and other reasons. The purpose of the present trial was to compare outcomes of clinic and webcam deliveries of the Lidcombe Program treatment (Packman et al., 2015) for early stuttering.

Method

The design was a parallel, open plan, noninferiority randomized controlled trial of the standard Lidcombe Program treatment and the experimental webcam Lidcombe Program treatment. Participants were 49 children aged 3 years 0 months to 5 years 11 months at the start of treatment. Primary outcomes were the percentage of syllables stuttered at 9 months postrandomization and the number of consultations to complete Stage 1 of the Lidcombe Program.

Results

There was insufficient evidence of a posttreatment difference of the percentage of syllables stuttered between the standard and webcam Lidcombe Program treatments. There was insufficient evidence of a difference between the groups for typical stuttering severity measured by parents or the reported clinical relationship with the treating speech-language pathologist.

Conclusions

This trial confirmed the viability of the webcam Lidcombe Program intervention. It appears to be as efficacious and economically viable as the standard, clinic Lidcombe Program treatment.

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Joint Engagement and Early Language in Young Children With Fragile X Syndrome

Purpose

In this study, we examine joint engagement (JE) in young children with fragile X syndrome (FXS) and its relationship to language abilities and autism spectrum disorder symptomatology at 24 to 36 months (toddler period) and 59 to 68 months (child period).

Method

Participants were 28 children with FXS (24 boys, four girls) and their mothers. Videotaped home observations were conducted during the toddler period and coded for JE. Language abilities were measured at both ages from a developmental assessment, a functional measure, and from a language sample. The Childhood Autism Rating Scale (Schopler, Reichler, & Renner, 1988) was completed at both ages.

Results

Children with FXS spent more time in supported JE than in coordinated JE. Using a weighted JE variable, we found that children with FXS who had higher weighted JE scores also had more advanced expressive language skills at both the toddler and child periods. Weighted JE was negatively related to autism symptomatology in the toddler period.

Conclusion

This study provides evidence that children with FXS who use more JE also have more advanced expressive language skills in early development. Therefore, existing early interventions that target JE behaviors may be effective for promoting language, social communication, and social interaction in this population.

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Epidemiology of Vocal Health in Young Adults Attending College in the United States

Purpose

The purpose of this study was to document typical vocal health characteristics (including voice-related activities, behaviors, and symptomatology) of young adults attending college and to determine lifetime and point prevalence rates of voice disorders.

Method

Undergraduates at University of Wisconsin–Madison completed an anonymous online survey detailing vocal use, symptomatology, impact, sociodemographics, and voice-related quality of life. Univariate analyses and multivariate regression models isolated risk factors for lifetime and point prevalence rates of a voice disorder.

Results

Vocal health and associated factors were analyzed for 652 students (predominantly 18–25 years of age). Lifetime prevalence rate of a voice disorder was 33.9% (point prevalence = 4.45%). Change in voice function (odds ratio [OR] = 2.77), seasonal or chronic postnasal drip (OR = 2.11), hoarseness (OR = 2.08), and restrictions to social activity (OR = 2.07; all p Conclusions

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Comprehension of Inferences in a Narrative in 3- to 6-Year-Old Children

Purpose

This study aimed to describe the development of inferential abilities of children age 3 to 6 years in a narrative using a dialogic reading task on an iPad.

Method

Participants were 121 typically developing children, divided into 3 groups according to age range (3–4 years old, 4–5 years old, 5–6 years old). Total score of inferential comprehension, subscores by causal inference type targeting elements of the story grammar, and quality of response were examined across groups.

Results

Inferential comprehension emerged early, from 3 to 4 years old, with considerable interindividual variability. Inferential comprehension scores increased significantly in relation to age, leading to developmental steps with regards to the type of causal inferences. The ability to infer the problem of the story, the internal response of a character, and predictions were easier starting at age 4 years. Then, the 5- to 6-year-olds were better able to infer the goal, the attempt to solve the problem, and the resolution. Last, between the ages of 3 and 6 years, children improved in terms of the quality of response they provided.

Conclusion

This study addresses important gaps in our knowledge of inferential comprehension in young children and has implications for planning of early education in this realm.

