Parenting Stress and Maternal Coherence: Mothers With Deaf or Hard-of-Hearing Children

Purpose

The aim of this study was to develop a substantive theory that explains parenting stress among mothers of deaf or hard-of-hearing (D/HH) children.

Method

Fifteen hearing mothers of children with severe-to-profound sensorineural hearing loss were interviewed. Interviews were transcribed verbatim, and a grounded theory approach was used to inductively analyze parental stress in mothers of D/HH children. Theory generation was achieved through triangulation of data sources and systematic organization of data into codes. The coding process identified salient themes that were constantly cross-checked and compared across data to further develop categories, properties, and tentative hypotheses.

Results

In general, two main themes emerged from the interviews: the contextual stressors and stress-reducing resources. The contextual stressors were labeled as distress over audiology-related needs, pressure to acquire new knowledge and skills, apprehension about the child's future, and demoralizing negative social attitudes. The stress-reducing resources that moderated parenting stress were identified to be the child's progress, mother's characteristics, professional support, and social support. The interaction between the identified stressors and adjustment process uncovered a central theme termed maternal coherence.

Conclusion

The substantive theory suggests that mothers of D/HH children can effectively manage parenting stress and increase well-being by capitalizing on relevant stress-reducing resources to achieve maternal coherence.

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Parenting Stress and Maternal Coherence: Mothers With Deaf or Hard-of-Hearing Children

Purpose

The aim of this study was to develop a substantive theory that explains parenting stress among mothers of deaf or hard-of-hearing (D/HH) children.

Method

Fifteen hearing mothers of children with severe-to-profound sensorineural hearing loss were interviewed. Interviews were transcribed verbatim, and a grounded theory approach was used to inductively analyze parental stress in mothers of D/HH children. Theory generation was achieved through triangulation of data sources and systematic organization of data into codes. The coding process identified salient themes that were constantly cross-checked and compared across data to further develop categories, properties, and tentative hypotheses.

Results

In general, two main themes emerged from the interviews: the contextual stressors and stress-reducing resources. The contextual stressors were labeled as distress over audiology-related needs, pressure to acquire new knowledge and skills, apprehension about the child's future, and demoralizing negative social attitudes. The stress-reducing resources that moderated parenting stress were identified to be the child's progress, mother's characteristics, professional support, and social support. The interaction between the identified stressors and adjustment process uncovered a central theme termed maternal coherence.

Conclusion

The substantive theory suggests that mothers of D/HH children can effectively manage parenting stress and increase well-being by capitalizing on relevant stress-reducing resources to achieve maternal coherence.

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Effects of Interventions That Include Aided Augmentative and Alternative Communication Input on the Communication of Individuals With Complex Communication Needs: A Meta-Analysis

Purpose

The purpose of this meta-analysis was to investigate the effects of augmentative and alternative communication (AAC) interventions that included aided AAC input (e.g., aided AAC modeling, aided language modeling, aided language stimulation, augmented input) on communicative outcomes (both comprehension and expression) for individuals with developmental disabilities who use AAC.

Method

A systematic search resulted in the identification of 26 single-case experimental designs (88 participants) and 2 group experimental designs (103 participants). Studies were coded in terms of participants, intervention characteristics, dependent variables, outcomes, and quality of evidence.

Results

AAC interventions that included aided AAC input in isolation, or as part of a multicomponent intervention, were found to be highly effective across participants of various ages, disabilities, and language skills. The interventions typically included aided AAC input in conjunction with expectant delay, direct prompting (e.g., spoken, gestural), contingent responding, and open-ended questions. The interventions were found to be highly effective in supporting both comprehension and expression across the domains of pragmatics, semantics, and morphosyntax. Outcomes related to expression were reported more often than outcomes related to comprehension.

Conclusion

Aided AAC input may reduce input–output asymmetry and enhance expression and comprehension for individuals who use AAC; the evidence suggests that partners should utilize this strategy. Future research is needed to investigate the effects of AAC input (aided and unaided) on long-term language development for individuals who require AAC.

Supplemental Material

https://doi.org/10.23641/asha.6394364

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Intrinsic Laryngeal Muscle Response to a Public Speech Preparation Stressor

Purpose

Research suggests that abnormal levels of intrinsic laryngeal muscle (ILM) contraction is a potential causal factor in stress-induced voice disorders. This study seeks to characterize the ILM stress response in a cohort of vocally healthy women.

Method

The authors used an unblinded, nonrandomized, repeated-measures design. Forty vocally healthy female adults were subjected to a stressful speech preparation task. Measurements of heart rate, blood pressure, trapezius muscle (positive control) activation, and tibialis muscle (negative control) activation were obtained from 37 participants before and during stressor exposure, in a nonvoice and nonspeaking task paradigm, to confirm physiological stress response compared to baseline. Fine wire electromyography of the ILMs (posterior cricoarytenoid, thyroarytenoid/lateral cricoarytenoid muscle complex, and cricothyroid) was performed simultaneously so that the activity of these muscles could be measured prior to and during stressor exposure.

Results

The protocol successfully elicited the typical and expected physiological stress responses. Findings supported the hypothesis that, in some individuals, the ILMs significantly increase in activity during stress reactions compared to baseline, as do the control muscles.

Conclusions

This study characterizes ILM responses to psychological stress in vocally healthy participants. Some of the female adults in this study appeared to be “laryngeal stress responders,” as evidenced by increased activity of the ILMs during a silent (i.e., nonvocal, nonspeech) speech preparation task that they considered to be stressful.

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Swallowing Kinematic Differences Across Frozen, Mixed, and Ultrathin Liquid Boluses in Healthy Adults: Age, Sex, and Normal Variability

Purpose

The aim of this study was to examine the effects of frozen and mixed-consistency boluses on the swallowing physiology of younger and older adults. We also aimed to quantify factors that lead to increased variability in swallowing outcomes (i.e., age, sex, bolus type).

Method

Forty-one healthy adults (18–85 years old) swallowed 5 blocks of 5 different boluses: 10-ml ultrathin liquid, a teaspoon of iced barium, a teaspoon of room-temperature pudding, a teaspoon of frozen pudding, and ultrathin barium with chocolate chips. All data were recorded with videofluoroscopy and underwent detailed timing kinematic measurements.

Results

Neither barium ice nor frozen pudding sped up swallow responses. Many healthy adults initiated swallowing with the bolus as deep as the pyriform sinuses. Swallowing temporal kinematics for ultrathin liquid consistencies are most different from all others tested, requiring the best possible physiological swallowing performance in younger and older healthy individuals (i.e., faster reaction times, longer durations) compared with other bolus types tested. In each measure, older adults had significantly longer durations compared with the younger adults. More variability in swallowing kinematics were seen with age and laryngeal vestibule kinematics.

Conclusion

This study provides important contributions to the literature by clarifying normal variability within a wide range of swallowing behaviors and by providing normative data from which to compare disordered populations.

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Forward and Backward Masking of Consonants in School-Age Children and Adults

Purpose

This experiment sought to determine whether children's increased susceptibility to nonsimultaneous masking, particularly backward masking, is evident for speech stimuli.

Method

Five- to 9-year-olds and adults with normal hearing heard nonsense consonant–vowel–consonant targets. In Experiments 1 and 2, those targets were presented between two 250-ms segments of 70-dB-SPL speech-shaped noise, at either −30 dB signal-to-noise ratio (Experiment 1) or at the listener's word recognition threshold (Experiment 2). In Experiment 3, the target was presented in steady speech-shaped noise at listener threshold. For all experiments, percent correct was estimated for initial and final consonants.

Results

In the nonsimultaneous noise conditions, child–adult differences were larger for the final consonant than the initial consonant whether listeners were tested at −30 dB signal-to-noise ratio (Experiment 1) or at their individual word recognition threshold (Experiment 2). Children were not particularly susceptible to backward masking relative to adults when tested in a steady masker (Experiment 3).

