Development of Grammatical Accuracy in English-Speaking Children With Cochlear Implants: A Longitudinal Study.
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ABSTRACT: 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.
SUBMITTER: Guo LY
PROVIDER: S-EPMC5548077 | biostudies-literature | 2017 Apr
REPOSITORIES: biostudies-literature
Publications
Development of Grammatical Accuracy in English-Speaking Children With Cochlear Implants: A Longitudinal Study.
Guo Ling-Yu LY Spencer Linda J LJ
Journal of speech, language, and hearing research : JSLHR 20170401 4
<h4>Purpose</h4>We sought to evaluate the development of grammatical accuracy in English-speaking children with cochlear implants (CIs) over a 3-year span.<h4>Method</h4>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 ...[more]
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Project description:Early auditory/language experience plays an important role in language development. In this study, we examined the effects of severe-to-profound hearing loss and subsequent cochlear implantation on the development of attention to speech in children with cochlear implants (CIs). In addition, we investigated the extent to which attention to speech may predict spoken language development in children with CIs. We tested children with CIs and compared them to chronologically age-matched peers with normal hearing (NH) on their attention to speech at four time points post implantation; specifically, less than 1 month, 3 to 6 months, 12 months, and 18 months post implantation. We also collected a variety of well-established speech perception and spoken language measures from the children with CIs in a 10-year longitudinal study. Children with CIs showed reduced attention to speech as compared to their peers with NH at less than 1 month post implantation, but a similar degree of attention to speech as their NH peers during later time points. In addition, attention to speech at 3 to 6 months post implantation predicts speech perception in children with CIs. These results inform language acquisition theories and bring insights into our understanding of early severe-to-profound hearing loss on infants' attention to speech skills. In addition, the findings have significant clinical implications for early intervention on hearing loss, which emphasizes the importance of developing strong listening skills. A video abstract of this article can be viewed at: https://www.youtube.com/watch?v=f7xiYo3Ua08&feature=youtu.be.
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Project description:Informal music activities such as singing may lead to augmented auditory perception and attention. In order to study the accuracy and development of music-related sound change detection in children with cochlear implants (CIs) and normal hearing (NH) aged 4-13 years, we recorded their auditory event-related potentials twice (at T1 and T2, 14-17 months apart). We compared their MMN (preattentive discrimination) and P3a (attention toward salient sounds) to changes in piano tone pitch, timbre, duration, and gaps. Of particular interest was to determine whether singing can facilitate auditory perception and attention of CI children. It was found that, compared to the NH group, the CI group had smaller and later timbre P3a and later pitch P3a, implying degraded discrimination and attention shift. Duration MMN became larger from T1 to T2 only in the NH group. The development of response patterns for duration and gap changes were not similar in the CI and NH groups. Importantly, CI singers had enhanced or rapidly developing P3a or P3a-like responses over all change types. In contrast, CI non-singers had rapidly enlarging pitch MMN without enlargement of P3a, and their timbre P3a became smaller and later over time. These novel results show interplay between MMN, P3a, brain development, cochlear implantation, and singing. They imply an augmented development of neural networks for attention and more accurate neural discrimination associated with singing. In future studies, differential development of P3a between CI and NH children should be taken into account in comparisons of these groups. Moreover, further studies are needed to assess whether singing enhances auditory perception and attention of children with CIs.