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An Item Analysis of the French Version of the Test for Reception of Grammar Among Children and Adolescents With Down Syndrome or Intellectual Disability of Undifferentiated Etiology

Purpose

An item analysis of Bishop's (1983) Test for Reception of Grammar (TROG) in its French version (F-TROG; Lecocq, 1996) was conducted to determine whether the difficulty of items is similar for participants with or without intellectual disability (ID).

Method

In Study 1, responses to the 92 F-TROG items by 55 participants with Down syndrome (DS), 55 with ID of undifferentiated etiology (UND), and 55 typical children (TYP) matched on their F-TROG total score were compared using the transformed item difficulties method, a statistical approach designed to detect differential item functioning (DIF) between groups. In Study 2, an additional comparison involving 526 TYP participants and 526 participants with UND was conducted to increase the statistical power of the analysis.

Results

The difficulty of items was highly similar whatever the sample size or clinical status of participants. Fewer than 3.5% of the items were flagged as showing DIF.

Conclusions

Tests such as the TROG can be used with confidence in clinical practice as well as in research studies comparing participants with or without ID. Methods designed for investigating potential internal test bias—such as done here—should be more regularly employed in the developmental disability field to affirm the absence of DIF.

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Towards a Theory of Learning for Naming Rehabilitation: Retrieval Practice and Spacing Effects

Purpose

The purpose of this article was to examine how different types of learning experiences affect naming impairment in aphasia.

Methods

In 4 people with aphasia with naming impairment, we compared the benefits of naming treatment that emphasized retrieval practice (practice retrieving target names from long-term memory) with errorless learning (repetition training, which preempts retrieval practice) according to different schedules of learning. The design was within subjects. Items were administered for multiple training trials for retrieval practice or repetition in a spaced schedule (an item's trials were separated by multiple unrelated trials) or massed schedule (1 trial intervened between an item's trials). In the spaced condition, we studied 3 magnitudes of spacing to evaluate the impact of effortful retrieval during training on the ultimate benefits conferred by retrieval practice naming treatment. The primary outcome was performance on a retention test of naming after 1 day, with a follow-up test after 1 week.

Results

Group analyses revealed that retrieval practice outperformed errorless learning, and spaced learning outperformed massed learning at retention test and at follow-up. Increases in spacing in the retrieval practice condition yielded more robust learning of retrieved information.

Conclusion

This study delineates the importance of retrieval practice and spacing for treating naming impairment in aphasia.

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Short-Term Memory Performance in 7- and 8-Year-Old Children: The Relationship Between Phonological and Pitch Processing

Purpose

The relationship between short-term memory for phonology and pitch was explored by examining accuracy scores for typically developing children for 5 experimental tasks: immediate nonword repetition (NWR), nonword repetition with an 8-s silent interference (NWRS), pitch discrimination (PD), pitch discrimination with an 8-s silent interference (PDS), and pitch matching (PM).

Method

Thirty-six 7- and 8-year-old children (21 girls, 15 boys) with normal hearing, language, and cognition were asked to listen to and repeat nonsense words (NWR, NWRS), make a same versus different decision between 2 tones (PD, PDS), and listen to and then vocally reproduce a tone (PM).

Results

Results showed no significant correlations between tasks of phonological memory and tests of pitch memory, that participants scored significantly better on nonword repetition tasks than PD and PM tasks, and that participants performed significantly better on tasks with no silent interference.

Discussion

These findings suggest that, for typically developing children, pitch may be stored and rehearsed in a separate location than phonological information. Because of fundamental task differences, further research is needed to corroborate these data and determine the presence of developmental effects and neuroanatomical locations where a potential language/music overlap is occurring in children.

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Automated Proposition Density Analysis for Discourse in Aphasia

Purpose

This study evaluates how proposition density can differentiate between persons with aphasia (PWA) and individuals in a control group, as well as among subtypes of aphasia, on the basis of procedural discourse and personal narratives collected from large samples of participants.

Method

Participants were 195 PWA and 168 individuals in a control group from the AphasiaBank database. PWA represented 6 aphasia types on the basis of the Western Aphasia Battery–Revised (Kertesz, 2006). Narrative samples were stroke stories for PWA and illness or injury stories for individuals in the control group. Procedural samples were from the peanut-butter-and-jelly-sandwich task. Language samples were transcribed using Codes for the Human Analysis of Transcripts (MacWhinney, 2000) and analyzed using Computerized Language Analysis (MacWhinney, 2000), which automatically computes proposition density (PD) using rules developed for automatic PD measurement by the Computerized Propositional Idea Density Rater program (Brown, Snodgrass, & Covington, 2007; Covington, 2007).

