A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: III. Theoretical Coherence of the Pause Marker with Speech Processing Deficits in Childhood Apraxia of Speech

Purpose

Previous articles in this supplement described rationale for and development of the pause marker (PM), a diagnostic marker of childhood apraxia of speech (CAS), and studies supporting its validity and reliability. The present article assesses the theoretical coherence of the PM with speech processing deficits in CAS.

Method

PM and other scores were obtained for 264 participants in 6 groups: CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech (AAS) consequent to stroke and primary progressive apraxia of speech; and idiopathic speech delay.

Results

Participants with CAS and AAS had significantly lower scores than typically speaking reference participants and speech delay controls on measures posited to assess representational and transcoding processes. Representational deficits differed between CAS and AAS groups, with support for both underspecified linguistic representations and memory/access deficits in CAS, but for only the latter in AAS. CAS–AAS similarities in the age–sex standardized percentages of occurrence of the most frequent type of inappropriate pauses (abrupt) and significant differences in the standardized occurrence of appropriate pauses were consistent with speech processing findings.

Conclusions

Results support the hypotheses of core representational and transcoding speech processing deficits in CAS and theoretical coherence of the PM's pause-speech elements with these deficits.

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Delayed Early Vocabulary Development in Children at Family Risk of Dyslexia

Purpose

This study aimed to gain more insight into the relation between vocabulary and reading acquisition by examining early growth trajectories in the vocabulary of children at family risk (FR) of dyslexia longitudinally.

Method

The sample included 212 children from the Dutch Dyslexia Program with and without an FR. Parents reported on their children's receptive and expressive vocabulary size at ages 17, 23, 29, and 35 months using the Dutch MacArthur Communicative Development Inventories. Dyslexia status at the end of Grade 2 (8 years) rendered 3 groups: FR-dyslexic (n = 51), FR-nondyslexic (n = 92), and typically developing–nondyslexic (TD) children (n = 69).

Results

Repeated measures analyses showed that FR-dyslexic children had lower receptive vocabulary scores from 23 months onward and lower expressive scores from 17 months onward than FR-nondyslexic children. Latent growth curve modeling showed lower initial growth rates in FR-dyslexic children, followed by partial recovery, indicating a delayed increase in receptive and expressive vocabulary. FR-nondyslexic and TD children did not differ.

Conclusions

Early deficits in receptive and expressive vocabulary are associated with later reading. Early vocabulary growth of FR-dyslexic children is characterized by a delay but not deviance of growth. Vocabulary can be considered an additional risk factor for dyslexia.

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Polish Vocabulary Development in 2-Year-Olds: Comparisons With English Using the Language Development Survey

Purpose

The objective of this study was to compare vocabulary size and composition in 2-year-olds learning Polish or English as measured by the Language Development Survey (LDS; Rescorla, 1989).

Method

Participants were 199 Polish toddlers (M = 24.14 months, SD = 0.35) and 422 U.S. toddlers (M = 24.69 months, SD = 0.78).

Results

Test–retest reliability was .92, internal consistency was .99, and concurrent validity was .55. Girls had higher vocabulary scores than boys. Mean LDS score was significantly lower in Polish than in English, and fewer Polish children had LDS scores >200 words. Also, more words were reported for Conclusions

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Examining a New Method to Studying Velopharyngeal Structures in a Child With 22q11.2 Deletion Syndrome

Purpose

To date, no studies have imaged the velopharynx in children with 22q11.2 deletion syndrome (22q11.2 DS) without the use of sedation. Dysmorphology in velopharyngeal structures has been shown to have significant negative implications on speech among these individuals. This single case study was designed to assess the feasibility of a child-friendly magnetic resonance imaging (MRI) scanning protocol in this clinically challenging population and to determine the utility of this MRI protocol for future work in this area.

Method

One 6-year-old White girl diagnosed with 22q11.2 DS was imaged using a child-friendly, nonsedated MRI protocol. Quantitative and qualitative measures of the velopharyngeal area and associated structures were evaluated, and comparisons were made to age-matched control subjects with normal velopharyngeal anatomy.

Results

MRI data were successfully obtained using the child-friendly scanning protocol in the subject in the present study. Quantitative and qualitative differences of the levator muscle and associated velopharyngeal structures were noted. Using these MRI and structural analyses methods, insights related to muscle morphology can be obtained and considered as part of the research and clinical examination of children with 22q11.2 DS.

Conclusion

The imaging protocol described in this study presents an effective means to counteract difficulties in imaging young children.

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The Effect of Tinnitus on Listening Effort in Normal-Hearing Young Adults: A Preliminary Study

Purpose

The objective of this study was to investigate the effect of chronic tinnitus on listening effort.

Method

Thirteen normal-hearing young adults with chronic tinnitus were matched with a control group for age, gender, hearing thresholds, and educational level. A dual-task paradigm was used to evaluate listening effort in different listening conditions. A primary speech-recognition task and a secondary memory task were performed both separately and simultaneously. Furthermore, subjective listening effort was questioned for various listening situations. The Tinnitus Handicap Inventory was used to control for tinnitus handicap.

Results

Listening effort significantly increased in the tinnitus group across listening conditions. There was no significant difference in listening effort between listening conditions, nor was there an interaction between groups and listening conditions. Subjective listening effort did not significantly differ between both groups.

Conclusions

This study is a first exploration of listening effort in normal-hearing participants with chronic tinnitus showing that listening effort is increased as compared with a control group. There is a need to further investigate the cognitive functions important for speech understanding and their possible relation with the presence of tinnitus and listening effort.

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Electrophysiology of Perception and Processing of Phonological Information as Indices of Toddlers' Language Performance

Purpose

The toddler years are a critical period for language development and growth. We investigated how event-related potentials (ERPs) to repeated and novel nonwords are associated with clinical assessments of language in young children. In addition, nonword repetition (NWR) was used to measure phonological working memory to determine the unique and collective contribution of ERP measures of phonemic discrimination and NWR as predictors of language ability.

Method

Forty children between the ages of 24–48 months participated in an ERP experiment to determine phonemic discrimination to repeated and novel nonwords in an old/new design. Participants also completed a NWR task to explore the contribution of phonological working memory in predicting language.

Results

ERP analyses revealed that faster responses to novel stimuli correlated with higher language performance on clinical assessments of language. Regression analyses revealed that an earlier component was associated with lower level phonemic sensitivity, and a later component was indexing phonological working memory skills similar to NWR.

Conclusion

Our findings suggest that passive ERP responses indexing phonological discrimination and phonological working memory are strongly related to behavioral measures of language.

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Speech Recognition in Adults With Cochlear Implants: The Effects of Working Memory, Phonological Sensitivity, and Aging

Purpose

Models of speech recognition suggest that “top-down” linguistic and cognitive functions, such as use of phonotactic constraints and working memory, facilitate recognition under conditions of degradation, such as in noise. The question addressed in this study was what happens to these functions when a listener who has experienced years of hearing loss obtains a cochlear implant.

Method

Thirty adults with cochlear implants and 30 age-matched controls with age-normal hearing underwent testing of verbal working memory using digit span and serial recall of words. Phonological capacities were assessed using a lexical decision task and nonword repetition. Recognition of words in sentences in speech-shaped noise was measured.

Results

Implant users had only slightly poorer working memory accuracy than did controls and only on serial recall of words; however, phonological sensitivity was highly impaired. Working memory did not facilitate speech recognition in noise for either group. Phonological sensitivity predicted sentence recognition for implant users but not for listeners with normal hearing.

Conclusion

Clinical speech recognition outcomes for adult implant users relate to the ability of these users to process phonological information. Results suggest that phonological capacities may serve as potential clinical targets through rehabilitative training. Such novel interventions may be particularly helpful for older adult implant users.

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Vocalization Rate and Consonant Production in Toddlers at High and Low Risk for Autism

Background

Previous work has documented lower vocalization rate and consonant acquisition delays in toddlers with autism spectrum disorder (ASD). We investigated differences in these variables at 12, 18, and 24 months in toddlers at high and low risk for ASD.

Method

Vocalization rate and number of different consonants were obtained from speech samples from a prospective study of infant siblings of children with ASD. Three groups were compared: 18 toddlers at low risk for ASD (low-risk control), 18 high-risk siblings without ASD (HRA−), and 10 high-risk siblings with ASD (HRA+).

Results

All groups' mean language scores were within the normal range. HRA+ toddlers showed consistently lower vocalization rate; vocalization rate did not predict number of different consonants at 12 months for HRA+. HRA−, not HRA+, toddlers had the smallest number of different consonants and produced significantly fewer different consonants than predicted by their vocalization rate at 12 months. Consonant-acquisition trajectories differed between groups, with HRA− showing the greatest increase from 12 to 18 months.

Conclusion

Lower vocalization rate was not associated with reduced number of different consonants in these toddlers. Between-groups differences in developmental trajectories are discussed in the context of the social feedback loop and differential ability to benefit from adult feedback between groups.

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Development of Grammatical Accuracy in English-Speaking Children With Cochlear Implants: A Longitudinal Study

Purpose

We sought to evaluate the development of grammatical accuracy in English-speaking children with cochlear implants (CIs) over a 3-year span.