Conclusions

Child–adult differences were greater for backward than forward masking for speech in a nonsimultaneous noise masker, as observed in previous psychophysical studies using tonal stimuli. Children's greater susceptibility to nonsimultaneous masking, and backward masking in particular, could play a role in their limited ability to benefit from masker envelope modulation when recognizing masked speech.

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“Do I Sound Straight?”: Acoustic Correlates of Actual and Perceived Sexual Orientation and Masculinity/Femininity in Men's Speech

Purpose

This study aims to give an integrative answer on which speech stereotypes exist toward German gay and straight men, whether and how acoustic correlates of actual and perceived sexual orientation are connected, and how this relates to masculinity/femininity. Hence, it tests speech stereotype accuracy in the context of sexual orientation.

Method

Twenty-five gay and 26 straight German speakers provided data for a fine-grained psychological self-assessment (e.g., masculinity/femininity) and explicit speech stereotypes. They were recorded for an extensive set of read and spontaneous speech samples using microphones and nasometry. Recordings were analyzed for a variety of acoustic parameters (e.g., fundamental frequency and nasalance). Seventy-four listeners categorized speakers as gay or straight on the basis of the same sentence.

Results

Most relevant explicitly expressed speech stereotypes encompass voice pitch, nasality, chromaticity, and smoothness. Demonstrating implicit stereotypes, speakers were perceived as sounding straighter, the lower their median f0, center of gravity in /s/, and mean F2. However, based on actual sexual orientation, straight men only showed lower mean F1 than gay men. Additionally, we found evidence that actual masculinity/femininity and the degree of sexual orientation were reflected in gay and straight men's speech.

Conclusion

Implicit and explicit speech stereotypes about gay and straight men do not contain a kernel of truth, and differences within groups are more important than differences between them.

Supplemental Material

https://doi.org/10.23641/asha.6484001

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Immature Auditory Evoked Potentials in Children With Moderate–Severe Developmental Language Disorder

Purpose

Immature auditory processing has been proposed to underlie language impairments in children with developmental language disorder (DLD; also known as specific language impairment). Using newly available normative auditory evoked potential (AEP) waveforms, we estimated AEP maturity in individual children with DLD and explored whether this maturational index was related to their language abilities.

Method

AEPs were elicited by 225 trials of a 490-Hz pure tone. Using intraclass correlation and our previously established normative AEP waveforms of 7- to 10-year-old children with typical development, we estimated the age equivalent of the AEPs (AEP–age) from 21 children with DLD. The relation between AEP maturity and language was explored through regression analysis.

Results

AEP–age predicted 31% of the variance in the language abilities of children with DLD. The AEP–age of children with mild DLD was similar to their chronological age, whereas children with moderate–severe DLD showed, on average, a 1.3-year delay in their neural responses. AEP–age predicted receptive, but not expressive, language performance.

Conclusion

Maturation in auditory neural responses is a significant predictor of language ability, particularly in children with moderate–severe DLD.

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The Role of Cognition on Navigational Skills of Children and Adolescents With Autism Spectrum Disorders

Purpose

This study examined the role of cognition on the navigational process of a speech-generating device (SGD) among individuals with a diagnosis of autism spectrum disorder (ASD). The objective was to investigate the role of various cognitive factors (i.e., cognitive flexibility, sustained attention, categorization, fluid reasoning, and working memory) on the ability to navigate an SGD with dynamic paging and taxonomic grids in individuals with ASD.

Method

Twenty individuals aged 5 to 20 years with ASD were assessed using the Leiter International Performance Scale–Revised (Roid & Miller, 1997) and the Automated Working Memory Assessment (Alloway, 2007). They also completed a navigational task using an iPad 4 (Apple, 2017; taxonomic organization).

Results

Significant correlations between all of the cognitive factors and the ability to navigate an SGD were revealed. A stepwise linear regression suggested that cognitive flexibility was the best predictor of navigational ability with this population.

Conclusion

The importance of cognition in the navigational process of an SGD with dynamic paging in children and adolescents with ASD has been highlighted by the results of this study.

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Acoustic Reflex Testing in Neonatal Hearing Screening and Subsequent Audiological Evaluation

Purpose

The aims of the study were to examine the acoustic reflex screening and threshold in healthy neonates and those at risk of hearing loss and to determine the effect of birth weight and gestational age on acoustic stapedial reflex (ASR).

Method

We assessed 18 healthy neonates (Group I) and 16 with at least 1 risk factor for hearing loss (Group II); all of them passed the transient evoked otoacoustic emission test that assessed neonatal hearing. The test battery included an acoustic reflex screening with activators of 0.5, 1, 2, and 4 kHz and broadband noise and an acoustic reflex threshold test with all of them, except for the broadband noise activator.

Results

In the evaluated neonates, the main risk factors were the gestational age at birth and a low birth weight; hence, these were further analyzed. The lower the gestational age at birth and birth weight, the less likely that an acoustic reflex would be elicited by pure-tone activators. This effect was significant at the frequencies of 0.5, 1, and 2 kHz for gestational age at birth and at the frequencies of 1 and 2 kHz for birth weight. When the broadband noise stimulus was used, a response was elicited in all neonates in both groups. When the pure-tone stimulus was used, the Group II showed the highest acoustic reflex thresholds and the highest percentage of cases with an absent ASR. The ASR threshold varied from 50 to 100 dB HL in both groups. Group II presented higher mean ASR thresholds than Group I, this difference being significant at frequencies of 1, 2, and 4 kHz.

Conclusions

Birth weight and gestational age at birth were related to the elicitation of the acoustic reflex. Neonates with these risk factors for hearing impairment were less likely to exhibit the acoustic reflex and had higher thresholds.

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Duration and Voice Quality of Early Infant Vocalizations

Purpose

Infant vocal durations have been studied from a variety of perspectives, including medical, social, and linguistic. The resultant developmental profile across the first 6 months of life, however, is still far from clear. The purpose of this study was to evaluate the durational properties of infant vocalizations from the unique perspective of voice quality. By considering an infant's modal and nonmodal voice qualities, the developmental range of vocalizations produced by infants during the early months of life was captured.

Method

Four Australian English–speaking infants were recorded for approximately 1 hr per week during the first 6 months of life. A total of 6,309 vocalizations were perceptually identified and labeled according to voice quality. The duration of each vocalization was subsequently measured.

Results

A nonlinear curve was evident for the duration of all vocalizations combined. Duration increased significantly between Months 3 and 5. Modal voice was the only voice quality that displayed a linear increase in duration across the study. All other voice qualities displayed polynomial trends.

Conclusions

Based on the current results, the inconsistent pattern of vocal duration development found previously can be reconciled when voice quality properties of vocalizations are taken into account. A nonlinear curve is evident when a broad corpus of infant vocalizations is used, whereas a narrow corpus containing predominantly modal vocalizations displays a linear trend. The results demonstrate the necessity of including nonmodal voice qualities in infant duration experiments so as to not overstate the linear nature of duration increases.

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Teleaudiology Services for Rehabilitation With Hearing Aids in Adults: A Systematic Review

Purpose

This review examined (a) the current evidence from studies on teleaudiology applications for rehabilitation of adults with hearing impairment with hearing aids and (b) whether it is sufficient to support the translation into routine clinical practice.

Method

A search strategy and eligibility criteria were utilized to include articles specifically related to hearing aid fitting and follow-up procedures that are involved in consultations for the rehabilitation of adults, where the service was provided by the clinician by teleaudiology. A search using key words and Medical Subject Headings (MeSH) was conducted on the main electronic databases that index health-related studies. The included studies were assessed using validated evaluation tools for methodological quality, level of evidence, and grade recommendations for application into practice.