Results

Participants in the control group scored significantly higher than PWA on both tasks. PD scores were significantly different among the aphasia types for both tasks. Pairwise comparisons for both discourse tasks revealed that PD scores for the Broca's group were significantly lower than those for all groups except Transcortical Motor. No significant quadratic or linear association between PD and severity was found.

Conclusion

Proposition density is differentially sensitive to aphasia type and most clearly differentiates individuals with Broca's aphasia from the other groups.

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Exploring the Clinical Utility of Relative Fundamental Frequency as an Objective Measure of Vocal Hyperfunction

Purpose

Vocal hyperfunction, related to abnormal laryngeal muscle activity, is considered the proximal cause of primary muscle tension dysphonia (pMTD). Relative fundamental frequency (RFF) has been proposed as an objective acoustic marker of vocal hyperfunction. This study examined (a) the ability of RFF to track changes in vocal hyperfunction after treatment for pMTD and (b) the influence of dysphonia severity, among other factors, on the feasibility of RFF computation.

Method

RFF calculations and dysphonia severity ratings were derived from pre- and posttreatment recordings from 111 women with pMTD and 20 healthy controls. Three vowel–voiceless consonant–vowel stimuli were analyzed.

Results

RFF onset slope consistently varied as a function of group (pMTD vs. controls) and time (pretherapy vs. posttherapy). Significant correlations between RFF onset cycle 1 and dysphonia severity were observed. However, in many samples, RFF could not be computed, and adjusted odds ratios revealed that these unanalyzable data were linked to dysphonia severity, phonetic (vowel–voiceless consonant–vowel) context, and group (pMTD vs. control).

Conclusions

RFF onset appears to be sensitive to the presence and degree of suspected vocal hyperfunction before and after therapy. The large number of unanalyzable samples (related especially to dysphonia severity in the pMTD group) represents an important limitation.

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Objective Measure of Nasal Air Emission Using Nasal Accelerometry

Purpose

This article describes the development and initial validation of an objective measure of nasal air emission (NAE) using nasal accelerometry.

Method

Nasal acceleration and nasal airflow signals were simultaneously recorded while an expert speech language pathologist modeled NAEs at a variety of severity levels. In addition, microphone and nasal accelerometer signals were collected during the production of /pɑpɑpɑpɑ/ speech utterances by 25 children with and without cleft palate. Fourteen inexperienced raters listened to the microphone signals from the pediatric speakers and rated the samples for the severity of NAE using direct magnitude estimation. Mean listener ratings were compared to a novel quantitative measurement of NAE derived from the nasal acceleration signals.

Results

Correlation between the nasal acceleration energy measure and the measured nasal airflow was high (r = .87). Correlation between the measure and auditory-perceptual ratings was moderate (r = .49).

Conclusion

The measure presented here is quantitative and noninvasive, and the required hardware is inexpensive ($150). Future studies will include speakers with a wider range of NAE severity and etiology, including cleft palate, hearing impairment, or dysarthria. Further development will also involve validation of the measure against airflow measures across subjects.

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Dyslexia Limits the Ability to Categorize Talker Dialect

Purpose

The purpose of this study was to determine whether the underlying phonological impairment in dyslexia is associated with a deficit in categorizing regional dialects.

Method

Twenty adults with dyslexia, 20 school-age children with dyslexia, and 40 corresponding control listeners with average reading ability listened to sentences produced by multiple talkers (both sexes) representing two dialects: Midland dialect in Ohio (same as listeners' dialect) and Southern dialect in Western North Carolina. Participants' responses were analyzed using signal detection theory.

Results

Listeners with dyslexia were less sensitive to talker dialect than listeners with average reading ability. Children were less sensitive to dialect than adults. Under stimulus uncertainty, listeners with average reading ability were biased toward Ohio dialect, whereas listeners with dyslexia were unbiased in their responses. Talker sex interacted with sensitivity and bias differently for listeners with dyslexia than for listeners with average reading ability. The correlations between dialect sensitivity and phonological memory scores were strongest for adults with dyslexia.

