The Production of Complex Syntax in Spontaneous Language by 4-Year-Old Children With Hearing Loss.
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ABSTRACT:
SUBMITTER: Werfel KL
PROVIDER: S-EPMC8740732 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:This article reports on the psychosocial development and factors influencing outcomes of 5-year-old children with cochlear implants (CIs) or hearing aids (HAs). It further examines differences between children with CIs and HAs with similar levels of hearing loss. Data were collected as part of the Longitudinal Outcomes of Children with Hearing Impairment study-a prospective, population-based study. Parents/caregivers of children completed the Strengths and Difficulties Questionnaire ( n = 333), the Social Skills subscale from the Child Development Inventory ( n = 317), and questionnaires on functional auditory behavior (Parents' Evaluation of Aural/oral performance of Children), and demographics. Children completed assessments of nonverbal cognitive ability (Wechsler Non-verbal Scale of Ability) and language (Preschool Language Scale - fourth edition). On average, parent-rated Strengths and Difficulties Questionnaire scores on emotional or behavioral difficulties were within 1 SD of the normative mean; however, Child Development Inventory scores on social skills were more than 1 SD below the norm. Children with severe-to-profound hearing losses using HAs had significantly more behavioral problems than children with CIs. Regression analyses showed that non-verbal cognitive ability, language, and functional auditory behavior were significantly associated with psychosocial outcomes for children with HAs, whereas outcomes for children with CIs were associated with functional auditory behavior and the presence of additional disabilities. Age at hearing intervention, severity of hearing loss, and communication mode were not associated with outcomes. The results suggest that even children who develop good language ability with the help of a HA or CI may have psychosocial problems if they exhibit difficulties with listening and communicating in everyday environments. The findings have implications for developing interventions for young children with hearing loss.
| S-EPMC5536374 | biostudies-other
Project description:OBJECTIVES:This study examined the language outcomes of children with mild to severe hearing loss during the preschool years. The longitudinal design was leveraged to test whether language growth trajectories were associated with degree of hearing loss and whether aided hearing influenced language growth in a systematic manner. The study also explored the influence of the timing of hearing aid fitting and extent of use on children's language growth. Finally, the study tested the hypothesis that morphosyntax may be at particular risk due to the demands it places on the processing of fine details in the linguistic input. DESIGN:The full cohort of children in this study comprised 290 children who were hard of hearing (CHH) and 112 children with normal hearing who participated in the Outcomes of Children with Hearing Loss (OCHL) study between the ages of 2 and 6 years. CHH had a mean better-ear pure-tone average of 47.66 dB HL (SD = 13.35). All children received a comprehensive battery of language measures at annual intervals, including standardized tests, parent-report measures, and spontaneous and elicited language samples. Principal components analysis supported the use of a single composite language score for each of the age levels (2, 3, 4, 5, and 6 years). Measures of unaided (better-ear pure-tone average, speech intelligibility index) and aided (residualized speech intelligibility index) hearing were collected, along with parent-report measures of daily hearing aid use time. Mixed modeling procedures were applied to examine the rate of change (227 CHH; 94 children with normal hearing) in language ability over time in relation to (1) degree of hearing loss, (2) aided hearing, (3) age of hearing aid fit and duration of use, and (4) daily hearing aid use. Principal components analysis was also employed to examine factor loadings from spontaneous language samples and to test their correspondence with standardized measures. Multiple regression analysis was used to test for differential effects of hearing loss on morphosyntax and lexical development. RESULTS:Children with mild to severe hearing loss, on average, showed depressed language levels compared with peers with normal hearing who were matched on age and socioeconomic status. The degree to which CHH fell behind increased with greater severity of hearing loss. The amount of improved audibility with hearing aids was associated with differential rates of language growth; better audibility was associated with faster rates of language growth in the preschool years. Children fit early with hearing aids had better early language achievement than children fit later. However, children who were fit after 18 months of age improved in their language abilities as a function of the duration of hearing aid use. These results suggest that the language learning system remains open to experience provided by improved access to linguistic input. Performance in the domain of morphosyntax was found to be more delayed in CHH than their semantic abilities. CONCLUSION:The data obtained in this study largely support the predictions, suggesting that mild to severe hearing loss places children at risk for delays in language development. Risks are moderated by the provision of early and consistent access to well-fit hearing aids that provide optimized audibility.
