Lexical and semantic ability in groups of children with cochlear implants, language impairment and autism spectrum disorder

Lexical Access in Preschool Mandarin-Speaking Children With Cochlear Implants

PURPOSE

Children with cochlear implants (CIs) have less experience accessing spoken language. Mandarin Chinese uses pitch information to contrast word meaning, and the signal that the CI devices provide is degraded. Thus, Mandarin-speaking children with CIs may face more challenges in the development of language skills. This study examines preschool Mandarin-speaking children's performance in lexical access. We hypothesized that children with CIs and their peers with normal hearing (NH) have comparable naming ability, but they process phonological or semantic information differently.

METHOD

Twenty children with CIs and 20 age-matched children with NH were tested. The cross-modal visual-auditory picture-word interference paradigm was applied. The distractor was either phonologically related (mao⁵⁵ cat -mao⁵¹ hat), semantically related (mao⁵⁵ cat -shu²¹⁴ mouse) or unrelated (mao⁵⁵ cat -zhi²¹⁴ paper) to the target, and it was aurally presented at four different points in time relative to the picture. Accuracy was compared between the two groups to tap into the children's naming abilities, and reaction time was analyzed to examine the effects of phonological and semantic information.

RESULTS

No group difference in accuracy was found. The phonologically related distractors led to significantly higher accuracy scores and shorter reaction times, whereas the semantically related distractors did not. Unlike the NH group, the CI group did not respond significantly faster or slower in phonologically related condition when the distractor and picture occurred simultaneously. Finally, the CI group made overall quicker responses than the NH group.

CONCLUSIONS

Children with CIs are as successful as children with NH in word retrieval and production, and the two groups both show phonological priming effect and lack semantic effect. However, children with CIs do not process phonological information as early as their NH peers, and they may be more tasks directed and hence make quicker responses.

Vocabulario profundo y lectura en el alumnado con sordera. Una revisión sistemática

Diferentes estudios en el ámbito de la comprensión lectora señalan que el vocabulario oral de una lengua, definido por dos variables, amplitud y profundidad, es uno de los factores que más contribuye a esta destreza en lectores típicos; siendo la profundidad, relacionada con la extensión de las representaciones semánticas subyacentes a los conceptos, más influyente que la amplitud, referida a la cantidad de palabras que una persona es capaz de reconocer. Estudios previos muestran las dificultades que el alumnado con sordera presenta en la realización de asociaciones entre palabras, en el establecimiento de relaciones entre significados o en el uso de sinónimos; todas ellas derivadas, principalmente, del déficit lingüístico primario que presentan. El objetivo de este estudio ha sido doble: por un lado, analizar los resultados de aquellas investigaciones que evalúan el rol del vocabulario profundo en la comprensión lectora del alumnado con sordera y, por otro lado, argumentar qué influencia tiene dicha profundidad en esta destreza. Se realizó una búsqueda bibliográfica en las principales bases de datos (2010 – 2021). En la búsqueda inicial se identificaron 373 artículos y, una vez aplicados los criterios de inclusión, 8 fueron los que cumplieron con los objetivos previamente definidos. Los resultados mostraron que el reconocimiento del vocabulario profundo en las investigaciones relacionadas con el desarrollo lector del alumnado con sordera podría desembocar en una mejor comprensión de su papel en las habilidades implicadas en dicho proceso. Por ello, es necesario ahondar teóricamente en su tratamiento y en sus implicaciones para la práctica educativa con estudiantes con sordera.

Lexical Semantic Knowledge of Children with ASD—a Review Study

Studies on the lexical semantic abilities of children with autism have yielded contradicting results. The aim of the current review was to explore studies that have specifically focused on the lexical semantic abilities of children with ASD and try to find an explanation for these contradictions. In the 32 studies reviewed, no single factor was found to affect lexical semantic skills, although children with broader linguistic impairment generally, but not universally, also showed impaired lexical semantic skills. The need for future studies with young ASD participants, with differing intellectual functioning, longitudinal studies, and studies assessing a wide range of language domains are discussed.

X-linked Malformation Deafness: Neurodevelopmental Symptoms Are Common in Children With IP3 Malformation and Mutation in POU3F4

Supplemental Digital Content is available in the text.