Conclusions

The results imply that the phonological deficit in dyslexia arises from impaired access to intact phonological representations rather than from poorly specified representations. It can be presumed that the impeded access to implicit long-term memory representations for indexical (dialect) information is due to less efficient operations in working memory, including deficiencies in utilizing talker normalization processes.

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Effects of Biofeedback on Control and Generalization of Nasalization in Typical Speakers

Purpose

The purpose of this study was to determine the effects of biofeedback on control of nasalization in individuals with typical speech.

Method

Forty-eight individuals with typical speech attempted to increase and decrease vowel nasalization. During training, stimuli consisted of consonant-vowel-consonant (CVC) tokens with the center vowels /a/ or /i/ in either a nasal or nonnasal phonemic context (e.g., /mim/ vs. /bib/), depending on the participant’s training group. Half of the participants had access to augmentative visual feedback during training, which was based on a less-invasive acoustic, accelerometric measure of vowel nasalization—the Horii oral–nasal coupling (HONC) score. During pre- and posttraining assessments, acoustically based nasalance was also measured from the center vowels /a/, /i/, /æ/, and /u/ of CVCs in both nasal and nonnasal contexts.

Results

Linear regressions indicated that both phonemic contexts (nasal or nonnasal) and the presence of augmentative visual feedback during training were significant predictors for changes in nasalance scores from pre- to posttraining.

Conclusions

Participants were able to change the nasalization of their speech following a training period with HONC biofeedback. Future work is necessary to examine the effect of such training in individuals with velopharyngeal dysfunction.

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Effects of Noise on Speech Recognition and Listening Effort in Children With Normal Hearing and Children With Mild Bilateral or Unilateral Hearing Loss

Purpose

This study examined the effects of stimulus type and hearing status on speech recognition and listening effort in children with normal hearing (NH) and children with mild bilateral hearing loss (MBHL) or unilateral hearing loss (UHL).

Method

Children (5–12 years of age) with NH (Experiment 1) and children (8–12 years of age) with MBHL, UHL, or NH (Experiment 2) performed consonant identification and word and sentence recognition in background noise. Percentage correct performance and verbal response time (VRT) were assessed (onset time, total duration).

Results

In general, speech recognition improved as signal-to-noise ratio (SNR) increased both for children with NH and children with MBHL or UHL. The groups did not differ on measures of VRT. Onset times were longer for incorrect than for correct responses. For correct responses only, there was a general increase in VRT with decreasing SNR.

Conclusions

Findings indicate poorer sentence recognition in children with NH and MBHL or UHL as SNR decreases. VRT results suggest that greater effort was expended when processing stimuli that were incorrectly identified. Increasing VRT with decreasing SNR for correct responses also supports greater effort in poorer acoustic conditions. The absence of significant hearing status differences suggests that VRT was not differentially affected by MBHL, UHL, or NH for children in this study.

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Screening for Language Delay: Growth Trajectories of Language Ability in Low- and High-Performing Children

Purpose

This study investigated the stability and growth of preschool language skills and explores latent class analysis as an approach for identifying children at risk of language impairment.

Method

The authors present data from a large-scale 2-year longitudinal study, in which 600 children were assessed with a language-screening tool (LANGUAGE4) at age 4 years. A subsample (n = 206) was assessed on measures of sentence repetition, vocabulary, and grammatical knowledge at ages 4, 5, and 6 years.

Results

A global latent language factor showed a high degree of longitudinal stability in children between the ages of 4 to 6 years. A low-performing group showing a language deficit compared to their age peers at age 4 was identified on the basis of the LANGUAGE4. The growth-rates during this 2-year time period were parallel for the low-performing and 3 higher performing groups of children.

Conclusions

There is strong stability in children's language skills between the ages of 4 and 6 years. The results demonstrate that a simple language screening measure can successfully identify a low-performing group of children who show persistent language weaknesses between the ages of 4 and 6 years.

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The Palin Parent Rating Scales: Parents' Perspectives of Childhood Stuttering and Its Impact

Purpose

The goal of this study is to explore the psychometric properties of the Parent Rating Scales–V1 (S. K. Millard, S. Edwards, & F. M. Cook, 2009), an assessment tool for parents of children who stutter, and to refine the measure accordingly.