Method

Ten children who received CIs before age 30 months participated in this study at 3, 4, and 5 years postimplantation. For the purpose of comparison, 10 children each at ages 3, 4, and 5 years with typical hearing were included as well. All children participated in a story-retell task. We computed percent grammatical communication units (PGCU) in the task.

Results

Children with CIs showed significant improvement in PGCU over the 3-year span. However, they produced lower PGCU than children with typical hearing who had matched hearing age at 4 and 5 years postimplantation. At the individual level, some children with CIs were able to produce PGCU comparable to children with typical hearing as early as 3 years after implantation. Better speech-perception skills at earlier time points were associated with higher PGCU at later time points. Moreover, children with and without CIs showed similar rankings in the types of grammatical errors.

Conclusion

Despite having auditory-perceptual and information-processing constraints, children who received CIs before age 30 months were able to produce grammatical sentences, albeit with a delayed pattern.

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The Relationship Between Executive Functions and Language Abilities in Children: A Latent Variables Approach

Purpose

We aimed to outline the latent variables approach for measuring nonverbal executive function (EF) skills in school-age children, and to examine the relationship between nonverbal EF skills and language performance in this age group.

Method

Seventy-one typically developing children, ages 8 through 11, participated in the study. Three EF components, inhibition, updating, and task-shifting, were each indexed using 2 nonverbal tasks. A latent variables approach was used to extract latent scores that represented each EF construct. Children were also administered common standardized language measures. Multiple regression analyses were conducted to examine the relationship between EF and language skills.

Results

Nonverbal updating was associated with the Receptive Language Index on the Clinical Evaluation of Language Fundamentals–Fourth Edition (CELF-4). When composites denoting lexical–semantic and syntactic abilities were derived, nonverbal inhibition (but not shifting or updating) was found to predict children's syntactic abilities. These relationships held when the effects of age, IQ, and socioeconomic status were controlled.

Conclusions

The study makes a methodological contribution by explicating a method by which researchers can use the latent variables approach when measuring EF performance in school-age children. The study makes a theoretical and a clinical contribution by suggesting that language performance may be related to domain-general EFs.

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Auditory Phenotype of Smith–Magenis Syndrome

Purpose

The purpose of this study was to describe the auditory phenotype of a large cohort with Smith–Magenis syndrome (SMS), a rare disorder including physical anomalies, cognitive deficits, sleep disturbances, and a distinct behavioral phenotype.

Method

Hearing-related data were collected for 133 individuals with SMS aged 1–49 years. Audiogram data (97 participants) were used for cross-sectional and longitudinal analyses. Caregivers completed a sound sensitivity survey for 98 individuals with SMS and a control group of 24 unaffected siblings.

Results

Nearly 80% of participants with interpretable audiograms (n = 76) had hearing loss, which was typically slight to mild in degree. When hearing loss type could be determined (40 participants), sensorineural hearing loss (48.1%) occurred most often in participants aged 11–49 years. Conductive hearing loss (35.2%) was typically observed in children aged 1–10 years. A pattern of fluctuating and progressive hearing decline was documented. Hyperacusis was reported in 73.5% of participants with SMS compared with 12.5% of unaffected siblings.

Conclusions

This study offers the most comprehensive characterization of the auditory phenotype of SMS to date. The auditory profile in SMS is multifaceted and can include a previously unreported manifestation of hyperacusis. Routine audiologic surveillance is recommended as part of standard clinical care.

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Gesture Production in Language Impairment: It's Quality, Not Quantity, That Matters

Purpose

The aim of this study was to determine whether children with language impairment (LI) use gesture to compensate for their language difficulties.

Method

The present study investigated gesture accuracy and frequency in children with LI (n = 21) across gesture imitation, gesture elicitation, spontaneous narrative, and interactive problem-solving tasks, relative to typically developing (TD) peers (n = 18) and peers with low language and educational concerns (n = 21).

Results

Children with LI showed weaknesses in gesture accuracy (imitation and gesture elicitation) in comparison to TD peers, but no differences in gesture rate. Children with low language only showed weaknesses in gesture imitation and used significantly more gestures than TD peers during parent–child interaction. Across the whole sample, motor abilities were significantly related to gesture accuracy but not gesture rate. In addition, children with LI produced proportionately more extending gestures, suggesting that they may use gesture to replace words that they are unable to articulate verbally.

Conclusion

The results support the notion that gesture and language form a tightly linked communication system in which gesture deficits are seen alongside difficulties with spoken communication. Furthermore, it is the quality, not quantity of gestures that distinguish children with LI from typical peers.

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Directional Asymmetries in Vowel Perception of Adult Nonnative Listeners Do Not Change Over Time With Language Experience

Purpose

This study tested an assumption of the Natural Referent Vowel (Polka & Bohn, 2011) framework, namely, that directional asymmetries in adult vowel perception can be influenced by language experience.

Method

Data from participants reported in Escudero and Williams (2014) were analyzed. Spanish participants categorized the Dutch vowels /aː/ and /ɑ/ in 2 separate sessions: before and after vowel distributional training. Sessions were 12 months apart. Categorization was assessed using the XAB task, where on each trial participants heard 3 sounds sequentially (first X, then A, then B) and had to decide whether X was more similar to A or B.

Results

Before training, participants exhibited a directional asymmetry in line with the prediction of Natural Referent Vowel. Specifically, Spanish listeners performed worse when the vowel change from X to A was a change from peripheral to central vowel (/ɑ/ to /aː/). However, this asymmetry was maintained 12 months later, even though distributional training improved vowel categorization performance.

Conclusions

Improvements in adult nonnative vowel categorization accuracy are not explained by attenuation of directional asymmetries. Directional asymmetries in vowel perception are altered during native language acquisition, but may possibly be impervious to nonnative language experiences in adulthood.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: I. Development and Description of the Pause Marker

Purpose

The goal of this article (PM I) is to describe the rationale for and development of the Pause Marker (PM), a single-sign diagnostic marker proposed to discriminate early or persistent childhood apraxia of speech from speech delay.

Method

The authors describe and prioritize 7 criteria with which to evaluate the research and clinical utility of a diagnostic marker for childhood apraxia of speech, including evaluation of the present proposal. An overview is given of the Speech Disorders Classification System, including extensions completed in the same approximately 3-year period in which the PM was developed.

Results

The finalized Speech Disorders Classification System includes a nosology and cross-classification procedures for childhood and persistent speech disorders and motor speech disorders (Shriberg, Strand, & Mabie, 2017). A PM is developed that provides procedural and scoring information, and citations to papers and technical reports that include audio exemplars of the PM and reference data used to standardize PM scores are provided.

Conclusions

The PM described here is an acoustic-aided perceptual sign that quantifies one aspect of speech precision in the linguistic domain of phrasing. This diagnostic marker can be used to discriminate early or persistent childhood apraxia of speech from speech delay.

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Masthead

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Word Learning Deficits in Children With Dyslexia

Purpose

The purpose of this study is to investigate word learning in children with dyslexia to ascertain their strengths and weaknesses during the configuration stage of word learning.

Method

Children with typical development (N = 116) and dyslexia (N = 68) participated in computer-based word learning games that assessed word learning in 4 sets of games that manipulated phonological or visuospatial demands. All children were monolingual English-speaking 2nd graders without oral language impairment. The word learning games measured children's ability to link novel names with novel objects, to make decisions about the accuracy of those names and objects, to recognize the semantic features of the objects, and to produce the names of the novel words. Accuracy data were analyzed using analyses of covariance with nonverbal intelligence scores as a covariate.

Results

Word learning deficits were evident for children with dyslexia across every type of manipulation and on 3 of 5 tasks, but not for every combination of task/manipulation. Deficits were more common when task demands taxed phonology. Visuospatial manipulations led to both disadvantages and advantages for children with dyslexia.

Conclusion

Children with dyslexia evidence spoken word learning deficits, but their performance is highly dependent on manipulations and task demand, suggesting a processing trade-off between visuospatial and phonological demands.

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Factors Influencing Consonant Acquisition in Brazilian Portuguese–Speaking Children

Purpose

We sought to provide valid and reliable data on the acquisition of consonant sounds in speakers of Brazilian Portuguese.

Method

The sample comprised 733 typically developing monolingual speakers of Brazilian Portuguese (ages 3;0–8;11 [years;months]). The presence of surface speech error patterns, the revised percentage consonants correct, and the age of sound acquisition were evaluated using phonological assessment software. The normative values for these variables were reported using means and standard deviations.

Results

Age had a significant impact on phoneme production. Increasing age was generally associated with an increase in correct phoneme production, a reduction in error patterns, and an increase in scores on revised percentage consonants correct. Phonological error patterns persisted for a longer time in consonants and consonant clusters acquired later in development. The 2 youngest age groups differed from the remainder of the sample on the frequency of the following phonological patterns: cluster reduction, liquid gliding, fricative deletion–coda, and weak-syllable deletion. Performance was similar between groups starting at 5;0 years old.

Conclusion

This study confirmed that nasal and stop consonants are acquired first, followed by fricatives and, finally, liquids. We suggest that future studies replicate our investigation in larger samples and younger age groups.