Incomplete partition type 3 (IP3) malformation deafness is a rare hereditary cause of congenital or rapid progressive hearing loss. The children present with a severe to profound mixed hearing loss and temporal bone imaging show a typical inner ear malformation classified as IP3. Cochlear implantation is one option of hearing restoration in severe cases. Little is known about other specific difficulties these children might exhibit, for instance possible neurodevelopmental symptoms.

Cochlear implant in patients with autistic spectrum disorder-a systematic review

Introduction

In cases of autism spectrum disorders with severe to profound hearing loss, cochlear implant is a therapeutic option.

Objective

To identify evidence in the scientific literature that the cochlear implant brings benefits to people with autism spectrum disorders with associated hearing loss.

Methods

Systematic review of the literature based on the criteria recommended by PRISMA. The population, intervention, comparison, outcomes, study design, PICOS strategy, was used to define the eligibility criteria. The studies that met the inclusion criteria for this second stage were included in a qualitative synthesis. Each type of study was analyzed according to the Joanna Briggs Institute's risk of bias assessment through the critical checklist for cohort studies, prevalence studies and critical criteria and case reports.

Results

Four hundred and eighty-four articles were found in eight databases and 100 in the gray literature, mentioning the relationship between cochlear implants in patients with autism spectrum disorder and hearing loss. Twelve articles were read in full and 7 were selected for qualitative analysis in this systematic review. All seven articles were analyzed on the critical evaluation checklist. Four articles had a low risk of bias and three articles had a moderate risk of bias. In this study, were included 66 patients with autism spectrum disorder and hearing loss who received cochlear implant.

Conclusion

This systematic review indicates that a cochlear implant can bring benefits to autism spectrum disorder patients with associated deafness.

Phonological and lexical abilities of Jordanian children with autism

This study examines phonological and lexical abilities of children with autism in Jordan. JISH Articulation Test (JAT) to measure phonological abilities and JISH School Readiness Screening Test to measure lexical abilities were used in the study. Children with ASD (n = 39) aged 4-8 years and 40 children with typical development were selected to participate in this study. The main finding of this study was that language impairment in both phonological and lexical abilities were noted among Jordanian children with ASD. The results also showed that phonological impairment was greater than lexical impairment. It is concluded that the findings of such study will be helpful to guide experts to provide children with ASD with appropriate educational programs and establish a comprehensive and effective treatment protocols that include phonological and lexical exercises to enhance their speech and language abilities.

Executive Functions, Pragmatic Skills, and Mental Health in Children With Congenital Cytomegalovirus (CMV) Infection With Cochlear Implants: A Pilot Study

Congenital cytomegalovirus (cCMV) infection is the most common cause of progressive hearing impairment. In our previous study around 90% of children with a cCMV infection and CI had severely damaged balance functions (Karltorp et al., 2014). Around 20% had vision impairment, 15% were diagnosed with Autism-Spectrum-Disorder, and 20% with ADHD. One clinical observation was that children with cCMV infection had problems with executive functioning (EF), while controls with a genetic cause of deafness (Connexin 26 mutations; Cx26) did not have similar difficulties. A follow-up study was therefore initiated with the main objective to examine EF and pragmatic skills in relation to mental health in children with a cCMV infection and to draw a comparison with matched controls with Cx26 mutations (age, sex, hearing, non-verbal cognitive ability, vocabulary, and socioeconomic status level). Ten children with a cCMV infection and CI (4.8–12:9 years) and seven children with CI (4:8–12:8 years) participated in the study, which had a multidisciplinary approach. Executive functioning was assessed both with formal tests targeting working memory and attention, parent and teacher questionnaires, and a systematic observation by a blinded psychologist during one test situation. Pragmatics and mental health were investigated with parent and teacher reports. In addition, the early language outcome was considered in non-parametric correlation analyses examining the possible relationships between later EF skills, pragmatics, and mental health. Children with cCMV had a statistically significant worse pragmatic outcome and phonological working memory than controls despite their groups having similar non-verbal cognitive ability and vocabulary. However, there were no statistical differences between the groups regarding their EF skills in everyday settings and mental health. There were associations between early language outcomes and later EF skills and pragmatics in the whole sample.

Conclusion: Children with a cCMV infection are at risk of developing learning difficulties in school due to difficulties with phonological working memory and pragmatic skills in social interactions.