Method

We included 259 scales completed prior to therapy. An exploratory factor analysis determined the test constructs and identified the items that had greatest loadings on those factors. Items that did not load on the factors were removed, and normative scores calculated.

Results

The resulting 19-item questionnaire measures three factors: (a) the impact of stuttering on the child; (b) the severity of stuttering and its impact on the parents; and (c) the parents' knowledge about stuttering and confidence in managing it. Reliability was demonstrated, norms established, and an automated online version constructed.

Conclusions

The Palin Parent Rating Scale is a valid and reliable tool, providing a method of exploring parents' perceptions of stuttering, the impact it has on the child and themselves, and the parents' knowledge of and confidence in managing the stuttering. This is an important addition to the existing range of assessments that may be used to evaluate stuttering in children up to age 14;6 (years;months) and allows the wider targets of parent-led therapy programs to be evaluated.

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Examining the Language Phenotype in Children With Typical Development, Specific Language Impairment, and Fragile X Syndrome

Purpose

One aspect of morphosyntax, finiteness marking, was compared in children with fragile X syndrome (FXS), specific language impairment (SLI), and typical development matched on mean length of utterance (MLU).

Method

Nineteen children with typical development (mean age = 3.3 years), 20 children with SLI (mean age = 4.9 years), and 17 boys with FXS (mean age = 11.9 years) completed the Test of Early Grammatical Impairment (TEGI; Rice & Wexler, 2001), and other cognitive and language assessments. Quantitative comparisons on finiteness marking and qualitative comparisons of unscorable (i.e., nontarget) TEGI responses were conducted.

Results

Children with typical development and FXS performed better on finiteness marking than children with SLI. Although unscorable responses were infrequent, boys with FXS produced more unscorable responses than children with typical development and SLI.

Conclusions

Although boys with FXS have language deficits, they performed similarly to MLU-matched typically developing children on finiteness marking. This language profile differs from children with SLI, who present with a delay-within-a-delay profile with finiteness marking delays that exceed delays in MLU. Unscorable responses produced by the boys with FXS may reflect pragmatic deficits, which are prominent in this population. Assessment procedures should be carefully considered when examining language in boys with FXS.

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Glimpsing Speech in the Presence of Nonsimultaneous Amplitude Modulations From a Competing Talker: Effect of Modulation Rate, Age, and Hearing Loss

Purpose

This study investigated how listeners process acoustic cues preserved during sentences interrupted by nonsimultaneous noise that was amplitude modulated by a competing talker.

Method

Younger adults with normal hearing and older adults with normal or impaired hearing listened to sentences with consonants or vowels replaced with noise amplitude modulated by a competing talker. Sentences were spectrally shaped according to individual audiograms or to the mean audiogram from the listeners with hearing impairment for a younger spectrally shaped control group. The modulation spectrum of the noise was low-pass filtered at different modulation cutoff frequencies. The effect of noise level was also examined.

Results

Performance declined when nonsimultaneous masker modulation included faster rates and was maximized when masker modulation matched the preserved primary speech modulation. Vowels resulted in better performance compared with consonants at slower modulation cutoff rates, likely due to suprasegmental features. Poorer overall performance was observed with increased age or hearing loss, and for listeners who received spectrally shaped speech.

Conclusions

Nonsimultaneous amplitude modulations from a competing talker significantly interacted with the preserved speech segment, and additional listener factors were observed for age and hearing loss. Importantly, listeners may obtain benefit from nonsimultaneous competing modulations when they match the preserved modulations of the sentence.

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Longitudinal Effects on Early Adolescent Language: A Twin Study

Purpose

We evaluated genetic and environmental contributions to individual differences in language skills during early adolescence, measured by both language sampling and standardized tests, and examined the extent to which these genetic and environmental effects are stable across time.

Method

We used structural equation modeling on latent factors to estimate additive genetic, shared environmental, and nonshared environmental effects on variance in standardized language skills (i.e., Formal Language) and productive language-sample measures (i.e., Productive Language) in a sample of 527 twins across 3 time points (mean ages 10–12 years).