Results

Fourteen studies were identified as being within the scope of this review. The evaluation tools showed that none of these studies demonstrated either a strong methodological quality or high level of evidence. Analysis of evidence identified 19 activities, which were classified into service outcomes categories of feasibility, barriers, efficiency, quality, and effectiveness. Recommendations could be made regarding the (a) feasibility, (b) barriers, and (c) efficiency of teleaudiology for the rehabilitation of hearing loss with hearing aids.

Conclusion

This review provides up-to-date evidence for teleaudiology hearing aid services in new and experienced hearing aid users in different practice settings. Findings direct future research priorities to strengthen evidence-based practice. There is a need for further studies of many aspects of teleaudiology services for rehabilitation with hearing aids to support their implementation into clinical practice.

Supplemental Material

https://doi.org/10.23641/asha.6534473

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The Swallowing Profile of Healthy Aging Adults: Comparing Noninvasive Swallow Tests to Videofluoroscopic Measures of Safety and Efficiency

Purpose

It has been widely reported that a proportion of healthy, community-dwelling seniors will develop dysphagia in the absence of a known neurological, neuromuscular, or structural cause. Our objective was to test whether various feasible, noninvasive measures of swallowing could differentiate safe versus unsafe and efficient versus inefficient swallowing on videofluoroscopy (VF) in a sample of healthy seniors.

Method

VFs from 44 (21 male, 23 female) healthy community-dwelling seniors (> 65 years old) were compared with a series of feasible, noninvasive swallowing metrics: maximal tongue strength (anterior and posterior), hand grip strength, pharyngeal volume, age, body mass index, 3-oz water swallow challenge, the 10-item Eating Assessment Tool questionnaire, and the Frailty Index. The VF protocol included 9 liquid barium boluses (3 × 5 ml thin, 3 × 20 ml thin, and 3 × 5 ml nectar). Each swallow was rated (randomized and blind) for safety using the Penetration–Aspiration Scale score and for efficiency using the Normalized Residue Ratio Scale (NRRS). Participants were deemed “unsafe” if they had any single Penetration–Aspiration Scale scores ≥ 3 and “inefficient” if they had any NRRS valleculae score > 0.082 or NRRS pyriform sinus score > 0.067. Univariate analyses of variance were run for each continuous swallowing measure by swallowing safety and swallowing efficiency status. Pearson's chi-square analyses were used to compare binary outcomes by swallow safety and efficiency status. Bonferroni corrections were applied to control for multiple comparisons.

Results

None of the swallowing measures significantly differentiated safe from unsafe swallows. Although several variables trended to distinguishing efficient from inefficient swallows (age, 10-item Eating Assessment Tool, 3-oz water swallow challenge), only one variable, pharyngeal volume, was significantly different between efficient and inefficient swallows (p = .002).

Conclusion

Our findings support the notion that larger pharyngeal volumes (measured using acoustic pharyngometry) are associated with worse swallowing efficiency, a finding we attribute to atrophy of the pharyngeal musculature in healthy aging.

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The Roles of Retrieval Practice Versus Errorless Learning in Strengthening Lexical Access in Aphasia

Purpose

The purpose of this study was to determine how 2 methods known to improve naming impairment in aphasia (i.e., retrieval practice and errorless learning) affect lexical access. We hypothesized that instances of naming during retrieval practice use and strengthen item-specific connections in each of 2 stages of lexical access: Stage 1, meaning-to-word connections, and Stage 2, word-to-phonology connections. In contrast, errorless learning prioritizes opportunities for repeating words, which we expect to primarily strengthen item-specific connections in Stage 2 because repetition circumvents the need for semantically driven word retrieval.

Method

We tested the outcomes of retrieval practice versus errorless learning training for items that were selected because the naming errors they elicited suggested weakened connections at Stage 1 or at Stage 2 of lexical access for each of 10 individuals with chronic aphasia. Each participant's Stage 1 items and Stage 2 items were divided evenly between the 2 training conditions. Naming tests were administered 1 day and 1 week after training to assess retention of training gains. We also examined whether the participants' pretraining naming error profiles were associated with the relative efficacy of retrieval practice versus errorless learning.

Results

The posttraining naming tests showed an advantage of retrieval practice over errorless learning for Stage 1 items and an advantage of errorless learning over retrieval practice for Stage 2 items. In addition, greater percentages of phonological error naming responses prior to training were associated with greater posttraining accuracy in the errorless learning condition relative to the retrieval practice condition.

Conclusions

The findings suggest that the advantage of retrieval practice for naming impairment in aphasia largely results from greater strengthening of practiced semantic–lexical connections compared with errorless learning, which prioritizes repetition and, therefore, mainly confers strengthening of practiced lexical–phonological connections. Understanding how specific training conditions improve naming can help predict the relative efficacy of each method for individuals with aphasia.

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Transfer of Learning: What Does It Tell Us About Speech Production Units?

Purpose

Words, syllables, and phonemes have each been regarded as basic encoding units of speech production in various psycholinguistic models. The present article investigates the role of each unit in the interface with speech articulation, using a paradigm from motor control research.

Method

Seventy-six native speakers of French were trained to change their production of /be/ in response to an auditory feedback perturbation (auditory–motor learning). We then assessed the magnitude of learning transfer from /be/ to the syllables in 2 pseudowords (/bepe/ and /pebe/) and 1 real word (/bebe/) as well as the aftereffect on the same utterance (/be/) with a between-subjects design. This made it possible to contrast the amplitude of transfer at the levels of the utterance, the syllable, and the phoneme, depending on the position in the word. Linear mixed models allowed us to study the amplitude as well as the dynamics of the transfer and the aftereffect over trials.

Results

Transfer from the training utterance /be/ was observed for all vowels of the test utterances but was larger to the syllable /be/ than to the syllable /pe/ at word-initial position and larger to the 1st syllable than to the 2nd syllable in the utterance.

Conclusions

Our study suggests that words, syllables, and phonemes may all contribute to the definition of speech motor commands. In addition, the observation of a serial order effect raises new questions related to the connection between psycholinguistic models and speech motor control approaches.

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Receptive Language Skills in Slovak-Speaking Children With Intellectual Disability: Understanding Words, Sentences, and Stories

Purpose

The study aims to describe receptive language skills in children with intellectual disability (ID) and to contribute to the debate on deviant versus delayed language development. This is the 1st study of receptive skills in children with ID who speak a Slavic language, providing insight into how language development is affected by disability and also language typology.

Method

Twenty-eight Slovak-speaking children participated in the study (14 children with ID and 14 typically developing [TD] children matched on nonverbal reasoning abilities). The children were assessed by receptive language tasks targeting words, sentences, and stories, and the groups were compared quantitatively and qualitatively.

Results

The groups showed similar language profiles, with a better understanding of words, followed by sentences, with the poorest comprehension for stories. Nouns were comprehended better than verbs; sentence constructions also showed a qualitatively similar picture, although some dissimilarities emerged. Verb comprehension was strongly related to sentence comprehension in both groups and related to story comprehension in the TD group only.

Conclusion

The findings appear to support the view that receptive language skills follow the same developmental route in children with ID as seen in younger TD children, suggesting that language development is a robust process and does not seem to be differentially affected by ID even when delayed.

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Short-Term Memory, Inhibition, and Attention in Developmental Stuttering: A Meta-Analysis

Purpose

This study presents a meta-analytic review of differences in verbal short-term memory, inhibition, and attention between children who stutter (CWS) and children who do not stutter (CWNS).

Method

Electronic databases and reference sections of articles were searched for candidate studies that examined verbal short-term memory, inhibition, and attention using behavioral and/or parent report measures. Twenty-nine studies met the eligibility criteria, which included, among other things, children between the ages of 3 and 18 years and the availability of quantitative data for effect size calculations. Data were extracted, coded, and analyzed, with the magnitude of the difference between the 2 groups of children being estimated using Hedge's g (Hedges & Olkin, 1985).

