Effect of phonological training in French children with SLI: perspectives on voicing identification, discrimination and categorical perception

Abilities of children with developmental language disorders in perceiving phonological, grammatical, and semantic structures

This study aims to investigate the perception of phonological, grammatical, and semantic structures by 8 children (age range: 8;2-9;5) with developmental language disorders (DLD). Another 8 age-matched (age range: 8;4-10;0) typically developing (TD) children served as controls. The results demonstrated that children with DLD had lower performance than children with TD in the phonology and grammar tests, corroborating earlier findings, which reported difficulties of children with DLD in discriminating voicing contrasts and perceiving grammatical structures. However, both groups had similar performance in the semantic test. The absence of semantic atypicality can be explained possibly due to the simplicity of the sentences included in the test. The study offers important clinical implications for the identification and treatment of the disorder.

Categorical perception of Mandarin lexical tones in language-delayed autistic children

Enhanced pitch perception has been identified in autistic individuals, but it remains understudied whether such enhancement can be observed in the lexical tone perception of language-delayed autistic children. This study examined the categorical perception of Mandarin lexical tones in 23 language-delayed autistic children and two groups of non-autistic children, with one matched on chronological age ( n = 23) and the other on developmental age in language ability ( n = 23). The participants were required to identify and discriminate lexical tones. A wider identification boundary width and a lower between-category discrimination accuracy were found in autistic children than their chronological-age-matched non-autistic peers, but the autistic group exhibited seemingly comparable performance to the group of developmental-age-matched non-autistic children. While both non-autistic groups displayed a typical categorical perception pattern with enhanced sensitivity to between-category tone pairs relative to within-category ones, such a categorical perception pattern was not observed in the autistic group. These findings suggest among language-delayed autistic children with a developmental age around 4, categorical perception is still developing. Finally, we found categorical perception performance correlated with language ability, indicating autistic children’s language disability might be predictive of their poor categorical perception of speech sounds.

Lay abstract

Some theories suggested that autistic people have better pitch perception skills than non-autistic people. However, in a context where pitch patterns are used to differentiate word meanings (i.e. lexical tones), autistic people may encounter difficulties, especially those with less language experience. We tested this by asking language-delayed autistic children to identify and discriminate two Mandarin lexical tones (/yi/ with Tone 1, meaning ‘clothes’; /yi/ with Tone 2, meaning ‘aunt’; /yi/: the standard romanization of Mandarin Chinese). On average, these autistic children were 7.35 years old, but their developmental age in language ability was 4.20, lagging behind 7-year-old non-autistic children in terms of language ability. Autistic children’s performance in identifying and discriminating lexical tones was compared with two groups of non-autistic children: one group was matched with the autistic group on age, and the other was matched based on language ability. Autistic children performed differently from the non-autistic children matched on age, while autistic and non-autistic children matched on language ability exhibited seemingly similar performance. However, both the non-autistic groups have developed the perceptual ability to process lexical tones as different categories, but this ability was still developing in autistic children. Finally, we found autistic children who performed worse in identifying lexical tones had poorer language ability. The results suggest that language disability might have adverse influence on the development of skills of speech sound processing.

Who is Right? A Word-Identification-in-Noise Test for Young Children Using Minimal Pair Distracters

PURPOSE

Many children have difficulties understanding speech. At present, there are few assessments that test for subtle impairments in speech perception with normative data from U.K. children. We present a new test that evaluates children's ability to identify target words in background noise by choosing between minimal pair alternatives that differ by a single articulatory phonetic feature. This task (a) is tailored to testing young children, but also readily applicable to adults; (b) has minimal memory demands; (c) adapts to the child's ability; and (d) does not require reading or verbal output.

METHOD

We tested 155 children and young adults aged from 5 to 25 years on this new test of single word perception.

RESULTS

Speech-in-noise abilities in this particular task develop rapidly through childhood until they reach maturity at around 9 years of age.