Results

Individual differences in the Formal Language factor were influenced primarily by genetic factors at each age, whereas individual differences in the Productive Language factor were primarily due to nonshared environmental influences. For the Formal Language factor, the stability of genetic effects was high across all 3 time points. For the Productive Language factor, nonshared environmental effects showed low but statistically significant stability across adjacent time points.

Conclusions

The etiology of language outcomes may differ substantially depending on assessment context. In addition, the potential mechanisms for nonshared environmental influences on language development warrant further investigation.

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Patient-Reported Measures of Hearing Loss and Tinnitus in Pediatric Cancer and Hematopoietic Stem Cell Transplantation: A Systematic Review

Purpose

We identified studies that described use of any patient-reported outcome scale for hearing loss or tinnitus among children and adolescents and young adults (AYAs) with cancer or hematopoietic stem cell transplantation (HSCT) recipients.

Method

In this systematic review, we performed electronic searches of OvidSP MEDLINE, EMBASE, and PsycINFO to August 2015. We included studies if they used any patient-reported scale of hearing loss or tinnitus among children and AYAs with cancer or HSCT recipients. Only English language publications were included. Two reviewers identified studies and abstracted data.

Results

There were 953 studies screened; 6 met eligibility criteria. All studies administered hearing patient-reported outcomes only once, after therapy completion. None of the studies described the psychometric properties of the hearing-specific component. Three instruments (among 6 studies) were used: Health Utilities Index (Barr et al., 2000; Fu et al., 2006; Kennedy et al., 2014), Hearing Measurement Scales (Einar-Jon et al., 2011; Einarsson et al., 2011), and the Tinnitus Questionnaire for Auditory Brainstem Implant (Soussi & Otto, 1994). All had limitations, precluding routine use for hearing assessment in this population.

Conclusions

We identified few studies that included hearing patient-reported measures for children and AYA cancer and HSCT patients. None are ideal to take forward into future studies. Future work should focus on the creation of a new psychometrically sound instrument for hearing outcomes in this population.

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Executive Functions in Children With Specific Language Impairment: A Meta-Analysis

Purpose

Mounting evidence demonstrates deficits in children with specific language impairment (SLI) beyond the linguistic domain. Using meta-analysis, this study examined differences in children with and without SLI on tasks measuring inhibition and cognitive flexibility.

Method

Databases were searched for articles comparing children (4–14 years) with and without SLI on behavioral measures of inhibition or cognitive flexibility. Weighted average effect size was calculated using multilevel modeling to measure potential group differences.

Results

The analysis included 46 studies. Of those, 34 included inhibitory control measures and 22 included cognitive flexibility tasks. Children with SLI performed below same-aged peers on both inhibitory control tasks (g = −.56) and cognitive flexibility tasks (g = −.27). Moderator analyses showed no effect of linguistic task demands, participant age, or severity of language impairment on the degree of difference between children with SLI and controls on measures of inhibitory control.

Conclusion

Reliable differences between children with and without SLI were found on inhibition and cognitive flexibility tasks. A moderate group effect was found for inhibition tasks, but there was only a small effect for cognitive flexibility tasks. Results of moderator analyses suggest that these deficits are present throughout development despite task demands or severity of linguistic impairment.

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Lidcombe Program Webcam Treatment for Early Stuttering: A Randomized Controlled Trial

Purpose

Webcam treatment is potentially useful for health care in cases of early stuttering in which clients are isolated from specialized treatment services for geographic and other reasons. The purpose of the present trial was to compare outcomes of clinic and webcam deliveries of the Lidcombe Program treatment (Packman et al., 2015) for early stuttering.

Method

The design was a parallel, open plan, noninferiority randomized controlled trial of the standard Lidcombe Program treatment and the experimental webcam Lidcombe Program treatment. Participants were 49 children aged 3 years 0 months to 5 years 11 months at the start of treatment. Primary outcomes were the percentage of syllables stuttered at 9 months postrandomization and the number of consultations to complete Stage 1 of the Lidcombe Program.

Results

There was insufficient evidence of a posttreatment difference of the percentage of syllables stuttered between the standard and webcam Lidcombe Program treatments. There was insufficient evidence of a difference between the groups for typical stuttering severity measured by parents or the reported clinical relationship with the treating speech-language pathologist.