Results

Based on the random-effects model (Hunter & Schmidt, 2004), findings revealed that CWS scored lower than CWNS on measures of nonword repetition (Hedges' g = −0.62), particularly at lengths of 2 and 3 syllables (Hedges' g = −0.62 and − 0.50, respectively), and forward span (Hedges' g = −0.40). Analyses further revealed that the parents of CWS rated their children as having weaker inhibition (Hedges' g = −0.44) and attentional focus/persistence (Hedges' g = −0.36) skills than the parents of CWNS, but there were no significant differences between CWS and CWNS in behavioral measures of inhibition and attention.

Conclusion

The present findings were taken to suggest that cognitive processes are important variables associated with developmental stuttering.

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Auditory Lexical Decisions in Developmental Language Disorder: A Meta-Analysis of Behavioral Studies

Purpose

Despite the apparent primacy of syntactic deficits, children with developmental language disorder (DLD) often also evidence lexical impairments. In particular, it has been argued that this population have difficulty forming lexical representations that are detailed enough to support effective spoken word processing. In order to better understand this deficit, a meta-analysis of studies testing children with DLD in the auditory lexical decision task was conducted. The objective was to provide summary effect size estimates for accuracy and response time measures for comparisons to age- and language-matched control groups.

Method

Two thousand three hundred seventy-two records were initially identified through electronic searches and expert consultation, with this cohort reduced to 9 through duplicate removal and the application of eligibility and quality criteria. The final study cohort included 499 children aged 3;8–11;4 (years;months).

Results

Multivariate analysis suggests that children with DLD were significantly less accurate in the auditory lexical decision task than age-matched controls. For the response time estimate, however, confidence intervals for the same group comparison crossed 0, suggesting no reliable difference between groups. Confidence intervals also crossed 0 for language-matched control estimates for both accuracy and response time, suggesting no reliable difference between groups on either measure.

Conclusion

Results broadly support the hypothesis that children with DLD have difficulty in forming detailed lexical representations relative to age- though not language-matched peers. However, further work is required to determine the performance profiles of potential subgroups and the impact of manipulating different lexical characteristics, such as the position and degree of nonword error, phonotactic probability, and semantic network size.

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Stuttering and Labor Market Outcomes in the United States

Purpose

The purpose of this study was to quantify relationships between stuttering and labor market outcomes, determine if outcomes differ by gender, and explain the earnings difference between people who stutter and people who do not stutter.

Method

Survey and interview data were obtained from the National Longitudinal Study of Adolescent to Adult Health. Of the 13,564 respondents who completed 4 waves of surveys over 14 years and answered questions about stuttering, 261 people indicated that they stutter. Regression analysis, propensity score matching, and Blinder–Oaxaca decomposition were used.

Results

After controlling for numerous variables related to demographics and comorbidity, the deficit in earnings associated with stuttering exceeded $7,000. Differences in observable characteristics between people who stutter and people who do not stutter (e.g., education, occupation, self-perception, hours worked) accounted for most of the earnings gap for males but relatively little for females. Females who stutter were also 23% more likely to be underemployed than females who do not stutter.

Conclusions

Stuttering was associated with reduced earnings and other gender-specific disadvantages in the labor market. Preliminary evidence indicates that discrimination may have contributed to the earnings gap associated with stuttering, particularly for females.

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Exploring Optimal Stimulus Frequency Ratio for Measurement of the Quadratic f 2 –f 1 Distortion Product Otoacoustic Emission in Humans

Purpose

Distortion product otoacoustic emissions (DPOAEs) are a by-product of active cochlear processes that lead to the compressive nonlinearity of healthy ears. The most commonly studied emission is at the frequency 2f₁–f₂, but there has been recent interest in using the quadratic distortion product at the frequency f₂–f₁ to detect cochleopathies including endolymphatic hydrops. Before the DPOAE at f₂–f₁ can be applied clinically in any capacity, optimal stimulus parameters for its elicitation must be established.

Method

We investigated stimulus parameters for the DPOAEs at f₂–f₁ and 2f₁–f₂ in 23 adults with normal hearing. Logarithmically swept tones between approximately 0.6 and 20 kHz (L₁ = L₂ = 70 dB SPL) served as the higher frequency stimulus (f₂). DPOAEs were measured for 6 f₂/f₁ ratios: 1.14, 1.18, 1.22, 1.30, 1.32, and 1.36.

Results

Both DPOAEs were consistently measurable. In line with previous investigations, the highest levels of the DPOAE at 2f₁–f₂ were generated between f₂/f₁ ratios of 1.14–1.22, with a peak in the level ratio function at 1.22. In contrast, f₂–f₁ was less influenced by ratio, although the narrowest ratio (1.14) produced slightly higher levels across frequency.

Conclusion

The DPOAE at f₂–f₁ is measurable in individuals with normal hearing up to f₂ of 20 kHz at narrow f₂/f₁ ratios. Measurements at additional stimulus levels and in subjects with hearing impairment will be needed before clinical implementation.

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Treatment Response to a Double Administration of Constraint-Induced Language Therapy in Chronic Aphasia

Purpose

This study investigated changes in oral–verbal expressive language associated with improvements following 2 treatment periods of constraint-induced language therapy in 4 participants with stroke-induced chronic aphasia. Generalization of treatment to untrained materials and to discourse production was also analyzed, as was the durability of the treatment effect.

Method

Participants with aphasia were assessed using standardized measures and discourse tasks at 3 to 4 time points to document behavioral changes throughout each of two 30-hr treatment periods of constraint-induced language therapy. Daily probes of trained and untrained materials were also administered.

Results

Despite participant heterogeneity, behavioral results for each person with aphasia indicated a positive response to treatment following each treatment period indicated by performance on standardized tests, trained materials, or both. Treatment effects generalized to some degree to untrained stimuli and to discourse measures and were generally maintained at follow-up testing.

Conclusions

Data support the utility of a 2nd treatment period. Results are relevant to rehabilitation in chronic aphasia, confirming that significant language gains continue well past the point of spontaneous recovery and can occur in a relatively short time period. Importantly, changes are not confined to a single treatment period, suggesting that people with aphasia may benefit from multiple doses of high-intensity treatment.

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Effects of Second Language Proficiency and Linguistic Uncertainty on Recognition of Speech in Native and Nonnative Competing Speech

Purpose

The purpose of this study was to investigate the effects of 2nd language proficiency and linguistic uncertainty on performance and listening effort in mixed language contexts.

Method

Thirteen native speakers of Dutch with varying degrees of fluency in English listened to and repeated sentences produced in both Dutch and English and presented in the presence of single-talker competing speech in both Dutch and English. Target and masker language combinations were presented in both blocked and mixed (unpredictable) conditions. In the blocked condition, in each block of trials the target–masker language combination remained constant, and the listeners were informed of both prior to beginning the block. In the mixed condition, target and masker language varied randomly from trial to trial. All listeners participated in all conditions. Performance was assessed in terms of speech reception thresholds, whereas listening effort was quantified in terms of pupil dilation.

Results

Performance (speech reception thresholds) and listening effort (pupil dilation) were both affected by 2nd language proficiency (English test score) and target and masker language: Performance was better in blocked as compared to mixed conditions, with Dutch as compared to English targets, and with English as compared to Dutch maskers. English proficiency was correlated with listening performance. Listeners also exhibited greater peak pupil dilation in mixed as compared to blocked conditions for trials with Dutch maskers, whereas pupil dilation during preparation for speaking was higher for English targets as compared to Dutch ones in almost all conditions.

Conclusions

Both listener's proficiency in a 2nd language and uncertainty about the target language on a given trial play a significant role in how bilingual listeners attend to speech in the presence of competing speech in different languages, but precise effects also depend on which language is serving as target and which as masker.