| S-EPMC4261723 | biostudies-literature
Project description:ObjectivesSlowed speaking rate was examined for its effects on speech intelligibility, its interaction with the benefit of contextual cues, and the impact of these factors on listening effort in adults with cochlear implants.DesignParticipants (n = 21 cochlear implant users) heard high- and low-context sentences that were played at the original speaking rate, as well as a slowed (1.4× duration) speaking rate, using uniform pitch-synchronous time warping. In addition to intelligibility measures, changes in pupil dilation were measured as a time-varying index of processing load or listening effort. Slope of pupil size recovery to baseline after the sentence was used as an index of resolution of perceptual ambiguity.ResultsSpeech intelligibility was better for high-context compared to low-context sentences and slightly better for slower compared to original-rate speech. Speech rate did not affect magnitude and latency of peak pupil dilation relative to sentence offset. However, baseline pupil size recovered more substantially for slower-rate sentences, suggesting easier processing in the moment after the sentence was over. The effect of slowing speech rate was comparable to changing a sentence from low context to high context. The effect of context on pupil dilation was not observed until after the sentence was over, and one of two analyses suggested that context had greater beneficial effects on listening effort when the speaking rate was slower. These patterns maintained even at perfect sentence intelligibility, suggesting that correct speech repetition does not guarantee efficient or effortless processing. With slower speaking rates, there was less variability in pupil dilation slopes following the sentence, implying mitigation of some of the difficulties shown by individual listeners who would otherwise demonstrate prolonged effort after a sentence is heard.ConclusionsSlowed speaking rate provides release from listening effort when hearing an utterance, particularly relieving effort that would have lingered after a sentence is over. Context arguably provides even more release from listening effort when speaking rate is slower. The pattern of prolonged pupil dilation for faster speech is consistent with increased need to mentally correct errors, although that exact interpretation cannot be verified with intelligibility data alone or with pupil data alone. A pattern of needing to dwell on a sentence to disambiguate misperceptions likely contributes to difficulty in running conversation where there are few opportunities to pause and resolve recently heard utterances.
| S-EPMC8005496 | biostudies-literature
Project description:Localizing sounds in our environment is one of the fundamental perceptual abilities that enable humans to communicate, and to remain safe. Because the acoustic cues necessary for computing source locations consist of differences between the two ears in signal intensity and arrival time, sound localization is fairly poor when a single ear is available. In adults who become deaf and are fitted with cochlear implants (CIs) sound localization is known to improve when bilateral CIs (BiCIs) are used compared to when a single CI is used. The aim of the present study was to investigate the emergence of spatial hearing sensitivity in children who use BiCIs, with a particular focus on the development of behavioral localization patterns when stimuli are presented in free-field horizontal acoustic space. A new analysis was implemented to quantify patterns observed in children for mapping acoustic space to a spatially relevant perceptual representation. Children with normal hearing were found to distribute their responses in a manner that demonstrated high spatial sensitivity. In contrast, children with BiCIs tended to classify sound source locations to the left and right; with increased bilateral hearing experience, they developed a perceptual map of space that was better aligned with the acoustic space. The results indicate experience-dependent refinement of spatial hearing skills in children with CIs. Localization strategies appear to undergo transitions from sound source categorization strategies to more fine-grained location identification strategies. This may provide evidence for neural plasticity, with implications for training of spatial hearing ability in CI users.
| S-EPMC4545829 | biostudies-literature
Project description:ImportanceChildren who receive a cochlear implant (CI) for early severe to profound sensorineural hearing loss may achieve age-appropriate spoken language skills not possible before implantation. Despite these advances, reduced access to auditory experience may have downstream effects on fundamental neurocognitive processes for some children with CIs.ObjectiveTo determine the relative risk (RR) of clinically significant executive functioning deficits in children with CIs compared with children with normal hearing (NH).Design, setting, and participantsIn this prospective, cross-sectional study, 73 children at a hospital-based clinic who received their CIs before 7 years of age and 78 children with NH, with average to above average mean nonverbal IQ scores, were recruited in 2 age groups: preschool age (age range, 3-5 years) and school age (age range, 7-17 years). No children presented with other developmental, cognitive, or neurologic diagnoses.InterventionsParent-reported checklist measures of executive functioning were completed during psychological testing sessions.Main outcomes and measuresEstimates of the RR of clinically significant deficits in executive functioning (≥1 SDs above the mean) for children with CIs compared with children with NH were obtained based on 2 parent-reported child behavior checklists of everyday problems with executive functioning.ResultsIn most domains of executive functioning, children with CIs were at 2 to 5 times greater risk of clinically significant deficits compared with children with NH. The RRs for preschoolers and school-aged children, respectively, were greatest in the areas of comprehension and conceptual learning (RR [95% CI], 3.56 [1.71-7.43] and 6.25 [2.64-14.77]), factual memory ( 4.88 [1.58-15.07] and 5.47 [2.03-14.77]), attention (3.38 [1.03-11.04] and 3.13 [1.56-6.26]), sequential processing (11.25 [1.55-81.54] and 2.44 [1.24-4.76]), working memory (4.13 [1.30-13.06] and 3.64 [1.61-8.25] for one checklist and 1.77 [0.82-3.83] and 2.78 [1.18-6.51] for another checklist), and novel problem-solving (3.93 [1.50-10.34] and 3.13 [1.46-6.67]). No difference between the CI and NH samples was found for visual-spatial organization (2.63 [0.76-9.03] and 1.04 [0.45-2.40] on one checklist and 2.86 [0.98-8.39] for school-aged children on the other checklist).Conclusions and relevanceA large proportion of children with CIs are at risk for clinically significant deficits across multiple domains of executive functioning, a rate averaging 2 to 5 times that of children with NH for most domains. Screening for risk of executive functioning deficits should be a routine part of the clinical evaluation of all children with deafness and CIs.