Conclusions

This trial confirmed the viability of the webcam Lidcombe Program intervention. It appears to be as efficacious and economically viable as the standard, clinic Lidcombe Program treatment.

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Joint Engagement and Early Language in Young Children With Fragile X Syndrome

Purpose

In this study, we examine joint engagement (JE) in young children with fragile X syndrome (FXS) and its relationship to language abilities and autism spectrum disorder symptomatology at 24 to 36 months (toddler period) and 59 to 68 months (child period).

Method

Participants were 28 children with FXS (24 boys, four girls) and their mothers. Videotaped home observations were conducted during the toddler period and coded for JE. Language abilities were measured at both ages from a developmental assessment, a functional measure, and from a language sample. The Childhood Autism Rating Scale (Schopler, Reichler, & Renner, 1988) was completed at both ages.

Results

Children with FXS spent more time in supported JE than in coordinated JE. Using a weighted JE variable, we found that children with FXS who had higher weighted JE scores also had more advanced expressive language skills at both the toddler and child periods. Weighted JE was negatively related to autism symptomatology in the toddler period.

Conclusion

This study provides evidence that children with FXS who use more JE also have more advanced expressive language skills in early development. Therefore, existing early interventions that target JE behaviors may be effective for promoting language, social communication, and social interaction in this population.

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Epidemiology of Vocal Health in Young Adults Attending College in the United States

Purpose

The purpose of this study was to document typical vocal health characteristics (including voice-related activities, behaviors, and symptomatology) of young adults attending college and to determine lifetime and point prevalence rates of voice disorders.

Method

Undergraduates at University of Wisconsin–Madison completed an anonymous online survey detailing vocal use, symptomatology, impact, sociodemographics, and voice-related quality of life. Univariate analyses and multivariate regression models isolated risk factors for lifetime and point prevalence rates of a voice disorder.

Results

Vocal health and associated factors were analyzed for 652 students (predominantly 18–25 years of age). Lifetime prevalence rate of a voice disorder was 33.9% (point prevalence = 4.45%). Change in voice function (odds ratio [OR] = 2.77), seasonal or chronic postnasal drip (OR = 2.11), hoarseness (OR = 2.08), and restrictions to social activity (OR = 2.07; all p Conclusions

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Comprehension of Inferences in a Narrative in 3- to 6-Year-Old Children

Purpose

This study aimed to describe the development of inferential abilities of children age 3 to 6 years in a narrative using a dialogic reading task on an iPad.

Method

Participants were 121 typically developing children, divided into 3 groups according to age range (3–4 years old, 4–5 years old, 5–6 years old). Total score of inferential comprehension, subscores by causal inference type targeting elements of the story grammar, and quality of response were examined across groups.

Results

Inferential comprehension emerged early, from 3 to 4 years old, with considerable interindividual variability. Inferential comprehension scores increased significantly in relation to age, leading to developmental steps with regards to the type of causal inferences. The ability to infer the problem of the story, the internal response of a character, and predictions were easier starting at age 4 years. Then, the 5- to 6-year-olds were better able to infer the goal, the attempt to solve the problem, and the resolution. Last, between the ages of 3 and 6 years, children improved in terms of the quality of response they provided.

Conclusion

This study addresses important gaps in our knowledge of inferential comprehension in young children and has implications for planning of early education in this realm.

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An Item Analysis of the French Version of the Test for Reception of Grammar Among Children and Adolescents With Down Syndrome or Intellectual Disability of Undifferentiated Etiology

Purpose

An item analysis of Bishop's (1983) Test for Reception of Grammar (TROG) in its French version (F-TROG; Lecocq, 1996) was conducted to determine whether the difficulty of items is similar for participants with or without intellectual disability (ID).

Method

In Study 1, responses to the 92 F-TROG items by 55 participants with Down syndrome (DS), 55 with ID of undifferentiated etiology (UND), and 55 typical children (TYP) matched on their F-TROG total score were compared using the transformed item difficulties method, a statistical approach designed to detect differential item functioning (DIF) between groups. In Study 2, an additional comparison involving 526 TYP participants and 526 participants with UND was conducted to increase the statistical power of the analysis.