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Characterizing Articulation in Apraxic Speech Using Real-Time Magnetic Resonance Imaging

Purpose

Real-time magnetic resonance imaging (MRI) and accompanying analytical methods are shown to capture and quantify salient aspects of apraxic speech, substantiating and expanding upon evidence provided by clinical observation and acoustic and kinematic data. Analysis of apraxic speech errors within a dynamic systems framework is provided and the nature of pathomechanisms of apraxic speech discussed.

Method

One adult male speaker with apraxia of speech was imaged using real-time MRI while producing spontaneous speech, repeated naming tasks, and self-paced repetition of word pairs designed to elicit speech errors. Articulatory data were analyzed, and speech errors were detected using time series reflecting articulatory activity in regions of interest.

Results

Real-time MRI captured two types of apraxic gestural intrusion errors in a word pair repetition task. Gestural intrusion errors in nonrepetitive speech, multiple silent initiation gestures at the onset of speech, and covert (unphonated) articulation of entire monosyllabic words were also captured.

Conclusion

Real-time MRI and accompanying analytical methods capture and quantify many features of apraxic speech that have been previously observed using other modalities while offering high spatial resolution. This patient's apraxia of speech affected the ability to select only the appropriate vocal tract gestures for a target utterance, suppressing others, and to coordinate them in time.

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Temperament and Early Stuttering Development: Cross-Sectional Findings From a Community Cohort

Purpose

The purpose of this study was to ascertain if there is an association between stuttering severity and behaviors and the expression of temperament characteristics, including precursors of anxiety.

Method

We studied temperament characteristics of a prospectively recruited community cohort of children who stutter (N = 173) at ages 3, 4, and 6 years using the Short Temperament Scale STS (Prior, Sanson, Smart & Oberklaid, 2000).

Results

Six of 131 statistical tests of association between stuttering severity and behaviors and temperament traits were statistically significant at the 5% level, which was no more than expected by chance alone.

Conclusions

On the basis of parent responses to the STS, preschoolers who exhibited different levels of stuttering severity and behaviors did not generally express temperament traits differently from one another. Stuttering severity and stuttering behaviors were not associated with the precursors of anxiety. Overall, taking multiple tests into consideration, results show little evidence of association between stuttering severity and temperament up to 4 years of age or between stuttering behaviors and temperament up to 6 years of age.

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Motor Speech Phenotypes of Frontotemporal Dementia, Primary Progressive Aphasia, and Progressive Apraxia of Speech

Purpose

Our purpose was to create a comprehensive review of speech impairment in frontotemporal dementia (FTD), primary progressive aphasia (PPA), and progressive apraxia of speech in order to identify the most effective measures for diagnosis and monitoring, and to elucidate associations between speech and neuroimaging.

Method

Speech and neuroimaging data described in studies of FTD and PPA were systematically reviewed. A meta-analysis was conducted for speech measures that were used consistently in multiple studies.

Results

The methods and nomenclature used to describe speech in these disorders varied between studies. Our meta-analysis identified 3 speech measures which differentiate variants or healthy control-group participants (e.g., nonfluent and logopenic variants of PPA from all other groups, behavioral-variant FTD from a control group). Deficits within the frontal-lobe speech networks are linked to motor speech profiles of the nonfluent variant of PPA and progressive apraxia of speech. Motor speech impairment is rarely reported in semantic and logopenic variants of PPA. Limited data are available on motor speech impairment in the behavioral variant of FTD.

Conclusions

Our review identified several measures of speech which may assist with diagnosis and classification, and consolidated the brain–behavior associations relating to speech in FTD, PPA, and progressive apraxia of speech.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: III. Theoretical Coherence of the Pause Marker with Speech Processing Deficits in Childhood Apraxia of Speech

Purpose

Previous articles in this supplement described rationale for and development of the pause marker (PM), a diagnostic marker of childhood apraxia of speech (CAS), and studies supporting its validity and reliability. The present article assesses the theoretical coherence of the PM with speech processing deficits in CAS.

Method

PM and other scores were obtained for 264 participants in 6 groups: CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech (AAS) consequent to stroke and primary progressive apraxia of speech; and idiopathic speech delay.

Results

Participants with CAS and AAS had significantly lower scores than typically speaking reference participants and speech delay controls on measures posited to assess representational and transcoding processes. Representational deficits differed between CAS and AAS groups, with support for both underspecified linguistic representations and memory/access deficits in CAS, but for only the latter in AAS. CAS–AAS similarities in the age–sex standardized percentages of occurrence of the most frequent type of inappropriate pauses (abrupt) and significant differences in the standardized occurrence of appropriate pauses were consistent with speech processing findings.

Conclusions

Results support the hypotheses of core representational and transcoding speech processing deficits in CAS and theoretical coherence of the PM's pause-speech elements with these deficits.

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Delayed Early Vocabulary Development in Children at Family Risk of Dyslexia

Purpose

This study aimed to gain more insight into the relation between vocabulary and reading acquisition by examining early growth trajectories in the vocabulary of children at family risk (FR) of dyslexia longitudinally.

Method

The sample included 212 children from the Dutch Dyslexia Program with and without an FR. Parents reported on their children's receptive and expressive vocabulary size at ages 17, 23, 29, and 35 months using the Dutch MacArthur Communicative Development Inventories. Dyslexia status at the end of Grade 2 (8 years) rendered 3 groups: FR-dyslexic (n = 51), FR-nondyslexic (n = 92), and typically developing–nondyslexic (TD) children (n = 69).

Results

Repeated measures analyses showed that FR-dyslexic children had lower receptive vocabulary scores from 23 months onward and lower expressive scores from 17 months onward than FR-nondyslexic children. Latent growth curve modeling showed lower initial growth rates in FR-dyslexic children, followed by partial recovery, indicating a delayed increase in receptive and expressive vocabulary. FR-nondyslexic and TD children did not differ.

Conclusions

Early deficits in receptive and expressive vocabulary are associated with later reading. Early vocabulary growth of FR-dyslexic children is characterized by a delay but not deviance of growth. Vocabulary can be considered an additional risk factor for dyslexia.

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Polish Vocabulary Development in 2-Year-Olds: Comparisons With English Using the Language Development Survey

Purpose

The objective of this study was to compare vocabulary size and composition in 2-year-olds learning Polish or English as measured by the Language Development Survey (LDS; Rescorla, 1989).

Method

Participants were 199 Polish toddlers (M = 24.14 months, SD = 0.35) and 422 U.S. toddlers (M = 24.69 months, SD = 0.78).

Results

Test–retest reliability was .92, internal consistency was .99, and concurrent validity was .55. Girls had higher vocabulary scores than boys. Mean LDS score was significantly lower in Polish than in English, and fewer Polish children had LDS scores >200 words. Also, more words were reported for Conclusions

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Examining a New Method to Studying Velopharyngeal Structures in a Child With 22q11.2 Deletion Syndrome

Purpose

To date, no studies have imaged the velopharynx in children with 22q11.2 deletion syndrome (22q11.2 DS) without the use of sedation. Dysmorphology in velopharyngeal structures has been shown to have significant negative implications on speech among these individuals. This single case study was designed to assess the feasibility of a child-friendly magnetic resonance imaging (MRI) scanning protocol in this clinically challenging population and to determine the utility of this MRI protocol for future work in this area.

Method

One 6-year-old White girl diagnosed with 22q11.2 DS was imaged using a child-friendly, nonsedated MRI protocol. Quantitative and qualitative measures of the velopharyngeal area and associated structures were evaluated, and comparisons were made to age-matched control subjects with normal velopharyngeal anatomy.

Results

MRI data were successfully obtained using the child-friendly scanning protocol in the subject in the present study. Quantitative and qualitative differences of the levator muscle and associated velopharyngeal structures were noted. Using these MRI and structural analyses methods, insights related to muscle morphology can be obtained and considered as part of the research and clinical examination of children with 22q11.2 DS.

Conclusion

The imaging protocol described in this study presents an effective means to counteract difficulties in imaging young children.

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The Effect of Tinnitus on Listening Effort in Normal-Hearing Young Adults: A Preliminary Study

Purpose

The objective of this study was to investigate the effect of chronic tinnitus on listening effort.

Method

Thirteen normal-hearing young adults with chronic tinnitus were matched with a control group for age, gender, hearing thresholds, and educational level. A dual-task paradigm was used to evaluate listening effort in different listening conditions. A primary speech-recognition task and a secondary memory task were performed both separately and simultaneously. Furthermore, subjective listening effort was questioned for various listening situations. The Tinnitus Handicap Inventory was used to control for tinnitus handicap.

Results

Listening effort significantly increased in the tinnitus group across listening conditions. There was no significant difference in listening effort between listening conditions, nor was there an interaction between groups and listening conditions. Subjective listening effort did not significantly differ between both groups.

Conclusions

This study is a first exploration of listening effort in normal-hearing participants with chronic tinnitus showing that listening effort is increased as compared with a control group. There is a need to further investigate the cognitive functions important for speech understanding and their possible relation with the presence of tinnitus and listening effort.