| S-EPMC4704115 | biostudies-literature
Project description:IMPORTANCE Hearing loss (HL) in children can be deleterious to their speech and language development. The standard of practice has been early provision of hearing aids (HAs) to moderate these effects; however, there have been few empirical studies evaluating the effectiveness of this practice on speech and language development among children with mild-to-severe HL. OBJECTIVE To investigate the contributions of aided hearing and duration of HA use to speech and language outcomes in children with mild-to-severe HL. DESIGN, SETTING, AND PARTICIPANTS An observational cross-sectional design was used to examine the association of aided hearing levels and length of HA use with levels of speech and language outcomes. One hundred eighty 3- and 5-year-old children with HL were recruited through records of Universal Newborn Hearing Screening and referrals from clinical service providers in the general community in 6 US states. INTERVENTIONS All but 4 children had been fitted with HAs, and measures of aided hearing and the duration of HA use were obtained. MAIN OUTCOMES AND MEASURES Standardized measures of speech and language ability were obtained. RESULTS Measures of the gain in hearing ability for speech provided by the HA were significantly correlated with levels of speech (?179?=?0.20; P?=?.008) and language: ?155?=?0.21; P?=?.01) ability. These correlations were indicative of modest levels of association between aided hearing and speech and language outcomes. These benefits were found for children with mild and moderate-to-severe HL. In addition, the amount of benefit from aided hearing interacted with the duration of HA experience (Speech: F4,161?=?4.98; P?<?.001; Language: F4,138?=?2.91; P?<?.02). Longer duration of HA experience was most beneficial for children who had the best aided hearing. CONCLUSIONS AND RELEVANCE The degree of improved hearing provided by HAs was associated with better speech and language development in children. In addition, the duration of HA experience interacted with the aided hearing to influence outcomes. These results provide support for the provision of well-fitted HAs to children with HL. In particular, the findings support early HA fitting and HA provision to children with mild HL.
| S-EPMC4066968 | biostudies-literature
Project description:This study examined the relationship between working memory capacity and narrative abilities in 5-6-year-old children. 269 children were assessed on their visual and verbal working memory and performed in a story retelling and a story creation (based on a single picture and on a series of pictures) tasks. The stories were evaluated on their macrostructure and microstructure. The results revealed a significant relationship between both components (verbal and visual) of working memory and the global indicators of a story's macrostructure-such as semantic completeness, semantic adequacy, programming and narrative structure-and with the indicators of a story's microstructure, such as grammatical accuracy and number of syntagmas. Yet, this relationship was systematically stronger for verbal working memory, as compared to visual working memory, suggesting that a well-developed verbal working memory leads to lexically and grammatically more accurate language production in preschool children.
| S-EPMC7071471 | biostudies-literature
Project description:Permanent childhood hearing loss affects 1 to 3 per 1000 children and frequently disrupts typical spoken language acquisition. Early identification of hearing loss through universal newborn hearing screening and the use of new hearing technologies including cochlear implants make spoken language an option for most children. However, there is no consensus on what constitutes optimal interventions for children when spoken language is the desired outcome. Intervention and educational approaches ranging from oral language only to oral language combined with various forms of sign language have evolved. Parents are therefore faced with important decisions in the first months of their child's life.This article presents the protocol for a systematic review of the effects of using sign language in combination with oral language intervention on spoken language acquisition. Studies addressing early intervention will be selected in which therapy involving oral language intervention and any form of sign language or sign support is used. Comparison groups will include children in early oral language intervention programs without sign support. The primary outcomes of interest to be examined include all measures of auditory, vocabulary, language, speech production, and speech intelligibility skills. We will include randomized controlled trials, controlled clinical trials, and other quasi-experimental designs that include comparator groups as well as prospective and retrospective cohort studies. Case-control, cross-sectional, case series, and case studies will be excluded. Several electronic databases will be searched (for example, MEDLINE, EMBASE, CINAHL, PsycINFO) as well as grey literature and key websites. We anticipate that a narrative synthesis of the evidence will be required. We will carry out meta-analysis for outcomes if clinical similarity, quantity and quality permit quantitative pooling of data. We will conduct subgroup analyses if possible according to severity/type of hearing disorder, age of identification, and type of hearing technology.This review will provide evidence on the effectiveness of using sign language in combination with oral language therapies for developing spoken language in children with hearing loss who are identified at a young age. The information from this review can provide guidance to parents and intervention specialists, inform policy decisions and provide directions for future research.CRD42013005426.
