Prevalence of Auditory Problems in Children With Feeding and Swallowing Disorders

Purpose

Although an interdisciplinary approach is recommended for assessment and management of feeding or swallowing difficulties, audiologists are not always included in the interdisciplinary team. The purpose of this study is to report the prevalence of middle ear and hearing problems in children with feeding and swallowing disorders and to compare this prevalence with that in typical children.

Method

A total of 103 children were included in the study: 44 children with feeding and swallowing disorders and 59 children without any such disorders. Audiological examinations included case-history information, visualization of the ear canals through otoscopy, middle ear evaluation through tympanometry, and hearing screenings using an audiometer.

Results

The odds of excessive cerumen (p = .0000, small effect size), middle ear dysfunction (p = .0148, small effect size), and hearing screening failure (p = .0000, large effect size) were 22.14%, 2.97%, and 13.5% higher, respectively, in children with feeding and swallowing disorders compared with typically developing children.

Conclusion

The significantly higher prevalence of hearing problems in children with feeding and swallowing disorders compared with typically developing children suggests that inclusion of an audiologist on the interdisciplinary team is likely to improve overall interventional outcomes for children with feeding and swallowing disorders.

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Speech Rate Normalization and Phonemic Boundary Perception in Cochlear-Implant Users

Purpose

Normal-hearing (NH) listeners rate normalize, temporarily remapping phonemic category boundaries to account for a talker's speech rate. It is unknown if adults who use auditory prostheses called cochlear implants (CI) can rate normalize, as CIs transmit degraded speech signals to the auditory nerve. Ineffective adjustment to rate information could explain some of the variability in this population's speech perception outcomes.

Method

Phonemes with manipulated voice-onset-time (VOT) durations were embedded in sentences with different speech rates. Twenty-three CI and 29 NH participants performed a phoneme identification task. NH participants heard the same unprocessed stimuli as the CI participants or stimuli degraded by a sine vocoder, simulating aspects of CI processing.

Results

CI participants showed larger rate normalization effects (6.6 ms) than the NH participants (3.7 ms) and had shallower (less reliable) category boundary slopes. NH participants showed similarly shallow slopes when presented acoustically degraded vocoded signals, but an equal or smaller rate effect in response to reductions in available spectral and temporal information.

Conclusion

CI participants can rate normalize, despite their degraded speech input, and show a larger rate effect compared to NH participants. CI participants may particularly rely on rate normalization to better maintain perceptual constancy of the speech signal.

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Spoken Language Production in Young Adults: Examining Syntactic Complexity

Purpose

In this study, we examined syntactic complexity in the spoken language samples of young adults. Its purpose was to contribute to the expanding knowledge base in later language development and to begin building a normative database of language samples that potentially could be used to evaluate young adults with known or suspected language impairment.

Method

Forty adults (mean age = 22 years, 10 months) with typical language development participated in an interview that consisted of 3 speaking tasks: a general conversation about common, everyday topics; a narrative retelling task that involved fables; and a question-and-answer, critical-thinking task about the fables. Each speaker's interview was audio-recorded, transcribed, broken into communication units, coded for main and subordinate clauses, entered into Systematic Analysis of Language Transcripts (Miller, Iglesias, & Nockerts, 2004), and analyzed for mean length of communication unit and clausal density.

Results

Both the narrative and critical-thinking tasks elicited significantly greater syntactic complexity than the conversational task. It was also found that syntactic complexity was significantly greater during the narrative task than the critical-thinking task.

Conclusion

Syntactic complexity was best revealed by a narrative task that involved fables. The study offers benchmarks for language development during early adulthood.

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Efficacy of Visual–Acoustic Biofeedback Intervention for Residual Rhotic Errors: A Single-Subject Randomization Study

Purpose

This study documented the efficacy of visual–acoustic biofeedback intervention for residual rhotic errors, relative to a comparison condition involving traditional articulatory treatment. All participants received both treatments in a single-subject experimental design featuring alternating treatments with blocked randomization of sessions to treatment conditions.

Method

Seven child and adolescent participants received 20 half-hour sessions of individual treatment over 10 weeks. Within each week, sessions were randomly assigned to feature traditional or biofeedback intervention. Perceptual accuracy of rhotic production was assessed in a blinded, randomized fashion. Each participant's response to the combined treatment package was evaluated by using effect sizes and visual inspection. Differences in the magnitude of response to traditional versus biofeedback intervention were measured with individual randomization tests.