CONCLUSIONS

We make this test freely available and provide associated normative data. We hope that it will be useful to researchers and clinicians in the assessment of speech perception abilities in children who are hard of hearing or have developmental language disorder, dyslexia, or auditory processing disorder.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.17155934.

Auditory processing disorder in children: the value of a multidisciplinary assessment

PURPOSE

Auditory processing disorder (APD) may affect 0.2-5% of the paediatric population. The diagnosis of APD remains difficult because of polymorphic symptoms possibly entangled with other difficulties. The purpose of this study was to evaluate a new multi-disciplinary assessment in the French language.

METHODS

The battery of tests was composed of: (a) APD targeted speech assessment: speech perception in noise, a dichotic test, temporal processing tests (patterns); (b) Psychometric assessment: sustained auditory attention, sustained visual attention, evaluation of cognitive functions; (c) phonemic identification and discrimination; (d) ENT examination, tonal and vocal audiometry and ABR recordings. The diagnosis was made if two of the targeted speech tests were 2 standard deviations (SDs) below the mean or if only one of the tests was 3 SDs below. The auditory attention tests, as well as the phonemic identification and discrimination tests were complementary to the diagnostic battery. However, they did not allow for the diagnosis of APD.

RESULTS

50 children suspected of APD benefited from this protocol, and 12 were excluded from the study. A diagnosis of APD was confirmed in 17 children (45%). 59% of the patients had associated disorders. The most effective tests for diagnosing APD were dichotic testing (p = 0.001) and pattern recognition (frequency, p = 0.001). The sustained auditory attention test (p = 0.01) and the phonemic identification and discrimination test reinforced the diagnosis of APD.

CONCLUSION

It seems important to evaluate children suspected of APD with a multi-disciplinary protocol. It makes it possible to diagnose APD children, but also to identify attentional difficulties and cognitive disorders that may be associated.

Remediation of Allophonic Perception and Visual Attention Span in Developmental Dyslexia: A Joint Assay

Categorical perception of phonemes and visual attention span are cognitive processes that contribute independently to poor reading skills in developmental dyslexia. We here explored whether training programs specifically targeting one or the other process do improve reading performance in dyslexic children. The dyslexic participants were trained using either the RapDys© program designed to improve phonemic perception or the MAEVA© program targeting visual attention span. Each participant was provided the two programs successively for intensive training. Results show specific effects of RapDys© on phonemic discrimination and pseudo-word reading. MAEVA© specifically improved visual attention span and irregular word reading. Phonemic awareness and regular word reading improved after application of both training programs, suggesting similar positive effects of both methods although effects of concomitant phonic training cannot be ruled out (as there was no control group). The overall findings suggest that both categorical perception and visual attention span remediation contribute to reading.

Delayed development of phonological constancy in toddlers at family risk for dyslexia

Phonological constancy refers to infants' ability to disregard variations in the phonetic realisation of speech sounds that do not indicate lexical contrast, e.g., when listening to accented speech. In typically-developing infants, this ability develops between 15- and 19-months of age, coinciding with the consolidation of infants' native phonological competence and vocabulary growth. Here we investigated the developmental time course of phonological constancy in infants at family risk for developmental dyslexia, using a longitudinal design. Developmental dyslexia is a disorder affecting the acquisition of reading and spelling skills, and it also affects early auditory processing, speech perception, and lexical acquisition. Infants at-risk and not at-risk for dyslexia, based on a family history of dyslexia, participated when they were 15-, 19-, and 26-months of age. Phonological constancy was indexed by comparing at-risk and not at-risk infants' ability to recognise familiar words in two preferential looking tasks: (1) a task using words presented in their native accent, and (2) a task using words presented in a non-native accent. We expected a delay in phonological constancy for the at-risk infants. As predicted, in the non-native accent task, not at-risk infants recognised familiar words by 19 months, but at-risk infants did not. The control infants thus exhibited phonological constancy. By 26 months, at-risk toddlers did show successful word recognition in the native accent task. However, for the non-native accent task at 26 months, neither at-risk nor control infants showed familiar word recognition. These findings are discussed in terms of the impact of family risk for dyslexia on toddlers' consolidation of early phonological and lexical skills.