Validation of the Egyptian Arabic Assessment of Auditory Skills development using children with Cochlear Implants

INTRODUCTION

Audition is the gateway to spoken language, and infants' early accomplishments in acquiring the sound structure of their native language lays a critical ground work for subsequent learning. The development of pre-lingual auditory perceptual skills for cochlear implanted children is crucial for initial development of oral language.

OBJECTIVE

The aims of the present study were to validate the Egyptian Arabic Assessment of Auditory Skills, and to track the development of auditory skills in Egyptian children fitted with CI during the first three years post implantation.

METHODS

The study included 90 Arabic Egyptian children attending the phoniatric unit, Kasr El Aini hospital. Their chronological age ranged from 36 to 72 months. The study lasted for 18 months from July 2015 to January 2017. The children were divided into six groups according to their cochlear age i.e., amount of implant experience. An Arabic assessment chart of auditory skills was tailored that included six auditory skills' domains; detection, identification, short term auditory memory, supra-segmental discrimination, segmental discrimination and linguistic auditory processing. This chart was then used to develop an assessment tool which was then applied to all the study participants. All children had bilateral Sensorineural Hearing Loss (SNHL) since birth. None of the participants had prior Cochlear Implant (CI), but all had tried conventional hearing aids. All participants were implanted unilateral, with CI devices. All met selection criteria applied in the Egyptian national insurance committee for cochlear implantation.

RESULTS

All auditory skills domains improved with cochlear age. There was significant improvement between 1-6 and 7-12 months in the scores of the Detection (DET) domain. There was significant difference between 1-6 and 7-12 months, 7-12 and 13-18 months, 19-24 and 25-30 months in the scores of the Identification (IDENT) domain. Regarding the Short Term Auditory Memory (STAM) domain scores and the Supra-segmental Discrimination (SSD) domain scores there was significant difference between all the groups. Regarding the Segmental Discrimination (SGD) domain scores, there was significant difference between group 1-6 and 7-12 months, 7-12 and 13-18 months, 19-24 and 25-30 months, 25-30 and 31-36 months. Regarding the Linguistic Auditory Processing (LAP) domain, there was significant difference between group 1-6 and 7-12 months, 7-12 and 13-18 months, 25-30 and 31-36 months.

CONCLUSIONS

Children fitted with Cochlear Implants (CIs) appeared to show improvement in acquisition of auditory skills over a period of three years that followed a hierarchy of development dependent on the cochlear age.

Linear Mixed-Model Analysis to Examine Longitudinal Trajectories in Vocabulary Depth and Breadth in Children Who Are Hard of Hearing

Purpose Children who are hard of hearing (CHH) tend to have reduced vocabularies compared to children with normal hearing (CNH). Prior research on vocabulary skills in children with hearing loss has focused primarily on their breadth of knowledge (how many words are known). Depth of vocabulary knowledge (how well words are known) is not well documented for CHH. The current study used linear mixed models (LMMs) to investigate growth trajectories of vocabulary depth and breadth in CHH relative to age-matched CNH. Method Participants for this study included 155 children (93 CHH, 62 CNH) enrolled in a longitudinal study. Examiners administered a standardized measure of vocabulary knowledge at ages 7, 8, and 9 years. We constructed multiple LMMs with fixed effects for group and age. The models included various combinations of random intercepts for subject and item and random slope for age. Results For depth, CHH showed significant and stable deficits compared to CNH over time. For breadth, CNH showed greater vocabulary breadth, but the group differences diminished with age. For CHH, higher aided audibility, age, and maternal educational level were associated with greater vocabulary breadth and depth. Age at hearing aid fitting was not. Conclusions A major advantage of using LMM is that it allowed us to cope with missing data points while still accounting for variability within and across participants. Assessment of both vocabulary breadth and depth may be useful in identifying school-age CHH who are at risk of delays in language outcomes.

Parents' Perception of Health-Related Quality of Life in Children With Cochlear Implants: The Impact of Language Skills and Hearing

PURPOSE

The study compared how parents of children with cochlear implants (CIs) and parents of children with normal hearing perceive their children's health-related quality of life (HR-QOL).

METHOD

The sample consisted of 186 Norwegian-speaking children in the age span of 5;0-12;11 (years;months): 106 children with CIs (53% boys, 47% girls) and 80 children with normal hearing (44% boys, 56% girls). No children had known additional disabilities affecting language, cognitive development, or HR-QOL. Parents completed the generic questionnaire Pediatric Quality of Life Inventory (Varni, Seid, & Kurtin, 2001), whereas children completed a test battery measuring different aspects of language and hearing.