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Effects of Interventions That Include Aided Augmentative and Alternative Communication Input on the Communication of Individuals With Complex Communication Needs: A Meta-Analysis

Purpose

The purpose of this meta-analysis was to investigate the effects of augmentative and alternative communication (AAC) interventions that included aided AAC input (e.g., aided AAC modeling, aided language modeling, aided language stimulation, augmented input) on communicative outcomes (both comprehension and expression) for individuals with developmental disabilities who use AAC.

Method

A systematic search resulted in the identification of 26 single-case experimental designs (88 participants) and 2 group experimental designs (103 participants). Studies were coded in terms of participants, intervention characteristics, dependent variables, outcomes, and quality of evidence.

Results

AAC interventions that included aided AAC input in isolation, or as part of a multicomponent intervention, were found to be highly effective across participants of various ages, disabilities, and language skills. The interventions typically included aided AAC input in conjunction with expectant delay, direct prompting (e.g., spoken, gestural), contingent responding, and open-ended questions. The interventions were found to be highly effective in supporting both comprehension and expression across the domains of pragmatics, semantics, and morphosyntax. Outcomes related to expression were reported more often than outcomes related to comprehension.

Conclusion

Aided AAC input may reduce input–output asymmetry and enhance expression and comprehension for individuals who use AAC; the evidence suggests that partners should utilize this strategy. Future research is needed to investigate the effects of AAC input (aided and unaided) on long-term language development for individuals who require AAC.

Supplemental Material

https://doi.org/10.23641/asha.6394364

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Intrinsic Laryngeal Muscle Response to a Public Speech Preparation Stressor

Purpose

Research suggests that abnormal levels of intrinsic laryngeal muscle (ILM) contraction is a potential causal factor in stress-induced voice disorders. This study seeks to characterize the ILM stress response in a cohort of vocally healthy women.

Method

The authors used an unblinded, nonrandomized, repeated-measures design. Forty vocally healthy female adults were subjected to a stressful speech preparation task. Measurements of heart rate, blood pressure, trapezius muscle (positive control) activation, and tibialis muscle (negative control) activation were obtained from 37 participants before and during stressor exposure, in a nonvoice and nonspeaking task paradigm, to confirm physiological stress response compared to baseline. Fine wire electromyography of the ILMs (posterior cricoarytenoid, thyroarytenoid/lateral cricoarytenoid muscle complex, and cricothyroid) was performed simultaneously so that the activity of these muscles could be measured prior to and during stressor exposure.

Results

The protocol successfully elicited the typical and expected physiological stress responses. Findings supported the hypothesis that, in some individuals, the ILMs significantly increase in activity during stress reactions compared to baseline, as do the control muscles.

Conclusions

This study characterizes ILM responses to psychological stress in vocally healthy participants. Some of the female adults in this study appeared to be “laryngeal stress responders,” as evidenced by increased activity of the ILMs during a silent (i.e., nonvocal, nonspeech) speech preparation task that they considered to be stressful.

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Swallowing Kinematic Differences Across Frozen, Mixed, and Ultrathin Liquid Boluses in Healthy Adults: Age, Sex, and Normal Variability

Purpose

The aim of this study was to examine the effects of frozen and mixed-consistency boluses on the swallowing physiology of younger and older adults. We also aimed to quantify factors that lead to increased variability in swallowing outcomes (i.e., age, sex, bolus type).

Method

Forty-one healthy adults (18–85 years old) swallowed 5 blocks of 5 different boluses: 10-ml ultrathin liquid, a teaspoon of iced barium, a teaspoon of room-temperature pudding, a teaspoon of frozen pudding, and ultrathin barium with chocolate chips. All data were recorded with videofluoroscopy and underwent detailed timing kinematic measurements.

Results

Neither barium ice nor frozen pudding sped up swallow responses. Many healthy adults initiated swallowing with the bolus as deep as the pyriform sinuses. Swallowing temporal kinematics for ultrathin liquid consistencies are most different from all others tested, requiring the best possible physiological swallowing performance in younger and older healthy individuals (i.e., faster reaction times, longer durations) compared with other bolus types tested. In each measure, older adults had significantly longer durations compared with the younger adults. More variability in swallowing kinematics were seen with age and laryngeal vestibule kinematics.

Conclusion

This study provides important contributions to the literature by clarifying normal variability within a wide range of swallowing behaviors and by providing normative data from which to compare disordered populations.

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Forward and Backward Masking of Consonants in School-Age Children and Adults

Purpose

This experiment sought to determine whether children's increased susceptibility to nonsimultaneous masking, particularly backward masking, is evident for speech stimuli.

Method

Five- to 9-year-olds and adults with normal hearing heard nonsense consonant–vowel–consonant targets. In Experiments 1 and 2, those targets were presented between two 250-ms segments of 70-dB-SPL speech-shaped noise, at either −30 dB signal-to-noise ratio (Experiment 1) or at the listener's word recognition threshold (Experiment 2). In Experiment 3, the target was presented in steady speech-shaped noise at listener threshold. For all experiments, percent correct was estimated for initial and final consonants.

Results

In the nonsimultaneous noise conditions, child–adult differences were larger for the final consonant than the initial consonant whether listeners were tested at −30 dB signal-to-noise ratio (Experiment 1) or at their individual word recognition threshold (Experiment 2). Children were not particularly susceptible to backward masking relative to adults when tested in a steady masker (Experiment 3).

Conclusions

Child–adult differences were greater for backward than forward masking for speech in a nonsimultaneous noise masker, as observed in previous psychophysical studies using tonal stimuli. Children's greater susceptibility to nonsimultaneous masking, and backward masking in particular, could play a role in their limited ability to benefit from masker envelope modulation when recognizing masked speech.

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“Do I Sound Straight?”: Acoustic Correlates of Actual and Perceived Sexual Orientation and Masculinity/Femininity in Men's Speech

Purpose

This study aims to give an integrative answer on which speech stereotypes exist toward German gay and straight men, whether and how acoustic correlates of actual and perceived sexual orientation are connected, and how this relates to masculinity/femininity. Hence, it tests speech stereotype accuracy in the context of sexual orientation.

Method

Twenty-five gay and 26 straight German speakers provided data for a fine-grained psychological self-assessment (e.g., masculinity/femininity) and explicit speech stereotypes. They were recorded for an extensive set of read and spontaneous speech samples using microphones and nasometry. Recordings were analyzed for a variety of acoustic parameters (e.g., fundamental frequency and nasalance). Seventy-four listeners categorized speakers as gay or straight on the basis of the same sentence.

Results

Most relevant explicitly expressed speech stereotypes encompass voice pitch, nasality, chromaticity, and smoothness. Demonstrating implicit stereotypes, speakers were perceived as sounding straighter, the lower their median f0, center of gravity in /s/, and mean F2. However, based on actual sexual orientation, straight men only showed lower mean F1 than gay men. Additionally, we found evidence that actual masculinity/femininity and the degree of sexual orientation were reflected in gay and straight men's speech.

Conclusion

Implicit and explicit speech stereotypes about gay and straight men do not contain a kernel of truth, and differences within groups are more important than differences between them.

Supplemental Material

https://doi.org/10.23641/asha.6484001

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Immature Auditory Evoked Potentials in Children With Moderate–Severe Developmental Language Disorder

Purpose

Immature auditory processing has been proposed to underlie language impairments in children with developmental language disorder (DLD; also known as specific language impairment). Using newly available normative auditory evoked potential (AEP) waveforms, we estimated AEP maturity in individual children with DLD and explored whether this maturational index was related to their language abilities.

Method

AEPs were elicited by 225 trials of a 490-Hz pure tone. Using intraclass correlation and our previously established normative AEP waveforms of 7- to 10-year-old children with typical development, we estimated the age equivalent of the AEPs (AEP–age) from 21 children with DLD. The relation between AEP maturity and language was explored through regression analysis.