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Electrophysiology of Perception and Processing of Phonological Information as Indices of Toddlers' Language Performance

Purpose

The toddler years are a critical period for language development and growth. We investigated how event-related potentials (ERPs) to repeated and novel nonwords are associated with clinical assessments of language in young children. In addition, nonword repetition (NWR) was used to measure phonological working memory to determine the unique and collective contribution of ERP measures of phonemic discrimination and NWR as predictors of language ability.

Method

Forty children between the ages of 24–48 months participated in an ERP experiment to determine phonemic discrimination to repeated and novel nonwords in an old/new design. Participants also completed a NWR task to explore the contribution of phonological working memory in predicting language.

Results

ERP analyses revealed that faster responses to novel stimuli correlated with higher language performance on clinical assessments of language. Regression analyses revealed that an earlier component was associated with lower level phonemic sensitivity, and a later component was indexing phonological working memory skills similar to NWR.

Conclusion

Our findings suggest that passive ERP responses indexing phonological discrimination and phonological working memory are strongly related to behavioral measures of language.

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Speech Recognition in Adults With Cochlear Implants: The Effects of Working Memory, Phonological Sensitivity, and Aging

Purpose

Models of speech recognition suggest that “top-down” linguistic and cognitive functions, such as use of phonotactic constraints and working memory, facilitate recognition under conditions of degradation, such as in noise. The question addressed in this study was what happens to these functions when a listener who has experienced years of hearing loss obtains a cochlear implant.

Method

Thirty adults with cochlear implants and 30 age-matched controls with age-normal hearing underwent testing of verbal working memory using digit span and serial recall of words. Phonological capacities were assessed using a lexical decision task and nonword repetition. Recognition of words in sentences in speech-shaped noise was measured.

Results

Implant users had only slightly poorer working memory accuracy than did controls and only on serial recall of words; however, phonological sensitivity was highly impaired. Working memory did not facilitate speech recognition in noise for either group. Phonological sensitivity predicted sentence recognition for implant users but not for listeners with normal hearing.

Conclusion

Clinical speech recognition outcomes for adult implant users relate to the ability of these users to process phonological information. Results suggest that phonological capacities may serve as potential clinical targets through rehabilitative training. Such novel interventions may be particularly helpful for older adult implant users.

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Vocalization Rate and Consonant Production in Toddlers at High and Low Risk for Autism

Background

Previous work has documented lower vocalization rate and consonant acquisition delays in toddlers with autism spectrum disorder (ASD). We investigated differences in these variables at 12, 18, and 24 months in toddlers at high and low risk for ASD.

Method

Vocalization rate and number of different consonants were obtained from speech samples from a prospective study of infant siblings of children with ASD. Three groups were compared: 18 toddlers at low risk for ASD (low-risk control), 18 high-risk siblings without ASD (HRA−), and 10 high-risk siblings with ASD (HRA+).

Results

All groups' mean language scores were within the normal range. HRA+ toddlers showed consistently lower vocalization rate; vocalization rate did not predict number of different consonants at 12 months for HRA+. HRA−, not HRA+, toddlers had the smallest number of different consonants and produced significantly fewer different consonants than predicted by their vocalization rate at 12 months. Consonant-acquisition trajectories differed between groups, with HRA− showing the greatest increase from 12 to 18 months.

Conclusion

Lower vocalization rate was not associated with reduced number of different consonants in these toddlers. Between-groups differences in developmental trajectories are discussed in the context of the social feedback loop and differential ability to benefit from adult feedback between groups.

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Development of Grammatical Accuracy in English-Speaking Children With Cochlear Implants: A Longitudinal Study

Purpose

We sought to evaluate the development of grammatical accuracy in English-speaking children with cochlear implants (CIs) over a 3-year span.

Method

Ten children who received CIs before age 30 months participated in this study at 3, 4, and 5 years postimplantation. For the purpose of comparison, 10 children each at ages 3, 4, and 5 years with typical hearing were included as well. All children participated in a story-retell task. We computed percent grammatical communication units (PGCU) in the task.

Results

Children with CIs showed significant improvement in PGCU over the 3-year span. However, they produced lower PGCU than children with typical hearing who had matched hearing age at 4 and 5 years postimplantation. At the individual level, some children with CIs were able to produce PGCU comparable to children with typical hearing as early as 3 years after implantation. Better speech-perception skills at earlier time points were associated with higher PGCU at later time points. Moreover, children with and without CIs showed similar rankings in the types of grammatical errors.

Conclusion

Despite having auditory-perceptual and information-processing constraints, children who received CIs before age 30 months were able to produce grammatical sentences, albeit with a delayed pattern.

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The Relationship Between Executive Functions and Language Abilities in Children: A Latent Variables Approach

Purpose

We aimed to outline the latent variables approach for measuring nonverbal executive function (EF) skills in school-age children, and to examine the relationship between nonverbal EF skills and language performance in this age group.

Method

Seventy-one typically developing children, ages 8 through 11, participated in the study. Three EF components, inhibition, updating, and task-shifting, were each indexed using 2 nonverbal tasks. A latent variables approach was used to extract latent scores that represented each EF construct. Children were also administered common standardized language measures. Multiple regression analyses were conducted to examine the relationship between EF and language skills.

Results

Nonverbal updating was associated with the Receptive Language Index on the Clinical Evaluation of Language Fundamentals–Fourth Edition (CELF-4). When composites denoting lexical–semantic and syntactic abilities were derived, nonverbal inhibition (but not shifting or updating) was found to predict children's syntactic abilities. These relationships held when the effects of age, IQ, and socioeconomic status were controlled.

Conclusions

The study makes a methodological contribution by explicating a method by which researchers can use the latent variables approach when measuring EF performance in school-age children. The study makes a theoretical and a clinical contribution by suggesting that language performance may be related to domain-general EFs.

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Auditory Phenotype of Smith–Magenis Syndrome

Purpose

The purpose of this study was to describe the auditory phenotype of a large cohort with Smith–Magenis syndrome (SMS), a rare disorder including physical anomalies, cognitive deficits, sleep disturbances, and a distinct behavioral phenotype.

Method

Hearing-related data were collected for 133 individuals with SMS aged 1–49 years. Audiogram data (97 participants) were used for cross-sectional and longitudinal analyses. Caregivers completed a sound sensitivity survey for 98 individuals with SMS and a control group of 24 unaffected siblings.

Results

Nearly 80% of participants with interpretable audiograms (n = 76) had hearing loss, which was typically slight to mild in degree. When hearing loss type could be determined (40 participants), sensorineural hearing loss (48.1%) occurred most often in participants aged 11–49 years. Conductive hearing loss (35.2%) was typically observed in children aged 1–10 years. A pattern of fluctuating and progressive hearing decline was documented. Hyperacusis was reported in 73.5% of participants with SMS compared with 12.5% of unaffected siblings.

Conclusions

This study offers the most comprehensive characterization of the auditory phenotype of SMS to date. The auditory profile in SMS is multifaceted and can include a previously unreported manifestation of hyperacusis. Routine audiologic surveillance is recommended as part of standard clinical care.

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Gesture Production in Language Impairment: It's Quality, Not Quantity, That Matters

Purpose

The aim of this study was to determine whether children with language impairment (LI) use gesture to compensate for their language difficulties.

Method

The present study investigated gesture accuracy and frequency in children with LI (n = 21) across gesture imitation, gesture elicitation, spontaneous narrative, and interactive problem-solving tasks, relative to typically developing (TD) peers (n = 18) and peers with low language and educational concerns (n = 21).

Results

Children with LI showed weaknesses in gesture accuracy (imitation and gesture elicitation) in comparison to TD peers, but no differences in gesture rate. Children with low language only showed weaknesses in gesture imitation and used significantly more gestures than TD peers during parent–child interaction. Across the whole sample, motor abilities were significantly related to gesture accuracy but not gesture rate. In addition, children with LI produced proportionately more extending gestures, suggesting that they may use gesture to replace words that they are unable to articulate verbally.

Conclusion

The results support the notion that gesture and language form a tightly linked communication system in which gesture deficits are seen alongside difficulties with spoken communication. Furthermore, it is the quality, not quantity of gestures that distinguish children with LI from typical peers.

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Directional Asymmetries in Vowel Perception of Adult Nonnative Listeners Do Not Change Over Time With Language Experience

Purpose

This study tested an assumption of the Natural Referent Vowel (Polka & Bohn, 2011) framework, namely, that directional asymmetries in adult vowel perception can be influenced by language experience.

Method

Data from participants reported in Escudero and Williams (2014) were analyzed. Spanish participants categorized the Dutch vowels /aː/ and /ɑ/ in 2 separate sessions: before and after vowel distributional training. Sessions were 12 months apart. Categorization was assessed using the XAB task, where on each trial participants heard 3 sounds sequentially (first X, then A, then B) and had to decide whether X was more similar to A or B.

Results

Before training, participants exhibited a directional asymmetry in line with the prediction of Natural Referent Vowel. Specifically, Spanish listeners performed worse when the vowel change from X to A was a change from peripheral to central vowel (/ɑ/ to /aː/). However, this asymmetry was maintained 12 months later, even though distributional training improved vowel categorization performance.