| S-EPMC4029089 | biostudies-other
Project description:The organization of the language network undergoes continuous changes during development as children learn to understand sentences. In the present study, functional magnetic resonance imaging and behavioral measures were utilized to investigate functional activation and functional connectivity (FC) in three-year-old (3yo) and six-year-old (6yo) children during sentence comprehension. Transitive German sentences varying the word order (subject-initial and object-initial) with case marking were presented auditorily. We selected children who were capable of processing the subject-initial sentences above chance level accuracy from each age group to ensure that we were tapping real comprehension. Both age groups showed a main effect of word order in the left posterior superior temporal gyrus (pSTG), with greater activation for object-initial compared to subject-initial sentences. However, age differences were observed in the FC between left pSTG and the left inferior frontal gyrus (IFG). The 6yo group showed stronger FC between the left pSTG and Brodmann area (BA) 44 of the left IFG compared to the 3yo group. For the 3yo group, in turn, the FC between left pSTG and left BA 45 was stronger than with left BA 44. Our study demonstrates that while task-related activation was comparable, the small behavioral differences between age groups were reflected in the underlying functional organization revealing the ongoing development of the neural language network.
| S-EPMC5407357 | biostudies-literature
Project description:Purpose Language difficulties are prevalent among children born preterm. Existing studies have largely used standardized language tests, providing limited scope for detailed descriptive examination of preterm language. This study aimed to examine differences in conversational language between children born < 30 weeks and at term as well as correlations between language sample analysis (LSA) and a standardized language tool. Method Two hundred four 3-year-olds (103 born < 30 weeks, 101 born at term) recruited at birth provided a 10-min language sample and completed the Preschool Language Scales-Fifth Edition (I. Zimmerman, Steiner, & Pond, 2011). LSA was conducted using the Systematic Analysis of Language Transcripts and Index of Productive Syntax. Group differences were analyzed using linear regression, and Pearson correlation coefficient (coef) was used to determine correlations between measures. Results Children born < 30 weeks scored lower than term-born peers on multiple metrics when controlled for confounding factors (sex, high social risk, multilingualism, and diagnosed neurodevelopmental disorders), including mean length of utterance in morphemes (coef = -0.28, 95% confidence interval [CI] [-0.56, 0.01]) and words (coef = -0.29, 95% CI [-0.53, -0.05]), number of different word roots (coef = -10.04, 95% CI [-17.93, -2.14]), and Index of Productive Syntax sentence structures (coef = -1.81, 95% CI [-3.10, -0.52]). Other variables (e.g., number of utterances, number of nouns and adjectives) were not significantly different between groups. LSA and the Preschool Language Scales-Fifth Edition were at most moderately correlated (≤ .45). Conclusions Three-year-old children born preterm demonstrated poorer conversational language than children born at term, with some specific areas of deficit emerging. Furthermore, formal assessment and LSA appear to provide relatively distinct and yet complementary data to guide diagnostic and intervention decisions. Supplemental Material https://doi.org/10.23641/asha.11368073.
| S-EPMC7213482 | biostudies-literature
Project description:BackgroundHearing ability is essential for normal speech development, however the precise mechanisms linking auditory input and the improvement of speaking ability remain poorly understood. Auditory feedback during speech production is believed to play a critical role by providing the nervous system with information about speech outcomes that is used to learn and subsequently fine-tune speech motor output. Surprisingly, few studies have directly investigated such auditory-motor learning in the speech production of typically developing children.Methodology/principal findingsIn the present study, we manipulated auditory feedback during speech production in a group of 9-11-year old children, as well as in adults. Following a period of speech practice under conditions of altered auditory feedback, compensatory changes in speech production and perception were examined. Consistent with prior studies, the adults exhibited compensatory changes in both their speech motor output and their perceptual representations of speech sound categories. The children exhibited compensatory changes in the motor domain, with a change in speech output that was similar in magnitude to that of the adults, however the children showed no reliable compensatory effect on their perceptual representations.ConclusionsThe results indicate that 9-11-year-old children, whose speech motor and perceptual abilities are still not fully developed, are nonetheless capable of auditory-feedback-based sensorimotor adaptation, supporting a role for such learning processes in speech motor development. Auditory feedback may play a more limited role, however, in the fine-tuning of children's perceptual representations of speech sound categories.