Results

AEP–age predicted 31% of the variance in the language abilities of children with DLD. The AEP–age of children with mild DLD was similar to their chronological age, whereas children with moderate–severe DLD showed, on average, a 1.3-year delay in their neural responses. AEP–age predicted receptive, but not expressive, language performance.

Conclusion

Maturation in auditory neural responses is a significant predictor of language ability, particularly in children with moderate–severe DLD.

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The Role of Cognition on Navigational Skills of Children and Adolescents With Autism Spectrum Disorders

Purpose

This study examined the role of cognition on the navigational process of a speech-generating device (SGD) among individuals with a diagnosis of autism spectrum disorder (ASD). The objective was to investigate the role of various cognitive factors (i.e., cognitive flexibility, sustained attention, categorization, fluid reasoning, and working memory) on the ability to navigate an SGD with dynamic paging and taxonomic grids in individuals with ASD.

Method

Twenty individuals aged 5 to 20 years with ASD were assessed using the Leiter International Performance Scale–Revised (Roid & Miller, 1997) and the Automated Working Memory Assessment (Alloway, 2007). They also completed a navigational task using an iPad 4 (Apple, 2017; taxonomic organization).

Results

Significant correlations between all of the cognitive factors and the ability to navigate an SGD were revealed. A stepwise linear regression suggested that cognitive flexibility was the best predictor of navigational ability with this population.

Conclusion

The importance of cognition in the navigational process of an SGD with dynamic paging in children and adolescents with ASD has been highlighted by the results of this study.

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Acoustic Reflex Testing in Neonatal Hearing Screening and Subsequent Audiological Evaluation

Purpose

The aims of the study were to examine the acoustic reflex screening and threshold in healthy neonates and those at risk of hearing loss and to determine the effect of birth weight and gestational age on acoustic stapedial reflex (ASR).

Method

We assessed 18 healthy neonates (Group I) and 16 with at least 1 risk factor for hearing loss (Group II); all of them passed the transient evoked otoacoustic emission test that assessed neonatal hearing. The test battery included an acoustic reflex screening with activators of 0.5, 1, 2, and 4 kHz and broadband noise and an acoustic reflex threshold test with all of them, except for the broadband noise activator.

Results

In the evaluated neonates, the main risk factors were the gestational age at birth and a low birth weight; hence, these were further analyzed. The lower the gestational age at birth and birth weight, the less likely that an acoustic reflex would be elicited by pure-tone activators. This effect was significant at the frequencies of 0.5, 1, and 2 kHz for gestational age at birth and at the frequencies of 1 and 2 kHz for birth weight. When the broadband noise stimulus was used, a response was elicited in all neonates in both groups. When the pure-tone stimulus was used, the Group II showed the highest acoustic reflex thresholds and the highest percentage of cases with an absent ASR. The ASR threshold varied from 50 to 100 dB HL in both groups. Group II presented higher mean ASR thresholds than Group I, this difference being significant at frequencies of 1, 2, and 4 kHz.

Conclusions

Birth weight and gestational age at birth were related to the elicitation of the acoustic reflex. Neonates with these risk factors for hearing impairment were less likely to exhibit the acoustic reflex and had higher thresholds.

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Duration and Voice Quality of Early Infant Vocalizations

Purpose

Infant vocal durations have been studied from a variety of perspectives, including medical, social, and linguistic. The resultant developmental profile across the first 6 months of life, however, is still far from clear. The purpose of this study was to evaluate the durational properties of infant vocalizations from the unique perspective of voice quality. By considering an infant's modal and nonmodal voice qualities, the developmental range of vocalizations produced by infants during the early months of life was captured.

Method

Four Australian English–speaking infants were recorded for approximately 1 hr per week during the first 6 months of life. A total of 6,309 vocalizations were perceptually identified and labeled according to voice quality. The duration of each vocalization was subsequently measured.

Results

A nonlinear curve was evident for the duration of all vocalizations combined. Duration increased significantly between Months 3 and 5. Modal voice was the only voice quality that displayed a linear increase in duration across the study. All other voice qualities displayed polynomial trends.

Conclusions

Based on the current results, the inconsistent pattern of vocal duration development found previously can be reconciled when voice quality properties of vocalizations are taken into account. A nonlinear curve is evident when a broad corpus of infant vocalizations is used, whereas a narrow corpus containing predominantly modal vocalizations displays a linear trend. The results demonstrate the necessity of including nonmodal voice qualities in infant duration experiments so as to not overstate the linear nature of duration increases.

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Teleaudiology Services for Rehabilitation With Hearing Aids in Adults: A Systematic Review

Purpose

This review examined (a) the current evidence from studies on teleaudiology applications for rehabilitation of adults with hearing impairment with hearing aids and (b) whether it is sufficient to support the translation into routine clinical practice.

Method

A search strategy and eligibility criteria were utilized to include articles specifically related to hearing aid fitting and follow-up procedures that are involved in consultations for the rehabilitation of adults, where the service was provided by the clinician by teleaudiology. A search using key words and Medical Subject Headings (MeSH) was conducted on the main electronic databases that index health-related studies. The included studies were assessed using validated evaluation tools for methodological quality, level of evidence, and grade recommendations for application into practice.

Results

Fourteen studies were identified as being within the scope of this review. The evaluation tools showed that none of these studies demonstrated either a strong methodological quality or high level of evidence. Analysis of evidence identified 19 activities, which were classified into service outcomes categories of feasibility, barriers, efficiency, quality, and effectiveness. Recommendations could be made regarding the (a) feasibility, (b) barriers, and (c) efficiency of teleaudiology for the rehabilitation of hearing loss with hearing aids.

Conclusion

This review provides up-to-date evidence for teleaudiology hearing aid services in new and experienced hearing aid users in different practice settings. Findings direct future research priorities to strengthen evidence-based practice. There is a need for further studies of many aspects of teleaudiology services for rehabilitation with hearing aids to support their implementation into clinical practice.

Supplemental Material

https://doi.org/10.23641/asha.6534473

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The Swallowing Profile of Healthy Aging Adults: Comparing Noninvasive Swallow Tests to Videofluoroscopic Measures of Safety and Efficiency

Purpose

It has been widely reported that a proportion of healthy, community-dwelling seniors will develop dysphagia in the absence of a known neurological, neuromuscular, or structural cause. Our objective was to test whether various feasible, noninvasive measures of swallowing could differentiate safe versus unsafe and efficient versus inefficient swallowing on videofluoroscopy (VF) in a sample of healthy seniors.

Method

VFs from 44 (21 male, 23 female) healthy community-dwelling seniors (> 65 years old) were compared with a series of feasible, noninvasive swallowing metrics: maximal tongue strength (anterior and posterior), hand grip strength, pharyngeal volume, age, body mass index, 3-oz water swallow challenge, the 10-item Eating Assessment Tool questionnaire, and the Frailty Index. The VF protocol included 9 liquid barium boluses (3 × 5 ml thin, 3 × 20 ml thin, and 3 × 5 ml nectar). Each swallow was rated (randomized and blind) for safety using the Penetration–Aspiration Scale score and for efficiency using the Normalized Residue Ratio Scale (NRRS). Participants were deemed “unsafe” if they had any single Penetration–Aspiration Scale scores ≥ 3 and “inefficient” if they had any NRRS valleculae score > 0.082 or NRRS pyriform sinus score > 0.067. Univariate analyses of variance were run for each continuous swallowing measure by swallowing safety and swallowing efficiency status. Pearson's chi-square analyses were used to compare binary outcomes by swallow safety and efficiency status. Bonferroni corrections were applied to control for multiple comparisons.