Results

Four of 7 participants demonstrated a clinically meaningful response to the combined treatment package. Three of 7 participants showed a statistically significant difference between treatment conditions. In all 3 cases, the magnitude of within-session gains associated with biofeedback exceeded the gains associated with traditional treatment.

Conclusions

These results suggest that the inclusion of visual–acoustic biofeedback can enhance the efficacy of intervention for some individuals with residual rhotic errors. Further research is needed to understand which participants represent better or poorer candidates for biofeedback treatment.

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Normative Study of Wideband Acoustic Immittance Measures in Newborn Infants

Objective

The purpose of this study was to describe normative aspects of wideband acoustic immittance (WAI) measures obtained from healthy White neonates.

Method

In this cross-sectional study, wideband absorbance (WBA), admittance magnitude, and admittance phase were measured under ambient pressure condition in 326 ears from 203 neonates (M age = 45.9 hr) who passed a battery of tests, including automated auditory brainstem response, high-frequency tympanometry, and distortion product otoacoustic emissions.

Results

Normative WBA data were in agreement with most previous studies. Normative data for both WBA and admittance magnitude revealed double-peaked patterns with the 1st peak at 1.25–2 kHz and the 2nd peak at 5–8 kHz, while normative admittance phase data showed 2 peaks at 0.8 and 4 kHz. There were no significant differences between ears or gender for the 3 WAI measures. Standard deviations for all 3 measures were highest at frequencies above 4 kHz.

Conclusions

The 3 WAI measures between 1 kHz and 4 kHz may provide the most stable response of the outer and middle ear. WAI measures at frequencies above 4 kHz were more variable. The normative data established in the present study may serve as a reference for evaluating outer and middle ear function in neonates.

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Speech Inconsistency in Children With Childhood Apraxia of Speech, Language Impairment, and Speech Delay: Depends on the Stimuli

Purpose

The current research sought to determine (a) if speech inconsistency is a core feature of childhood apraxia of speech (CAS) or if it is driven by comorbid language impairment that affects a large subset of children with CAS and (b) if speech inconsistency is a sensitive and specific diagnostic marker that can differentiate between CAS and speech delay.

Method

Participants included 48 children ranging between 4;7 to 17;8 (years;months) with CAS (n = 10), CAS + language impairment (n = 10), speech delay (n = 10), language impairment (n = 9), or typical development (n = 9). Speech inconsistency was assessed at phonemic and token-to-token levels using a variety of stimuli.

Results

Children with CAS and CAS + language impairment performed equivalently on all inconsistency assessments. Children with language impairment evidenced high levels of speech inconsistency on the phrase “buy Bobby a puppy.” Token-to-token inconsistency of monosyllabic words and the phrase “buy Bobby a puppy” was sensitive and specific in differentiating children with CAS and speech delay, whereas inconsistency calculated on other stimuli (e.g., multisyllabic words) was less efficacious in differentiating between these disorders.

Conclusions

Speech inconsistency is a core feature of CAS and is efficacious in differentiating between children with CAS and speech delay; however, sensitivity and specificity are stimuli dependent.

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The Role of Frequency in Learning Morphophonological Alternations: Implications for Children With Specific Language Impairment

Purpose

The aim of this article was to explore how the type of allomorph (e.g., past tense buzz[ d ] vs. nod[ əd ]) influences the ability to perceive and produce grammatical morphemes in children with typical development and with specific language impairment (SLI).

Method

The participants were monolingual Australian English–speaking children. The SLI group included 13 participants (mean age = 5;7 [years;months]); the control group included 19 children with typical development (mean age = 5;4). Both groups performed a grammaticality judgment and elicited production task with the same set of nonce verbs in third-person singular and past tense forms.

Results

Five-year-old children are still learning to generalize morphophonological patterns to novel verbs, and syllabic /əz/ and /əd/ allomorphs are significantly more challenging to produce, particularly for the SLI group. The greater phonetic content of these syllabic forms did not enhance perception.

Conclusions

Acquisition of morphophonological patterns involving low-frequency allomorphs is still underway in 5-year-old children with typical development, and it is even more protracted in SLI populations, despite these patterns being highly predictable. Children with SLI will therefore benefit from targeted intervention with low-frequency allomorphs.

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