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Project description:Purpose This study examines the influence of lexical and phonological factors on expressive lexicon size in 40 French-speaking children tested longitudinally from 22 to 48 months. The factors include those based on the lexical and phonological properties of words in the children's lexicons (phonetic complexity, word length, neighborhood density [ND], and word frequency [WF]) as well as variables measuring phonological production (percent consonants correct and phonetic inventory size). Specifically, we investigate the relative influence of these factors at individual ages, namely, 22, 29, 36, and 48 months, and which factors measured at 22 and 29 months influence lexicon size at 36 and 48 months. Method Children were selected based on parent-reported vocabulary size. We included children with low, medium, and high vocabulary scores. The children's lexicons were coded in terms of phonetic complexity, word length, ND, and WF, and their phonological production skills were based on measures of percent consonants correct and phonetic inventory size extracted from spontaneous speech samples at 29, 36, and 48 months. In the case of ND and WF, we focused on one- and two-syllable nouns. Results Across the age range, the most important factor that explained variance in lexicon size was the WF of nouns. Children who selected low-frequency nouns had larger vocabularies across all ages (22-48 months). The WF of two-syllable nouns and phonological production measured at 29 months influenced lexicon size at 36 months, whereas the WF (of one- and two-syllable words) influenced lexicon size at 48 months. Conclusions The findings support the role of WF and phonological production in explaining expressive vocabulary development. Children enlarge their vocabularies by adding nouns of increasingly lower frequency. Phonological production plays a role in accounting for vocabulary size up until the age of 36 months. Supplemental Material https://doi.org/10.23641/asha.12291074.
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Project description:UnlabelledIn normal-hearing children the latency of the P1 component of the cortical evoked response to sound varies as a function of age and, thus, can be used as a biomarker for maturation of central auditory pathways. We assessed P1 latency in 245 congenitally deaf children fit with cochlear implants following various periods of auditory deprivation. If children experience less than 3.5 years of auditory deprivation before implantation, P1 latencies fall into the range of normal following 3-6 months of electrical stimulation. Children who experience greater than 7 years of deprivation, however, generally do not develop normal P1 latencies even after years of stimulation. Moreover, the waveforms for these patients can be markedly abnormal. Cortical reorganization stimulated by deprivation is likely to be a significant factor in both variation in the latency and morphology of the cortical evoked response to sound for children fit with a cochlear implant and variation in the development of oral speech and language function.Learning outcomesThe reader will be introduced to research using cortical evoked responses (CAEPs), positron emission tomography (PET) scans and in-depth recording from the auditory cortex of congenitally deaf cats that converges on the existence of a sensitive period for the development of central auditory pathways in children. The reader will also be provided with two case studies that illustrate the use of the P1 response as biomarker for development of central auditory pathways. Finally, suggestions for future research will be provided.