RESULTS

Parents of children with CIs reported statistically significantly poorer HR-QOL in their children, on Pediatric Quality of Life Inventory total score and the subdomains social functioning and school functioning. Roughly 50% of parents of children with CIs reported HR-QOL levels (total score) within normal limits. No significant differences between groups emerged on the physical health and emotional functioning subscales. For the children in the group with CIs, better speech perception in everyday situations was associated with higher proxy-ratings of HR-QOL. Better spoken language skills were weakly to moderately associated with higher HR-QOL.

CONCLUSIONS

The findings suggest that the social and school situation is not yet resolved satisfactorily for children with CIs. Habilitation focusing on spoken language skills and better sound environment may improve social interactions with peers and overall school functioning.

Watch and listen - A cross-cultural study of audio-visual-matching behavior in 4.5-month-old infants in German and Swedish talking faces

Investigating infants' ability to match visual and auditory speech segments presented sequentially allows us to understand more about the type of information they encode in each domain, as well as their ability to relate the information. One previous study found that 4.5- month-old infants' preference for visual French or German speech depended on whether they had previously heard the respective language, suggesting a remarkable ability to encode and relate audio-visual speech cues and to use these to guide their looking behavior. However, French and German differ in their prosody, meaning that perhaps, the infants did not base their matching on phonological or phonetic cues, but on prosody patterns. The present study aimed to address this issue by tracking the eye gaze of 4.5-month-old German and Swedish infants cross-culturally in an intersensory matching procedure, comparing German and Swedish, two same-rhythm-class languages differing in phonetic and phonological attributes but not in prosody. Looking times indicated that even when distinctive prosodic cues were eliminated, 4.5- month-olds were able to extract subtle language properties and sequentially match visual and heard fluent speech. This outcome was the same for different individual speakers for the two modalities, ruling out the possibility that the infants matched speech patterns specific to one individual. This study confirms a remarkably early emerging ability of infants to match auditory and visual information. The fact that the types of information were matched despite sequential presentation demonstrates that the information is retained in short term memory, and thus goes beyond purely perceptual - here-and-now processing.

Profiling morpho-syntactical development of cochlear implanted children with TR-LARSP

This research aims to describe the grammatical development of Turkish-speaking children with cochlear implants (CI) using the Turkish adaptation of the Language Assessment and Remediation Profile (LARSP). The study was conducted on a total of 15 children with CIs aged 43-87 months with 22-45 months of hearing age. A total of 750 utterances were elicited from the CI group's recorded speech samples and analysed using the methodology of Turkish-Language Assessment and Remediation Profile (TR-LARSP). A cross-sectional descriptive model is used in the study. The results show that there is a significant difference in the acquisition of grammatical structures in children with CIs as compared to typically developing (TD) age-matched children in Turkish. In conclusion, this study suggests that after the implantation of these children, the speech therapist should consider the acquisition time of morpho-syntactical structures before making a language-based therapy plan.

Linguistic profiles of children with CI as compared with children with hearing or specific language impairment

BACKGROUND

The spoken language difficulties of children with moderate or severe to profound hearing loss are mainly related to limited auditory speech perception. However, degraded or filtered auditory input as evidenced in children with cochlear implants (CIs) may result in less efficient or slower language processing as well. To provide insight into the underlying nature of the spoken language difficulties in children with CIs, linguistic profiles of children with CIs are compared with those of hard-of-hearing (HoH) children with conventional hearing aids and children with specific language impairment (SLI).

AIMS

To examine differences in linguistic abilities and profiles of children with CIs as compared with HoH children and children with SLI, and whether the spoken language difficulties of children with CIs mainly lie in limited auditory perception or in language processing problems.

METHODS & PROCEDURE

Differences in linguistic abilities and differential linguistic profiles of 47 children with CI, 66 HoH children with moderate to severe hearing loss, and 127 children with SLI are compared, divided into two age cohorts. Standardized Dutch tests were administered. Factor analyses and cluster analyses were conducted to find homogeneous linguistic profiles of the children.

OUTCOMES & RESULTS

The children with CIs were outperformed by their HoH peers and peers with SLI on most linguistic abilities. Concerning the linguistic profiles, the largest group of children with CIs and HoH children shared similar profiles. The profiles observed for most of the children with SLI were different from those of their peers with hearing loss in both age cohorts.