Results

None of the swallowing measures significantly differentiated safe from unsafe swallows. Although several variables trended to distinguishing efficient from inefficient swallows (age, 10-item Eating Assessment Tool, 3-oz water swallow challenge), only one variable, pharyngeal volume, was significantly different between efficient and inefficient swallows (p = .002).

Conclusion

Our findings support the notion that larger pharyngeal volumes (measured using acoustic pharyngometry) are associated with worse swallowing efficiency, a finding we attribute to atrophy of the pharyngeal musculature in healthy aging.

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The Roles of Retrieval Practice Versus Errorless Learning in Strengthening Lexical Access in Aphasia

Purpose

The purpose of this study was to determine how 2 methods known to improve naming impairment in aphasia (i.e., retrieval practice and errorless learning) affect lexical access. We hypothesized that instances of naming during retrieval practice use and strengthen item-specific connections in each of 2 stages of lexical access: Stage 1, meaning-to-word connections, and Stage 2, word-to-phonology connections. In contrast, errorless learning prioritizes opportunities for repeating words, which we expect to primarily strengthen item-specific connections in Stage 2 because repetition circumvents the need for semantically driven word retrieval.

Method

We tested the outcomes of retrieval practice versus errorless learning training for items that were selected because the naming errors they elicited suggested weakened connections at Stage 1 or at Stage 2 of lexical access for each of 10 individuals with chronic aphasia. Each participant's Stage 1 items and Stage 2 items were divided evenly between the 2 training conditions. Naming tests were administered 1 day and 1 week after training to assess retention of training gains. We also examined whether the participants' pretraining naming error profiles were associated with the relative efficacy of retrieval practice versus errorless learning.

Results

The posttraining naming tests showed an advantage of retrieval practice over errorless learning for Stage 1 items and an advantage of errorless learning over retrieval practice for Stage 2 items. In addition, greater percentages of phonological error naming responses prior to training were associated with greater posttraining accuracy in the errorless learning condition relative to the retrieval practice condition.

Conclusions

The findings suggest that the advantage of retrieval practice for naming impairment in aphasia largely results from greater strengthening of practiced semantic–lexical connections compared with errorless learning, which prioritizes repetition and, therefore, mainly confers strengthening of practiced lexical–phonological connections. Understanding how specific training conditions improve naming can help predict the relative efficacy of each method for individuals with aphasia.

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Transfer of Learning: What Does It Tell Us About Speech Production Units?

Purpose

Words, syllables, and phonemes have each been regarded as basic encoding units of speech production in various psycholinguistic models. The present article investigates the role of each unit in the interface with speech articulation, using a paradigm from motor control research.

Method

Seventy-six native speakers of French were trained to change their production of /be/ in response to an auditory feedback perturbation (auditory–motor learning). We then assessed the magnitude of learning transfer from /be/ to the syllables in 2 pseudowords (/bepe/ and /pebe/) and 1 real word (/bebe/) as well as the aftereffect on the same utterance (/be/) with a between-subjects design. This made it possible to contrast the amplitude of transfer at the levels of the utterance, the syllable, and the phoneme, depending on the position in the word. Linear mixed models allowed us to study the amplitude as well as the dynamics of the transfer and the aftereffect over trials.

Results

Transfer from the training utterance /be/ was observed for all vowels of the test utterances but was larger to the syllable /be/ than to the syllable /pe/ at word-initial position and larger to the 1st syllable than to the 2nd syllable in the utterance.

Conclusions

Our study suggests that words, syllables, and phonemes may all contribute to the definition of speech motor commands. In addition, the observation of a serial order effect raises new questions related to the connection between psycholinguistic models and speech motor control approaches.

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Receptive Language Skills in Slovak-Speaking Children With Intellectual Disability: Understanding Words, Sentences, and Stories

Purpose

The study aims to describe receptive language skills in children with intellectual disability (ID) and to contribute to the debate on deviant versus delayed language development. This is the 1st study of receptive skills in children with ID who speak a Slavic language, providing insight into how language development is affected by disability and also language typology.

Method

Twenty-eight Slovak-speaking children participated in the study (14 children with ID and 14 typically developing [TD] children matched on nonverbal reasoning abilities). The children were assessed by receptive language tasks targeting words, sentences, and stories, and the groups were compared quantitatively and qualitatively.

Results

The groups showed similar language profiles, with a better understanding of words, followed by sentences, with the poorest comprehension for stories. Nouns were comprehended better than verbs; sentence constructions also showed a qualitatively similar picture, although some dissimilarities emerged. Verb comprehension was strongly related to sentence comprehension in both groups and related to story comprehension in the TD group only.

Conclusion

The findings appear to support the view that receptive language skills follow the same developmental route in children with ID as seen in younger TD children, suggesting that language development is a robust process and does not seem to be differentially affected by ID even when delayed.

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Short-Term Memory, Inhibition, and Attention in Developmental Stuttering: A Meta-Analysis

Purpose

This study presents a meta-analytic review of differences in verbal short-term memory, inhibition, and attention between children who stutter (CWS) and children who do not stutter (CWNS).

Method

Electronic databases and reference sections of articles were searched for candidate studies that examined verbal short-term memory, inhibition, and attention using behavioral and/or parent report measures. Twenty-nine studies met the eligibility criteria, which included, among other things, children between the ages of 3 and 18 years and the availability of quantitative data for effect size calculations. Data were extracted, coded, and analyzed, with the magnitude of the difference between the 2 groups of children being estimated using Hedge's g (Hedges & Olkin, 1985).

Results

Based on the random-effects model (Hunter & Schmidt, 2004), findings revealed that CWS scored lower than CWNS on measures of nonword repetition (Hedges' g = −0.62), particularly at lengths of 2 and 3 syllables (Hedges' g = −0.62 and − 0.50, respectively), and forward span (Hedges' g = −0.40). Analyses further revealed that the parents of CWS rated their children as having weaker inhibition (Hedges' g = −0.44) and attentional focus/persistence (Hedges' g = −0.36) skills than the parents of CWNS, but there were no significant differences between CWS and CWNS in behavioral measures of inhibition and attention.

Conclusion

The present findings were taken to suggest that cognitive processes are important variables associated with developmental stuttering.

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Auditory Lexical Decisions in Developmental Language Disorder: A Meta-Analysis of Behavioral Studies

Purpose

Despite the apparent primacy of syntactic deficits, children with developmental language disorder (DLD) often also evidence lexical impairments. In particular, it has been argued that this population have difficulty forming lexical representations that are detailed enough to support effective spoken word processing. In order to better understand this deficit, a meta-analysis of studies testing children with DLD in the auditory lexical decision task was conducted. The objective was to provide summary effect size estimates for accuracy and response time measures for comparisons to age- and language-matched control groups.

Method

Two thousand three hundred seventy-two records were initially identified through electronic searches and expert consultation, with this cohort reduced to 9 through duplicate removal and the application of eligibility and quality criteria. The final study cohort included 499 children aged 3;8–11;4 (years;months).

Results

Multivariate analysis suggests that children with DLD were significantly less accurate in the auditory lexical decision task than age-matched controls. For the response time estimate, however, confidence intervals for the same group comparison crossed 0, suggesting no reliable difference between groups. Confidence intervals also crossed 0 for language-matched control estimates for both accuracy and response time, suggesting no reliable difference between groups on either measure.

Conclusion

Results broadly support the hypothesis that children with DLD have difficulty in forming detailed lexical representations relative to age- though not language-matched peers. However, further work is required to determine the performance profiles of potential subgroups and the impact of manipulating different lexical characteristics, such as the position and degree of nonword error, phonotactic probability, and semantic network size.

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Stuttering and Labor Market Outcomes in the United States

Purpose

The purpose of this study was to quantify relationships between stuttering and labor market outcomes, determine if outcomes differ by gender, and explain the earnings difference between people who stutter and people who do not stutter.