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Project description:Purpose Early language input plays an important role in child language and cognitive development (e.g., Gilkerson et al., 2018; Hart & Risley, 1995). In this study, we examined the effects of child's hearing status on lexical repetition properties of speech produced by their caregivers with normal hearing (NH). In addition, we investigated the relationship between maternal lexical repetition properties and later language skills in English-learning infants with cochlear implants (CIs). Method In a free-play session, 17 mothers and their prelingually deaf infants who received CIs before 2 years of age (CI group) were recorded at two post-CI intervals: 3 and 6 months postactivation; 18 hearing experience-matched infants with NH and their mothers and 14 chronological age-matched infants with NH group and their mothers were matched to the CI group. Maternal speech was transcribed from the recordings, and measures of maternal lexical repetition were obtained. Standardized language assessments were administered on children with CIs approximately two years after CI activation. Results The findings indicated that measures of lexical repetition were similar among the three groups of mothers, regardless of the hearing status of their infants. In addition, lexical repetition measures were correlated with later language skills in infants with CIs. Conclusions Infants with CIs receive the language input that contains similar lexical repetition properties as that in the speech received by their peers with NH, which is likely to play an important role in child speech processing and language development. These findings provide the knowledge for professionals to coach parents to implement specific language intervention strategies to support language development in infants with hearing loss. Supplemental Material https://doi.org/10.23641/asha.11936322.
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Project description:Introduction Currently the cochlear implant allows access to sounds in individuals with profound hearing loss. The objective methods used to verify the integrity of the cochlear device and the electrophysiologic response of users have noted these improvements. Objective To establish whether the evoked compound action potential of the auditory nerve can appear after electrical stimulation when it is absent intraoperatively. Methods The clinical records of children implanted with the Nucleus Freedom (Cochlear Ltd., Australia) (CI24RE) cochlear implant between January 2009 and January 2010 with at least 6 months of use were evaluated. The neural response telemetry (NRT) thresholds of electrodes 1, 6, 11, 16, and 22 during surgery and after at least 3 months of implant use were analyzed and correlated with etiology, length of auditory deprivation, and chronological age. These data were compared between a group of children exhibiting responses in all of the tested electrodes and a group of children who had at least one absent response. Results The sample was composed of clinical records of 51 children. From these, 21% (11) showed no NRT in at least one of the tested electrodes. After an average of 4.9 months of stimulation, the number of individuals exhibiting absent responses decreased from 21 to 11% (n = 6). Conclusion It is feasible that absent responses present after a period of electrical stimulation. In our sample, 45% (n = 5) of the patients with intraoperative absence exhibited a positive response after an average of 4.9 months of continued electrical stimulation.
| S-EPMC4296982 | biostudies-other
Project description:Phonological awareness is a critical component of phonological processing that predicts children's literacy outcomes. Phonological awareness skills enable children to think about the sound structure of words and facilitates decoding and the analysis of words during spelling. Past research has shown that children's vocabulary knowledge and working memory capacity are associated with their phonological awareness skills. Linguistic characteristics of words, such as phonological neighborhood density and orthography congruency have also been found to influence children's performance in phonological awareness tasks. Literacy is a difficult area for deaf and hard of hearing children, who have poor phonological awareness skills. Although cochlear implantation (CI) has been found to improve these children's speech and language outcomes, limited research has investigated phonological awareness in children with CI. Rhyme awareness is the first level of phonological awareness to develop in children with normal hearing (NH). The current study investigates whether rhyme awareness in children with NH (n = 15, median age = 5; 5, IQR = 11 ms) and a small group of children with CI (n = 6, median age = 6; 11.5, IQR = 3.75 ms) is associated with individual differences in vocabulary and working memory. Using a rhyme oddity task, well-controlled for perceptual similarity, we also explored whether children's performance was associated with linguistic characteristics of the task items (e.g., rhyme neighborhood density, orthographic congruency). Results indicate that there is an association between vocabulary and working memory and performance in a rhyme awareness task in NH children. Only working memory was correlated with rhyme awareness performance in CI children. Linguistic characteristics of the task items, on the other hand, were not found to be associated with success. Implications of the results and future directions are discussed.
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