Results

The difficulty of items was highly similar whatever the sample size or clinical status of participants. Fewer than 3.5% of the items were flagged as showing DIF.

Conclusions

Tests such as the TROG can be used with confidence in clinical practice as well as in research studies comparing participants with or without ID. Methods designed for investigating potential internal test bias—such as done here—should be more regularly employed in the developmental disability field to affirm the absence of DIF.

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Towards a Theory of Learning for Naming Rehabilitation: Retrieval Practice and Spacing Effects

Purpose

The purpose of this article was to examine how different types of learning experiences affect naming impairment in aphasia.

Methods

In 4 people with aphasia with naming impairment, we compared the benefits of naming treatment that emphasized retrieval practice (practice retrieving target names from long-term memory) with errorless learning (repetition training, which preempts retrieval practice) according to different schedules of learning. The design was within subjects. Items were administered for multiple training trials for retrieval practice or repetition in a spaced schedule (an item's trials were separated by multiple unrelated trials) or massed schedule (1 trial intervened between an item's trials). In the spaced condition, we studied 3 magnitudes of spacing to evaluate the impact of effortful retrieval during training on the ultimate benefits conferred by retrieval practice naming treatment. The primary outcome was performance on a retention test of naming after 1 day, with a follow-up test after 1 week.

Results

Group analyses revealed that retrieval practice outperformed errorless learning, and spaced learning outperformed massed learning at retention test and at follow-up. Increases in spacing in the retrieval practice condition yielded more robust learning of retrieved information.

Conclusion

This study delineates the importance of retrieval practice and spacing for treating naming impairment in aphasia.

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Short-Term Memory Performance in 7- and 8-Year-Old Children: The Relationship Between Phonological and Pitch Processing

Purpose

The relationship between short-term memory for phonology and pitch was explored by examining accuracy scores for typically developing children for 5 experimental tasks: immediate nonword repetition (NWR), nonword repetition with an 8-s silent interference (NWRS), pitch discrimination (PD), pitch discrimination with an 8-s silent interference (PDS), and pitch matching (PM).

Method

Thirty-six 7- and 8-year-old children (21 girls, 15 boys) with normal hearing, language, and cognition were asked to listen to and repeat nonsense words (NWR, NWRS), make a same versus different decision between 2 tones (PD, PDS), and listen to and then vocally reproduce a tone (PM).

Results

Results showed no significant correlations between tasks of phonological memory and tests of pitch memory, that participants scored significantly better on nonword repetition tasks than PD and PM tasks, and that participants performed significantly better on tasks with no silent interference.

Discussion

These findings suggest that, for typically developing children, pitch may be stored and rehearsed in a separate location than phonological information. Because of fundamental task differences, further research is needed to corroborate these data and determine the presence of developmental effects and neuroanatomical locations where a potential language/music overlap is occurring in children.

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Automated Proposition Density Analysis for Discourse in Aphasia

Purpose

This study evaluates how proposition density can differentiate between persons with aphasia (PWA) and individuals in a control group, as well as among subtypes of aphasia, on the basis of procedural discourse and personal narratives collected from large samples of participants.

Method

Participants were 195 PWA and 168 individuals in a control group from the AphasiaBank database. PWA represented 6 aphasia types on the basis of the Western Aphasia Battery–Revised (Kertesz, 2006). Narrative samples were stroke stories for PWA and illness or injury stories for individuals in the control group. Procedural samples were from the peanut-butter-and-jelly-sandwich task. Language samples were transcribed using Codes for the Human Analysis of Transcripts (MacWhinney, 2000) and analyzed using Computerized Language Analysis (MacWhinney, 2000), which automatically computes proposition density (PD) using rules developed for automatic PD measurement by the Computerized Propositional Idea Density Rater program (Brown, Snodgrass, & Covington, 2007; Covington, 2007).

Results

Participants in the control group scored significantly higher than PWA on both tasks. PD scores were significantly different among the aphasia types for both tasks. Pairwise comparisons for both discourse tasks revealed that PD scores for the Broca's group were significantly lower than those for all groups except Transcortical Motor. No significant quadratic or linear association between PD and severity was found.

Conclusion

Proposition density is differentially sensitive to aphasia type and most clearly differentiates individuals with Broca's aphasia from the other groups.

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