Conclusions

Improvements in adult nonnative vowel categorization accuracy are not explained by attenuation of directional asymmetries. Directional asymmetries in vowel perception are altered during native language acquisition, but may possibly be impervious to nonnative language experiences in adulthood.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: I. Development and Description of the Pause Marker

Purpose

The goal of this article (PM I) is to describe the rationale for and development of the Pause Marker (PM), a single-sign diagnostic marker proposed to discriminate early or persistent childhood apraxia of speech from speech delay.

Method

The authors describe and prioritize 7 criteria with which to evaluate the research and clinical utility of a diagnostic marker for childhood apraxia of speech, including evaluation of the present proposal. An overview is given of the Speech Disorders Classification System, including extensions completed in the same approximately 3-year period in which the PM was developed.

Results

The finalized Speech Disorders Classification System includes a nosology and cross-classification procedures for childhood and persistent speech disorders and motor speech disorders (Shriberg, Strand, & Mabie, 2017). A PM is developed that provides procedural and scoring information, and citations to papers and technical reports that include audio exemplars of the PM and reference data used to standardize PM scores are provided.

Conclusions

The PM described here is an acoustic-aided perceptual sign that quantifies one aspect of speech precision in the linguistic domain of phrasing. This diagnostic marker can be used to discriminate early or persistent childhood apraxia of speech from speech delay.

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Masthead

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Word Learning Deficits in Children With Dyslexia

Purpose

The purpose of this study is to investigate word learning in children with dyslexia to ascertain their strengths and weaknesses during the configuration stage of word learning.

Method

Children with typical development (N = 116) and dyslexia (N = 68) participated in computer-based word learning games that assessed word learning in 4 sets of games that manipulated phonological or visuospatial demands. All children were monolingual English-speaking 2nd graders without oral language impairment. The word learning games measured children's ability to link novel names with novel objects, to make decisions about the accuracy of those names and objects, to recognize the semantic features of the objects, and to produce the names of the novel words. Accuracy data were analyzed using analyses of covariance with nonverbal intelligence scores as a covariate.

Results

Word learning deficits were evident for children with dyslexia across every type of manipulation and on 3 of 5 tasks, but not for every combination of task/manipulation. Deficits were more common when task demands taxed phonology. Visuospatial manipulations led to both disadvantages and advantages for children with dyslexia.

Conclusion

Children with dyslexia evidence spoken word learning deficits, but their performance is highly dependent on manipulations and task demand, suggesting a processing trade-off between visuospatial and phonological demands.

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Factors Influencing Consonant Acquisition in Brazilian Portuguese–Speaking Children

Purpose

We sought to provide valid and reliable data on the acquisition of consonant sounds in speakers of Brazilian Portuguese.

Method

The sample comprised 733 typically developing monolingual speakers of Brazilian Portuguese (ages 3;0–8;11 [years;months]). The presence of surface speech error patterns, the revised percentage consonants correct, and the age of sound acquisition were evaluated using phonological assessment software. The normative values for these variables were reported using means and standard deviations.

Results

Age had a significant impact on phoneme production. Increasing age was generally associated with an increase in correct phoneme production, a reduction in error patterns, and an increase in scores on revised percentage consonants correct. Phonological error patterns persisted for a longer time in consonants and consonant clusters acquired later in development. The 2 youngest age groups differed from the remainder of the sample on the frequency of the following phonological patterns: cluster reduction, liquid gliding, fricative deletion–coda, and weak-syllable deletion. Performance was similar between groups starting at 5;0 years old.

Conclusion

This study confirmed that nasal and stop consonants are acquired first, followed by fricatives and, finally, liquids. We suggest that future studies replicate our investigation in larger samples and younger age groups.

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Characterizing Articulation in Apraxic Speech Using Real-Time Magnetic Resonance Imaging

Purpose

Real-time magnetic resonance imaging (MRI) and accompanying analytical methods are shown to capture and quantify salient aspects of apraxic speech, substantiating and expanding upon evidence provided by clinical observation and acoustic and kinematic data. Analysis of apraxic speech errors within a dynamic systems framework is provided and the nature of pathomechanisms of apraxic speech discussed.

Method

One adult male speaker with apraxia of speech was imaged using real-time MRI while producing spontaneous speech, repeated naming tasks, and self-paced repetition of word pairs designed to elicit speech errors. Articulatory data were analyzed, and speech errors were detected using time series reflecting articulatory activity in regions of interest.

Results

Real-time MRI captured two types of apraxic gestural intrusion errors in a word pair repetition task. Gestural intrusion errors in nonrepetitive speech, multiple silent initiation gestures at the onset of speech, and covert (unphonated) articulation of entire monosyllabic words were also captured.

Conclusion

Real-time MRI and accompanying analytical methods capture and quantify many features of apraxic speech that have been previously observed using other modalities while offering high spatial resolution. This patient's apraxia of speech affected the ability to select only the appropriate vocal tract gestures for a target utterance, suppressing others, and to coordinate them in time.

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Temperament and Early Stuttering Development: Cross-Sectional Findings From a Community Cohort

Purpose

The purpose of this study was to ascertain if there is an association between stuttering severity and behaviors and the expression of temperament characteristics, including precursors of anxiety.

Method

We studied temperament characteristics of a prospectively recruited community cohort of children who stutter (N = 173) at ages 3, 4, and 6 years using the Short Temperament Scale STS (Prior, Sanson, Smart & Oberklaid, 2000).

Results

Six of 131 statistical tests of association between stuttering severity and behaviors and temperament traits were statistically significant at the 5% level, which was no more than expected by chance alone.

Conclusions

On the basis of parent responses to the STS, preschoolers who exhibited different levels of stuttering severity and behaviors did not generally express temperament traits differently from one another. Stuttering severity and stuttering behaviors were not associated with the precursors of anxiety. Overall, taking multiple tests into consideration, results show little evidence of association between stuttering severity and temperament up to 4 years of age or between stuttering behaviors and temperament up to 6 years of age.

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Motor Speech Phenotypes of Frontotemporal Dementia, Primary Progressive Aphasia, and Progressive Apraxia of Speech

Purpose

Our purpose was to create a comprehensive review of speech impairment in frontotemporal dementia (FTD), primary progressive aphasia (PPA), and progressive apraxia of speech in order to identify the most effective measures for diagnosis and monitoring, and to elucidate associations between speech and neuroimaging.

Method

Speech and neuroimaging data described in studies of FTD and PPA were systematically reviewed. A meta-analysis was conducted for speech measures that were used consistently in multiple studies.

Results

The methods and nomenclature used to describe speech in these disorders varied between studies. Our meta-analysis identified 3 speech measures which differentiate variants or healthy control-group participants (e.g., nonfluent and logopenic variants of PPA from all other groups, behavioral-variant FTD from a control group). Deficits within the frontal-lobe speech networks are linked to motor speech profiles of the nonfluent variant of PPA and progressive apraxia of speech. Motor speech impairment is rarely reported in semantic and logopenic variants of PPA. Limited data are available on motor speech impairment in the behavioral variant of FTD.

Conclusions

Our review identified several measures of speech which may assist with diagnosis and classification, and consolidated the brain–behavior associations relating to speech in FTD, PPA, and progressive apraxia of speech.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: III. Theoretical Coherence of the Pause Marker with Speech Processing Deficits in Childhood Apraxia of Speech

Purpose

Previous articles in this supplement described rationale for and development of the pause marker (PM), a diagnostic marker of childhood apraxia of speech (CAS), and studies supporting its validity and reliability. The present article assesses the theoretical coherence of the PM with speech processing deficits in CAS.

Method

PM and other scores were obtained for 264 participants in 6 groups: CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech (AAS) consequent to stroke and primary progressive apraxia of speech; and idiopathic speech delay.

Results

Participants with CAS and AAS had significantly lower scores than typically speaking reference participants and speech delay controls on measures posited to assess representational and transcoding processes. Representational deficits differed between CAS and AAS groups, with support for both underspecified linguistic representations and memory/access deficits in CAS, but for only the latter in AAS. CAS–AAS similarities in the age–sex standardized percentages of occurrence of the most frequent type of inappropriate pauses (abrupt) and significant differences in the standardized occurrence of appropriate pauses were consistent with speech processing findings.

Conclusions

Results support the hypotheses of core representational and transcoding speech processing deficits in CAS and theoretical coherence of the PM's pause-speech elements with these deficits.

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Delayed Early Vocabulary Development in Children at Family Risk of Dyslexia

Purpose

This study aimed to gain more insight into the relation between vocabulary and reading acquisition by examining early growth trajectories in the vocabulary of children at family risk (FR) of dyslexia longitudinally.

Method

The sample included 212 children from the Dutch Dyslexia Program with and without an FR. Parents reported on their children's receptive and expressive vocabulary size at ages 17, 23, 29, and 35 months using the Dutch MacArthur Communicative Development Inventories. Dyslexia status at the end of Grade 2 (8 years) rendered 3 groups: FR-dyslexic (n = 51), FR-nondyslexic (n = 92), and typically developing–nondyslexic (TD) children (n = 69).

Results

Repeated measures analyses showed that FR-dyslexic children had lower receptive vocabulary scores from 23 months onward and lower expressive scores from 17 months onward than FR-nondyslexic children. Latent growth curve modeling showed lower initial growth rates in FR-dyslexic children, followed by partial recovery, indicating a delayed increase in receptive and expressive vocabulary. FR-nondyslexic and TD children did not differ.