CONCLUSIONS & IMPLICATIONS

Results suggest that the underlying nature of spoken language problems in most children with CIs manifests in limited auditory perception instead of language processing difficulties. However, there appears to be a subgroup of children with CIs whose linguistic profiles resemble those of children with SLI.

Theory of Mind and Cognitive Function in Adults with Alström or Usher Syndrome

Objective

Theory of mind (ToM) refers to the ability to impute mental states to one's self and others. ToM was investigated in adults with Usher syndrome type 2 (USH2) or Alström syndrome (AS). Both syndromes cause deafblindness, but differ with regard to onset and degree of sensory loss. Individuals with AS, furthermore, display additional physical diseases. Comparisons were made with individuals with typical hearing and vision.

Methods

Thirteen people with USH2, 12 people with AS, and 33 people with typical hearing and vision performed tests of working memory capacity and verbal ability. ToM was tested via Happé's Strange Stories, assessing ability to understand the emotions and actions of story characters. The test also included matched physical stories to evaluate understanding of the logical outcomes associated with everyday situations.

Results

Significant differences were identified in problem solving regarding physical conditions, with higher scores for the typical hearing and vision group, H(2) = 22.91, p < 0.01. The two groups with deafblindness also demonstrated poorer ToM than the typical hearing and vision group, H(2) = 21.61, p < 0.01, and the USH2 group outperformed the AS group, U(34), z = 2.42, p = 0.016. Intra-group variability was related to working memory capacity, verbal ability, visual status, and to a minor extent auditory capacity. The prevalence of the additional physical diseases was not related to ToM performance.

Conclusions

Limited access to information due to visual loss may have reduced the degree of social experience, thereby negatively affecting the development of ToM. That working memory capacity and verbal ability displayed an impact implies that hearing also contributes to ToM development. Differences between the two groups might be a function of genetic conditions, in which the gene causing USH2 only affects the ears and the eyes, whereas AS has a multisystemic pathology.

Implications for practitioners

Advice and support technology should emphasize ease of communication and boost the development of the communication required to develop ToM.

Semantic Processing in Deaf and Hard-of-Hearing Children: Large N400 Mismatch Effects in Brain Responses, Despite Poor Semantic Ability

Difficulties in auditory and phonological processing affect semantic processing in speech comprehension for deaf and hard-of-hearing (DHH) children. However, little is known about brain responses related to semantic processing in this group. We investigated event-related potentials (ERPs) in DHH children with cochlear implants (CIs) and/or hearing aids (HAs), and in normally hearing controls (NH). We used a semantic priming task with spoken word primes followed by picture targets. In both DHH children and controls, cortical response differences between matching and mismatching targets revealed a typical N400 effect associated with semantic processing. Children with CI had the largest mismatch response despite poor semantic abilities overall; Children with CI also had the largest ERP differentiation between mismatch types, with small effects in within-category mismatch trials (target from same category as prime) and large effects in between-category mismatch trials (where target is from a different category than prime), compared to matching trials. Children with NH and HA had similar responses to both mismatch types. While the large and differentiated ERP responses in the CI group were unexpected and should be interpreted with caution, the results could reflect less precision in semantic processing among children with CI, or a stronger reliance on predictive processing.

Vocabulary Knowledge of Children With Cochlear Implants: A Meta-Analysis

This article employs meta-analysis procedures to evaluate whether children with cochlear implants demonstrate lower spoken-language vocabulary knowledge than peers with normal hearing. Of the 754 articles screened and 52 articles coded, 12 articles met predetermined inclusion criteria (with an additional 5 included for one analysis). Effect sizes were calculated for relevant studies and forest plots were used to compare differences between groups of children with normal hearing and children with cochlear implants. Weighted effect size averages for expressive vocabulary measures (g = -11.99; p < .001) and for receptive vocabulary measures (g = -20.33; p < .001) indicated that children with cochlear implants demonstrate lower vocabulary knowledge than children with normal hearing. Additional analyses confirmed the value of comparing vocabulary knowledge of children with hearing loss to a tightly matched (e.g., socioeconomic status-matched) sample. Age of implantation, duration of implantation, and chronological age at testing were not significantly related to magnitude of weighted effect size. Findings from this analysis represent a first step toward resolving discrepancies in the vocabulary knowledge literature.