Method

Survey and interview data were obtained from the National Longitudinal Study of Adolescent to Adult Health. Of the 13,564 respondents who completed 4 waves of surveys over 14 years and answered questions about stuttering, 261 people indicated that they stutter. Regression analysis, propensity score matching, and Blinder–Oaxaca decomposition were used.

Results

After controlling for numerous variables related to demographics and comorbidity, the deficit in earnings associated with stuttering exceeded $7,000. Differences in observable characteristics between people who stutter and people who do not stutter (e.g., education, occupation, self-perception, hours worked) accounted for most of the earnings gap for males but relatively little for females. Females who stutter were also 23% more likely to be underemployed than females who do not stutter.

Conclusions

Stuttering was associated with reduced earnings and other gender-specific disadvantages in the labor market. Preliminary evidence indicates that discrimination may have contributed to the earnings gap associated with stuttering, particularly for females.

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Exploring Optimal Stimulus Frequency Ratio for Measurement of the Quadratic f 2 –f 1 Distortion Product Otoacoustic Emission in Humans

Purpose

Distortion product otoacoustic emissions (DPOAEs) are a by-product of active cochlear processes that lead to the compressive nonlinearity of healthy ears. The most commonly studied emission is at the frequency 2f₁–f₂, but there has been recent interest in using the quadratic distortion product at the frequency f₂–f₁ to detect cochleopathies including endolymphatic hydrops. Before the DPOAE at f₂–f₁ can be applied clinically in any capacity, optimal stimulus parameters for its elicitation must be established.

Method

We investigated stimulus parameters for the DPOAEs at f₂–f₁ and 2f₁–f₂ in 23 adults with normal hearing. Logarithmically swept tones between approximately 0.6 and 20 kHz (L₁ = L₂ = 70 dB SPL) served as the higher frequency stimulus (f₂). DPOAEs were measured for 6 f₂/f₁ ratios: 1.14, 1.18, 1.22, 1.30, 1.32, and 1.36.

Results

Both DPOAEs were consistently measurable. In line with previous investigations, the highest levels of the DPOAE at 2f₁–f₂ were generated between f₂/f₁ ratios of 1.14–1.22, with a peak in the level ratio function at 1.22. In contrast, f₂–f₁ was less influenced by ratio, although the narrowest ratio (1.14) produced slightly higher levels across frequency.

Conclusion

The DPOAE at f₂–f₁ is measurable in individuals with normal hearing up to f₂ of 20 kHz at narrow f₂/f₁ ratios. Measurements at additional stimulus levels and in subjects with hearing impairment will be needed before clinical implementation.

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Treatment Response to a Double Administration of Constraint-Induced Language Therapy in Chronic Aphasia

Purpose

This study investigated changes in oral–verbal expressive language associated with improvements following 2 treatment periods of constraint-induced language therapy in 4 participants with stroke-induced chronic aphasia. Generalization of treatment to untrained materials and to discourse production was also analyzed, as was the durability of the treatment effect.

Method

Participants with aphasia were assessed using standardized measures and discourse tasks at 3 to 4 time points to document behavioral changes throughout each of two 30-hr treatment periods of constraint-induced language therapy. Daily probes of trained and untrained materials were also administered.

Results

Despite participant heterogeneity, behavioral results for each person with aphasia indicated a positive response to treatment following each treatment period indicated by performance on standardized tests, trained materials, or both. Treatment effects generalized to some degree to untrained stimuli and to discourse measures and were generally maintained at follow-up testing.

Conclusions

Data support the utility of a 2nd treatment period. Results are relevant to rehabilitation in chronic aphasia, confirming that significant language gains continue well past the point of spontaneous recovery and can occur in a relatively short time period. Importantly, changes are not confined to a single treatment period, suggesting that people with aphasia may benefit from multiple doses of high-intensity treatment.

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Effects of Second Language Proficiency and Linguistic Uncertainty on Recognition of Speech in Native and Nonnative Competing Speech

Purpose

The purpose of this study was to investigate the effects of 2nd language proficiency and linguistic uncertainty on performance and listening effort in mixed language contexts.

Method

Thirteen native speakers of Dutch with varying degrees of fluency in English listened to and repeated sentences produced in both Dutch and English and presented in the presence of single-talker competing speech in both Dutch and English. Target and masker language combinations were presented in both blocked and mixed (unpredictable) conditions. In the blocked condition, in each block of trials the target–masker language combination remained constant, and the listeners were informed of both prior to beginning the block. In the mixed condition, target and masker language varied randomly from trial to trial. All listeners participated in all conditions. Performance was assessed in terms of speech reception thresholds, whereas listening effort was quantified in terms of pupil dilation.

Results

Performance (speech reception thresholds) and listening effort (pupil dilation) were both affected by 2nd language proficiency (English test score) and target and masker language: Performance was better in blocked as compared to mixed conditions, with Dutch as compared to English targets, and with English as compared to Dutch maskers. English proficiency was correlated with listening performance. Listeners also exhibited greater peak pupil dilation in mixed as compared to blocked conditions for trials with Dutch maskers, whereas pupil dilation during preparation for speaking was higher for English targets as compared to Dutch ones in almost all conditions.

Conclusions

Both listener's proficiency in a 2nd language and uncertainty about the target language on a given trial play a significant role in how bilingual listeners attend to speech in the presence of competing speech in different languages, but precise effects also depend on which language is serving as target and which as masker.

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Education in ear and hearing care in remote or resource-constrained environments.

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Education in ear and hearing care in remote or resource-constrained environments.

J Laryngol Otol. 2018 Jul 12;:1-8

Authors: Clark MPA, Westerberg BD, Nakku D, Carling P

Abstract
BACKGROUND: At the heart of surgical care needs to be the education and training of staff, particularly in the low-income and/or resource-poor setting. This is the primary means by which self-sufficiency and sustainability will ultimately be achieved. As such, training and education should be integrated into any surgical programme that is undertaken. Numerous resources are available to help provide such a goal, and an open approach to novel, inexpensive training methods is likely to be helpful in this type of setting.The need for appropriately trained audiologists in low-income countries is well recognised and clearly goes beyond providing support for ear surgery. However, where ear surgery is being undertaken, it is vital to have audiology services established in order to correctly assess patients requiring surgery, and to be able to assess and manage outcomes of surgery. The training requirements of the two specialties are therefore intimately linked.
OBJECTIVE: This article highlights various methods, resources and considerations, for both otolaryngology and audiology training, which should prove a useful resource to those undertaking and organising such education, and to those staff members receiving it.

PMID: 29998812 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader https://ift.tt/2md05lx
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Education in ear and hearing care in remote or resource-constrained environments.

Related Articles

Education in ear and hearing care in remote or resource-constrained environments.

J Laryngol Otol. 2018 Jul 12;:1-8

Authors: Clark MPA, Westerberg BD, Nakku D, Carling P

Abstract
BACKGROUND: At the heart of surgical care needs to be the education and training of staff, particularly in the low-income and/or resource-poor setting. This is the primary means by which self-sufficiency and sustainability will ultimately be achieved. As such, training and education should be integrated into any surgical programme that is undertaken. Numerous resources are available to help provide such a goal, and an open approach to novel, inexpensive training methods is likely to be helpful in this type of setting.The need for appropriately trained audiologists in low-income countries is well recognised and clearly goes beyond providing support for ear surgery. However, where ear surgery is being undertaken, it is vital to have audiology services established in order to correctly assess patients requiring surgery, and to be able to assess and manage outcomes of surgery. The training requirements of the two specialties are therefore intimately linked.
OBJECTIVE: This article highlights various methods, resources and considerations, for both otolaryngology and audiology training, which should prove a useful resource to those undertaking and organising such education, and to those staff members receiving it.

PMID: 29998812 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader https://ift.tt/2md05lx
via IFTTT