Conclusions

Early deficits in receptive and expressive vocabulary are associated with later reading. Early vocabulary growth of FR-dyslexic children is characterized by a delay but not deviance of growth. Vocabulary can be considered an additional risk factor for dyslexia.

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Polish Vocabulary Development in 2-Year-Olds: Comparisons With English Using the Language Development Survey

Purpose

The objective of this study was to compare vocabulary size and composition in 2-year-olds learning Polish or English as measured by the Language Development Survey (LDS; Rescorla, 1989).

Method

Participants were 199 Polish toddlers (M = 24.14 months, SD = 0.35) and 422 U.S. toddlers (M = 24.69 months, SD = 0.78).

Results

Test–retest reliability was .92, internal consistency was .99, and concurrent validity was .55. Girls had higher vocabulary scores than boys. Mean LDS score was significantly lower in Polish than in English, and fewer Polish children had LDS scores >200 words. Also, more words were reported for Conclusions

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Examining a New Method to Studying Velopharyngeal Structures in a Child With 22q11.2 Deletion Syndrome

Purpose

To date, no studies have imaged the velopharynx in children with 22q11.2 deletion syndrome (22q11.2 DS) without the use of sedation. Dysmorphology in velopharyngeal structures has been shown to have significant negative implications on speech among these individuals. This single case study was designed to assess the feasibility of a child-friendly magnetic resonance imaging (MRI) scanning protocol in this clinically challenging population and to determine the utility of this MRI protocol for future work in this area.

Method

One 6-year-old White girl diagnosed with 22q11.2 DS was imaged using a child-friendly, nonsedated MRI protocol. Quantitative and qualitative measures of the velopharyngeal area and associated structures were evaluated, and comparisons were made to age-matched control subjects with normal velopharyngeal anatomy.

Results

MRI data were successfully obtained using the child-friendly scanning protocol in the subject in the present study. Quantitative and qualitative differences of the levator muscle and associated velopharyngeal structures were noted. Using these MRI and structural analyses methods, insights related to muscle morphology can be obtained and considered as part of the research and clinical examination of children with 22q11.2 DS.

Conclusion

The imaging protocol described in this study presents an effective means to counteract difficulties in imaging young children.

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The Effect of Tinnitus on Listening Effort in Normal-Hearing Young Adults: A Preliminary Study

Purpose

The objective of this study was to investigate the effect of chronic tinnitus on listening effort.

Method

Thirteen normal-hearing young adults with chronic tinnitus were matched with a control group for age, gender, hearing thresholds, and educational level. A dual-task paradigm was used to evaluate listening effort in different listening conditions. A primary speech-recognition task and a secondary memory task were performed both separately and simultaneously. Furthermore, subjective listening effort was questioned for various listening situations. The Tinnitus Handicap Inventory was used to control for tinnitus handicap.

Results

Listening effort significantly increased in the tinnitus group across listening conditions. There was no significant difference in listening effort between listening conditions, nor was there an interaction between groups and listening conditions. Subjective listening effort did not significantly differ between both groups.

Conclusions

This study is a first exploration of listening effort in normal-hearing participants with chronic tinnitus showing that listening effort is increased as compared with a control group. There is a need to further investigate the cognitive functions important for speech understanding and their possible relation with the presence of tinnitus and listening effort.

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Electrophysiology of Perception and Processing of Phonological Information as Indices of Toddlers' Language Performance

Purpose

The toddler years are a critical period for language development and growth. We investigated how event-related potentials (ERPs) to repeated and novel nonwords are associated with clinical assessments of language in young children. In addition, nonword repetition (NWR) was used to measure phonological working memory to determine the unique and collective contribution of ERP measures of phonemic discrimination and NWR as predictors of language ability.

Method

Forty children between the ages of 24–48 months participated in an ERP experiment to determine phonemic discrimination to repeated and novel nonwords in an old/new design. Participants also completed a NWR task to explore the contribution of phonological working memory in predicting language.

Results

ERP analyses revealed that faster responses to novel stimuli correlated with higher language performance on clinical assessments of language. Regression analyses revealed that an earlier component was associated with lower level phonemic sensitivity, and a later component was indexing phonological working memory skills similar to NWR.

Conclusion

Our findings suggest that passive ERP responses indexing phonological discrimination and phonological working memory are strongly related to behavioral measures of language.

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Speech Recognition in Adults With Cochlear Implants: The Effects of Working Memory, Phonological Sensitivity, and Aging

Purpose

Models of speech recognition suggest that “top-down” linguistic and cognitive functions, such as use of phonotactic constraints and working memory, facilitate recognition under conditions of degradation, such as in noise. The question addressed in this study was what happens to these functions when a listener who has experienced years of hearing loss obtains a cochlear implant.

Method

Thirty adults with cochlear implants and 30 age-matched controls with age-normal hearing underwent testing of verbal working memory using digit span and serial recall of words. Phonological capacities were assessed using a lexical decision task and nonword repetition. Recognition of words in sentences in speech-shaped noise was measured.

Results

Implant users had only slightly poorer working memory accuracy than did controls and only on serial recall of words; however, phonological sensitivity was highly impaired. Working memory did not facilitate speech recognition in noise for either group. Phonological sensitivity predicted sentence recognition for implant users but not for listeners with normal hearing.

Conclusion

Clinical speech recognition outcomes for adult implant users relate to the ability of these users to process phonological information. Results suggest that phonological capacities may serve as potential clinical targets through rehabilitative training. Such novel interventions may be particularly helpful for older adult implant users.

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Vocalization Rate and Consonant Production in Toddlers at High and Low Risk for Autism

Background

Previous work has documented lower vocalization rate and consonant acquisition delays in toddlers with autism spectrum disorder (ASD). We investigated differences in these variables at 12, 18, and 24 months in toddlers at high and low risk for ASD.

Method

Vocalization rate and number of different consonants were obtained from speech samples from a prospective study of infant siblings of children with ASD. Three groups were compared: 18 toddlers at low risk for ASD (low-risk control), 18 high-risk siblings without ASD (HRA−), and 10 high-risk siblings with ASD (HRA+).

Results

All groups' mean language scores were within the normal range. HRA+ toddlers showed consistently lower vocalization rate; vocalization rate did not predict number of different consonants at 12 months for HRA+. HRA−, not HRA+, toddlers had the smallest number of different consonants and produced significantly fewer different consonants than predicted by their vocalization rate at 12 months. Consonant-acquisition trajectories differed between groups, with HRA− showing the greatest increase from 12 to 18 months.

Conclusion

Lower vocalization rate was not associated with reduced number of different consonants in these toddlers. Between-groups differences in developmental trajectories are discussed in the context of the social feedback loop and differential ability to benefit from adult feedback between groups.

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Development of Grammatical Accuracy in English-Speaking Children With Cochlear Implants: A Longitudinal Study

Purpose

We sought to evaluate the development of grammatical accuracy in English-speaking children with cochlear implants (CIs) over a 3-year span.

Method

Ten children who received CIs before age 30 months participated in this study at 3, 4, and 5 years postimplantation. For the purpose of comparison, 10 children each at ages 3, 4, and 5 years with typical hearing were included as well. All children participated in a story-retell task. We computed percent grammatical communication units (PGCU) in the task.

Results

Children with CIs showed significant improvement in PGCU over the 3-year span. However, they produced lower PGCU than children with typical hearing who had matched hearing age at 4 and 5 years postimplantation. At the individual level, some children with CIs were able to produce PGCU comparable to children with typical hearing as early as 3 years after implantation. Better speech-perception skills at earlier time points were associated with higher PGCU at later time points. Moreover, children with and without CIs showed similar rankings in the types of grammatical errors.

Conclusion

Despite having auditory-perceptual and information-processing constraints, children who received CIs before age 30 months were able to produce grammatical sentences, albeit with a delayed pattern.

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The Relationship Between Executive Functions and Language Abilities in Children: A Latent Variables Approach

Purpose

We aimed to outline the latent variables approach for measuring nonverbal executive function (EF) skills in school-age children, and to examine the relationship between nonverbal EF skills and language performance in this age group.

Method

Seventy-one typically developing children, ages 8 through 11, participated in the study. Three EF components, inhibition, updating, and task-shifting, were each indexed using 2 nonverbal tasks. A latent variables approach was used to extract latent scores that represented each EF construct. Children were also administered common standardized language measures. Multiple regression analyses were conducted to examine the relationship between EF and language skills.

Results

Nonverbal updating was associated with the Receptive Language Index on the Clinical Evaluation of Language Fundamentals–Fourth Edition (CELF-4). When composites denoting lexical–semantic and syntactic abilities were derived, nonverbal inhibition (but not shifting or updating) was found to predict children's syntactic abilities. These relationships held when the effects of age, IQ, and socioeconomic status were controlled.

Conclusions

The study makes a methodological contribution by explicating a method by which researchers can use the latent variables approach when measuring EF performance in school-age children. The study makes a theoretical and a clinical contribution by suggesting that language performance may be related to domain-general EFs.