| S-EPMC2945760 | biostudies-literature
Project description:ImportanceHearing loss (HL), a major cause of disability globally, negatively affects both personal and professional life.ObjectiveTo describe the prevalence of sensorineural hearing loss (SNHL) among a population-based cohort of 9- to 11-year-old children, and to examine potential associations between purported risk factors and SNHL in early childhood.Design, setting, and participantsThe study was among the general, nonclinical, pediatric community within the city of Rotterdam, the Netherlands, and was conducted between 2012 and 2015 as a cross-sectional assessment within the Generation R Study, a population-based longitudinal cohort study from fetal life until adulthood. Participants are children of included pregnant women in the Generation R Study with an expected delivery date between April 2002 and January 2006. They form a prenatally recruited birth cohort.Main outcomes and measuresPure-tone air-conduction hearing thresholds were obtained at 0.5, 1, 2, 3, 4, 6, and 8 kHz, and tympanometry was performed in both ears. Demographic factors and parent-reported questionnaire data, including history of otitis media, were also measured.ResultsA total of 5368 participants with a mean age of 9 years 9 months (interquartile range, 9 years 7 months-9 years 11 months) completed audiometry and were included in the analyses. A total of 2720 were girls (50.7%), and 3627 (67.6%) were white. Most of the participants (4426 children [82.5%]) showed normal hearing thresholds 15 dB HL or less in both ears. Within the cohort, 418 children (7.8%) were estimated to have SNHL (≥16 dB HL at low-frequency pure-tone average; average at 0.5, 1, and 2 kHz or high-frequency pure-tone average; average at 3, 4, and 6 kHz in combination with a type A tympanogram) in at least 1 ear, most often at higher frequencies. In multivariable analyses, a history of recurrent acute otitis media and lower maternal education were associated with the estimated SNHL at ages 9 to 11 years (odds ratio, 2.0 [95% CI. 1.5-2.8] and 1.4 [95% CI, 1.1-1.7], respectively).Conclusions and relevanceWithin this cohort study in the Netherlands, 7.8% of the children ages 9 to 11 years had low-frequency or high-frequency HL of at least 16 dB HL in 1 or both ears. A history of recurrent acute otitis media and lower maternal education seem to be independent risk factors for presumed SNHL in early childhood.
| S-EPMC5710286 | biostudies-literature
Project description:Background: Down syndrome (DS) is associated with poor language skills that seem disproportionate to general nonverbal ability, but the nature and causes of this deficit are unclear. We assessed how individuals with DS understand complex linguistic constructions, and considered how cognitive ability and memory and impact the ability of those with DS to process these sentence types. Methods: There were three groups participating in the study: children with DS (n = 33) and two control groups composed of children with cognitive impairment of unknown aetiology (CI) (n = 32) and children with typical development (n = 33). The three groups did not differ on raw scores on a test of non-verbal cognitive ability. Using a newly devised animation task, we examined how well individuals with DS (n = 33) could understand relative clauses, complement clauses and adverbial clauses compared to children with CI and typically developing controls. Participants also completed the Test for the Reception of Grammar-2, three measures of memory (forward and backward digit recall, visuo-spatial memory) and a hearing screen. Results: Results indicated that (1) with the exception of intransitive subject relative clauses, children with DS performed at floor on all other complex sentences, (2) they performed at a significantly lower level than both control groups, and (3) DS status accounted for a significant proportion of the variance over and above memory skills. Conclusions: Our findings suggest that children with DS have a disproportionate difficulty understanding complex sentences compared to two control groups matched on mental age. Furthermore, their understanding of syntax is not completely explained by poor cognitive or memory skills, rather it appears to be a specific deficit that may distinguish children with DS from other neurodevelopmental disorders.
| S-EPMC6259485 | biostudies-literature