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Auditory Phenotype of Smith–Magenis Syndrome

Purpose

The purpose of this study was to describe the auditory phenotype of a large cohort with Smith–Magenis syndrome (SMS), a rare disorder including physical anomalies, cognitive deficits, sleep disturbances, and a distinct behavioral phenotype.

Method

Hearing-related data were collected for 133 individuals with SMS aged 1–49 years. Audiogram data (97 participants) were used for cross-sectional and longitudinal analyses. Caregivers completed a sound sensitivity survey for 98 individuals with SMS and a control group of 24 unaffected siblings.

Results

Nearly 80% of participants with interpretable audiograms (n = 76) had hearing loss, which was typically slight to mild in degree. When hearing loss type could be determined (40 participants), sensorineural hearing loss (48.1%) occurred most often in participants aged 11–49 years. Conductive hearing loss (35.2%) was typically observed in children aged 1–10 years. A pattern of fluctuating and progressive hearing decline was documented. Hyperacusis was reported in 73.5% of participants with SMS compared with 12.5% of unaffected siblings.

Conclusions

This study offers the most comprehensive characterization of the auditory phenotype of SMS to date. The auditory profile in SMS is multifaceted and can include a previously unreported manifestation of hyperacusis. Routine audiologic surveillance is recommended as part of standard clinical care.

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Gesture Production in Language Impairment: It's Quality, Not Quantity, That Matters

Purpose

The aim of this study was to determine whether children with language impairment (LI) use gesture to compensate for their language difficulties.

Method

The present study investigated gesture accuracy and frequency in children with LI (n = 21) across gesture imitation, gesture elicitation, spontaneous narrative, and interactive problem-solving tasks, relative to typically developing (TD) peers (n = 18) and peers with low language and educational concerns (n = 21).

Results

Children with LI showed weaknesses in gesture accuracy (imitation and gesture elicitation) in comparison to TD peers, but no differences in gesture rate. Children with low language only showed weaknesses in gesture imitation and used significantly more gestures than TD peers during parent–child interaction. Across the whole sample, motor abilities were significantly related to gesture accuracy but not gesture rate. In addition, children with LI produced proportionately more extending gestures, suggesting that they may use gesture to replace words that they are unable to articulate verbally.

Conclusion

The results support the notion that gesture and language form a tightly linked communication system in which gesture deficits are seen alongside difficulties with spoken communication. Furthermore, it is the quality, not quantity of gestures that distinguish children with LI from typical peers.

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Directional Asymmetries in Vowel Perception of Adult Nonnative Listeners Do Not Change Over Time With Language Experience

Purpose

This study tested an assumption of the Natural Referent Vowel (Polka & Bohn, 2011) framework, namely, that directional asymmetries in adult vowel perception can be influenced by language experience.

Method

Data from participants reported in Escudero and Williams (2014) were analyzed. Spanish participants categorized the Dutch vowels /aː/ and /ɑ/ in 2 separate sessions: before and after vowel distributional training. Sessions were 12 months apart. Categorization was assessed using the XAB task, where on each trial participants heard 3 sounds sequentially (first X, then A, then B) and had to decide whether X was more similar to A or B.

Results

Before training, participants exhibited a directional asymmetry in line with the prediction of Natural Referent Vowel. Specifically, Spanish listeners performed worse when the vowel change from X to A was a change from peripheral to central vowel (/ɑ/ to /aː/). However, this asymmetry was maintained 12 months later, even though distributional training improved vowel categorization performance.

Conclusions

Improvements in adult nonnative vowel categorization accuracy are not explained by attenuation of directional asymmetries. Directional asymmetries in vowel perception are altered during native language acquisition, but may possibly be impervious to nonnative language experiences in adulthood.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: I. Development and Description of the Pause Marker

Purpose

The goal of this article (PM I) is to describe the rationale for and development of the Pause Marker (PM), a single-sign diagnostic marker proposed to discriminate early or persistent childhood apraxia of speech from speech delay.

Method

The authors describe and prioritize 7 criteria with which to evaluate the research and clinical utility of a diagnostic marker for childhood apraxia of speech, including evaluation of the present proposal. An overview is given of the Speech Disorders Classification System, including extensions completed in the same approximately 3-year period in which the PM was developed.

Results

The finalized Speech Disorders Classification System includes a nosology and cross-classification procedures for childhood and persistent speech disorders and motor speech disorders (Shriberg, Strand, & Mabie, 2017). A PM is developed that provides procedural and scoring information, and citations to papers and technical reports that include audio exemplars of the PM and reference data used to standardize PM scores are provided.

Conclusions

The PM described here is an acoustic-aided perceptual sign that quantifies one aspect of speech precision in the linguistic domain of phrasing. This diagnostic marker can be used to discriminate early or persistent childhood apraxia of speech from speech delay.

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Masthead

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Word Learning Deficits in Children With Dyslexia

Purpose

The purpose of this study is to investigate word learning in children with dyslexia to ascertain their strengths and weaknesses during the configuration stage of word learning.

Method

Children with typical development (N = 116) and dyslexia (N = 68) participated in computer-based word learning games that assessed word learning in 4 sets of games that manipulated phonological or visuospatial demands. All children were monolingual English-speaking 2nd graders without oral language impairment. The word learning games measured children's ability to link novel names with novel objects, to make decisions about the accuracy of those names and objects, to recognize the semantic features of the objects, and to produce the names of the novel words. Accuracy data were analyzed using analyses of covariance with nonverbal intelligence scores as a covariate.

Results

Word learning deficits were evident for children with dyslexia across every type of manipulation and on 3 of 5 tasks, but not for every combination of task/manipulation. Deficits were more common when task demands taxed phonology. Visuospatial manipulations led to both disadvantages and advantages for children with dyslexia.

Conclusion

Children with dyslexia evidence spoken word learning deficits, but their performance is highly dependent on manipulations and task demand, suggesting a processing trade-off between visuospatial and phonological demands.

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Factors Influencing Consonant Acquisition in Brazilian Portuguese–Speaking Children

Purpose

We sought to provide valid and reliable data on the acquisition of consonant sounds in speakers of Brazilian Portuguese.

Method

The sample comprised 733 typically developing monolingual speakers of Brazilian Portuguese (ages 3;0–8;11 [years;months]). The presence of surface speech error patterns, the revised percentage consonants correct, and the age of sound acquisition were evaluated using phonological assessment software. The normative values for these variables were reported using means and standard deviations.

Results

Age had a significant impact on phoneme production. Increasing age was generally associated with an increase in correct phoneme production, a reduction in error patterns, and an increase in scores on revised percentage consonants correct. Phonological error patterns persisted for a longer time in consonants and consonant clusters acquired later in development. The 2 youngest age groups differed from the remainder of the sample on the frequency of the following phonological patterns: cluster reduction, liquid gliding, fricative deletion–coda, and weak-syllable deletion. Performance was similar between groups starting at 5;0 years old.

Conclusion

This study confirmed that nasal and stop consonants are acquired first, followed by fricatives and, finally, liquids. We suggest that future studies replicate our investigation in larger samples and younger age groups.

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Characterizing Articulation in Apraxic Speech Using Real-Time Magnetic Resonance Imaging

Purpose

Real-time magnetic resonance imaging (MRI) and accompanying analytical methods are shown to capture and quantify salient aspects of apraxic speech, substantiating and expanding upon evidence provided by clinical observation and acoustic and kinematic data. Analysis of apraxic speech errors within a dynamic systems framework is provided and the nature of pathomechanisms of apraxic speech discussed.

Method

One adult male speaker with apraxia of speech was imaged using real-time MRI while producing spontaneous speech, repeated naming tasks, and self-paced repetition of word pairs designed to elicit speech errors. Articulatory data were analyzed, and speech errors were detected using time series reflecting articulatory activity in regions of interest.

Results

Real-time MRI captured two types of apraxic gestural intrusion errors in a word pair repetition task. Gestural intrusion errors in nonrepetitive speech, multiple silent initiation gestures at the onset of speech, and covert (unphonated) articulation of entire monosyllabic words were also captured.

Conclusion

Real-time MRI and accompanying analytical methods capture and quantify many features of apraxic speech that have been previously observed using other modalities while offering high spatial resolution. This patient's apraxia of speech affected the ability to select only the appropriate vocal tract gestures for a target utterance, suppressing others, and to coordinate them in time.

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Temperament and Early Stuttering Development: Cross-Sectional Findings From a Community Cohort

Purpose

The purpose of this study was to ascertain if there is an association between stuttering severity and behaviors and the expression of temperament characteristics, including precursors of anxiety.

Method

We studied temperament characteristics of a prospectively recruited community cohort of children who stutter (N = 173) at ages 3, 4, and 6 years using the Short Temperament Scale STS (Prior, Sanson, Smart & Oberklaid, 2000).

Results

Six of 131 statistical tests of association between stuttering severity and behaviors and temperament traits were statistically significant at the 5% level, which was no more than expected by chance alone.

Conclusions

On the basis of parent responses to the STS, preschoolers who exhibited different levels of stuttering severity and behaviors did not generally express temperament traits differently from one another. Stuttering severity and stuttering behaviors were not associated with the precursors of anxiety. Overall, taking multiple tests into consideration, results show little evidence of association between stuttering severity and temperament up to 4 years of age or between stuttering behaviors and temperament up to 6 years of age.

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Motor Speech Phenotypes of Frontotemporal Dementia, Primary Progressive Aphasia, and Progressive Apraxia of Speech

Purpose

Our purpose was to create a comprehensive review of speech impairment in frontotemporal dementia (FTD), primary progressive aphasia (PPA), and progressive apraxia of speech in order to identify the most effective measures for diagnosis and monitoring, and to elucidate associations between speech and neuroimaging.

Method

Speech and neuroimaging data described in studies of FTD and PPA were systematically reviewed. A meta-analysis was conducted for speech measures that were used consistently in multiple studies.

Results

The methods and nomenclature used to describe speech in these disorders varied between studies. Our meta-analysis identified 3 speech measures which differentiate variants or healthy control-group participants (e.g., nonfluent and logopenic variants of PPA from all other groups, behavioral-variant FTD from a control group). Deficits within the frontal-lobe speech networks are linked to motor speech profiles of the nonfluent variant of PPA and progressive apraxia of speech. Motor speech impairment is rarely reported in semantic and logopenic variants of PPA. Limited data are available on motor speech impairment in the behavioral variant of FTD.

Conclusions

Our review identified several measures of speech which may assist with diagnosis and classification, and consolidated the brain–behavior associations relating to speech in FTD, PPA, and progressive apraxia of speech.

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Hair Cells Regeneration Research Shows There Might Be a Cure for Hearing Loss

Researchers from St. Jude Children's Research Hospital successfully regenerated auditory hair cells in adult mice, raising hope for a future hearing loss treatment. (Cell Reports. 2017;19[2]:307.) Auditory hair cells regenerate in fish and chicken but not humans, and that's where Jian Zuo,PhD, of St. Jude's department of developmental neurobiology and his team looked for answers. "The process involves down-regulating expression of the protein p27 and up-regulating the expression of the protein ATOH 1," Zuo said. "So we tried the same approach in specially bred adult mice." By manipulating these genes, Zuo and his colleagues induced supporting cells in the inner ear of adult mice to take on the appearance of immature hair cells and begin producing some of the signature proteins of hair cells.

They also identified the genetic pathway for hair cell regeneration and how proteins in that pathway, including GATA3, POUAF3, p27, and ATOH1, cooperate to foster the process. ATOH1 is a transcription factor necessary for hair cell development, but this gene is switched off in humans before birth. Zuo said, "This study suggests that targeting p27, GATA3, and POU4F3 may enhance the outcome of gene therapy and other approaches that aim to restart ATOH1 expression. Work will continue to identify other factors, including small molecules, necessary to promote the maturation and survival of the newly generated hair cells as well as increase their number, according to Zuo. 

Published: 4/14/2017 11:04:00 AM

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Hair Cells Regeneration Research Shows There Might Be a Cure for Hearing Loss

Researchers from St. Jude Children's Research Hospital successfully regenerated auditory hair cells in adult mice, raising hope for a future hearing loss treatment. (Cell Reports. 2017;19[2]:307.) Auditory hair cells regenerate in fish and chicken but not humans, and that's where Jian Zuo,PhD, of St. Jude's department of developmental neurobiology and his team looked for answers. "The process involves down-regulating expression of the protein p27 and up-regulating the expression of the protein ATOH 1," Zuo said. "So we tried the same approach in specially bred adult mice." By manipulating these genes, Zuo and his colleagues induced supporting cells in the inner ear of adult mice to take on the appearance of immature hair cells and begin producing some of the signature proteins of hair cells.

They also identified the genetic pathway for hair cell regeneration and how proteins in that pathway, including GATA3, POUAF3, p27, and ATOH1, cooperate to foster the process. ATOH1 is a transcription factor necessary for hair cell development, but this gene is switched off in humans before birth. Zuo said, "This study suggests that targeting p27, GATA3, and POU4F3 may enhance the outcome of gene therapy and other approaches that aim to restart ATOH1 expression. Work will continue to identify other factors, including small molecules, necessary to promote the maturation and survival of the newly generated hair cells as well as increase their number, according to Zuo. 

Published: 4/14/2017 11:04:00 AM

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Hair Cells Regeneration Research Shows There Might Be a Cure for Hearing Loss

Researchers from St. Jude Children's Research Hospital successfully regenerated auditory hair cells in adult mice, raising hope for a future hearing loss treatment. (Cell Reports. 2017;19[2]:307.) Auditory hair cells regenerate in fish and chicken but not humans, and that's where Jian Zuo,PhD, of St. Jude's department of developmental neurobiology and his team looked for answers. "The process involves down-regulating expression of the protein p27 and up-regulating the expression of the protein ATOH 1," Zuo said. "So we tried the same approach in specially bred adult mice." By manipulating these genes, Zuo and his colleagues induced supporting cells in the inner ear of adult mice to take on the appearance of immature hair cells and begin producing some of the signature proteins of hair cells.

They also identified the genetic pathway for hair cell regeneration and how proteins in that pathway, including GATA3, POUAF3, p27, and ATOH1, cooperate to foster the process. ATOH1 is a transcription factor necessary for hair cell development, but this gene is switched off in humans before birth. Zuo said, "This study suggests that targeting p27, GATA3, and POU4F3 may enhance the outcome of gene therapy and other approaches that aim to restart ATOH1 expression. Work will continue to identify other factors, including small molecules, necessary to promote the maturation and survival of the newly generated hair cells as well as increase their number, according to Zuo. 

Published: 4/14/2017 11:04:00 AM

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Sports-Related Concussions and Vestibular Symptoms

The annual estimate for sports-related concussions in the United States is between 1.6 and 3.8 million cases. Concussions produce a variety of symptoms with a headache as the top complaint. Other common complaints include auditory-vestibular symptoms, such as dizziness, tinnitus, and sound sensitivity.  Recently, Chorney et al. (2017) examined rates of audiovestibular symptoms following sports-related concussions among college athletes. Data were acquired from the National Collegiate Athletic Association (NCAA) Injury Surveillance System (ISS). 

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In Vivo Interplay between p27(Kip1), GATA3, ATOH1, and POU4F3 Converts Non-sensory Cells to Hair Cells in Adult Mice.

Related Articles

In Vivo Interplay between p27(Kip1), GATA3, ATOH1, and POU4F3 Converts Non-sensory Cells to Hair Cells in Adult Mice.

Cell Rep. 2017 Apr 11;19(2):307-320

Authors: Walters BJ, Coak E, Dearman J, Bailey G, Yamashita T, Kuo B, Zuo J

Abstract
Hearing loss is widespread and persistent because mature mammalian auditory hair cells (HCs) are nonregenerative. In mice, the ability to regenerate HCs from surrounding supporting cells (SCs) declines abruptly after postnatal maturation. We find that combining p27(Kip1) deletion with ectopic ATOH1 expression surmounts this age-related decline, leading to conversion of SCs to HCs in mature mouse cochleae and after noise damage. p27(Kip1) deletion, independent of canonical effects on Rb-family proteins, upregulated GATA3, a co-factor for ATOH1 that is lost from SCs with age. Co-activation of GATA3 or POU4F3 and ATOH1 promoted conversion of SCs to HCs in adult mice. Activation of POU4F3 alone also converted mature SCs to HCs in vivo. These data illuminate a genetic pathway that initiates auditory HC regeneration and suggest p27(Kip1), GATA3, and POU4F3 as additional therapeutic targets for ATOH1-mediated HC regeneration.

PMID: 28402854 [PubMed - in process]

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Impairments of balance, stepping reactions and gait in people with cervical dystonia

Publication date: June 2017
Source:Gait & Posture, Volume 55
Author(s): Christopher Barr, Rhiannon Barnard, Lauren Edwards, Sheila Lennon, Lynley Bradnam
BackgroundImpaired balance is common in neurological disorders. Cervical dystonia is a neurological movement disorder affecting the neck. The effect of this aberrant head posture on physical function is unknown.ObjectivesTo compare balance, mobility, gait and stepping reactions between ten people with cervical dystonia and ten control adults.MethodsSpatiotemporal gait parameters and walking speed were assessed using a computerised walkway. Step length and time, time in double support and gait variability were calculated, then normalised to gait speed. Centre of pressure path length was assessed with eyes open and eyes closed to calculate a Romberg Quotient. Simple and choice reaction times were measured using customised apparatus while mobility was assessed by the timed up and go. Cervical spine range of motion was measured using a head mounted goniometer. Self-reported scales included Falls Self Efficacy Scale and Dystonia Discomfort Scale.ResultsThere was a difference between groups for most outcome measures. The timed up-and-go and walking speed was slower (both P<0.005) and the Romberg Quotient lower (P=0.046) in cervical dystonia. People with cervical dystonia had lower falls self-efficacy (P=0.0002). Reduced cervical range of motion was correlated with balance, stepping reaction time and mobility (all P<0.05). Timed up and go was positively associated with stepping reaction time (P<0.01). Dystonia discomfort did not impact function.ConclusionsPeople with cervical dystonia displayed deficits in balance, gait and stepping reactions, and expressed higher fear of falling. Studies to further elucidate functional limitations and their impact on activity and participation in daily life are required.



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