Reading ability and phoneme categorization

Dyslexia is associated with abnormal performance on many auditory psychophysics tasks, particularly those involving the categorization of speech sounds. However, it is debated whether those apparent auditory deficits arise from (a) reduced sensitivity to particular acoustic cues, (b) the difficulty of experimental tasks, or (c) unmodeled lapses of attention. Here we investigate the relationship between phoneme categorization and reading ability, with special attention to the nature of the cue encoding the phoneme contrast (static versus dynamic), differences in task paradigm difficulty, and methodological details of psychometric model fitting. We find a robust relationship between reading ability and categorization performance, show that task difficulty cannot fully explain that relationship, and provide evidence that the deficit is not restricted to dynamic cue contrasts, contrary to prior reports. Finally, we demonstrate that improved modeling of behavioral responses suggests that performance does differ between children with dyslexia and typical readers, but that the difference may be smaller than previously reported.

Construction of an Arabic computerized battery for cognitive rehabilitation of children with specific learning disabilities

PURPOSE

The aim of this study was to design an Arabic computerized battery of cognitive skills for training children with specific learning disabilities (SLD).

SUBJECTS AND METHODS

Nineteen students from fourth grade primary schools in Assiut, Egypt, who were previously diagnosed with SLD, agreed to participate in the rehabilitation program. The study passed through four stages: first stage, detailed analysis of the cognitive profile of students with SLD (n=19), using a previously constructed diagnostic cognitive skill battery, to identify deficits in their cognitive skills; second stage, construction of an Arabic computerized battery for cognitive training of students with SLD; third stage, implementation of the constructed training program for the students, each tailored according to his/her previously diagnosed cognitive skill deficit/deficits; and fourth stage, post-training re-evaluation of academic achievement and cognitive skills' performance.

RESULTS

Students with SLD have a wide range of cognitive skill deficits, which are more frequent in auditory cognitive skills (68.4%) than in visual cognitive skills (64.1%), particularly in phonological awareness and auditory sequential memory (78.9%). Following implementation of the training program, there was a statistically significant increase (P<0.001) in the mean scores of total auditory and visual cognitive skills, as well as in academic achievement (P<0.001) of the study group.

CONCLUSION

Remediation-oriented diagnosis of cognitive skills, when tailored according to previously diagnosed cognitive deficits, leads to the improvement in learning abilities and academic achievement of students with SLD.

Is There a Relationship Between Speech Identification in Noise and Categorical Perception in Children With Dyslexia?

PURPOSE

Children with dyslexia have been suggested to experience deficits in both categorical perception (CP) and speech identification in noise (SIN) perception. However, results regarding both abilities are inconsistent, and the relationship between them is still unclear. Therefore, this study aimed to investigate the relationship between CP and the psychometric function of SIN perception.

METHOD

Sixteen children with dyslexia, 16 chronological-age controls, and 16 reading-level controls were evaluated in CP of a voicing continuum and in consonant identification in both stationary and fluctuating noises.

RESULTS

There was a small but significant impairment in speech identification performance of children with dyslexia in stationary noise compared with chronological age-matched controls (but not reading level-matched controls). However, their performance increased in a fluctuating background, hence suggesting normal masking and unmasking effects and preserved sensory processing of speech information. Regarding CP, location of the phoneme boundary differed in the children with dyslexia compared with both control groups. However, scrutinizing individual profiles failed to reveal consistently poor performance in SIN and CP tasks. In addition, there was no significant correlation between CP, SIN perception, and reading scores in the group with dyslexia.

CONCLUSIONS

The relationship between the SIN deficit and CP, and how they potentially affect reading in children with dyslexia, remains unclear. However, these results are inconsistent with the notion that children with dyslexia suffer from a low-level temporal processing deficit and rather suggest a role of nonsensory (e.g., attentional) factors in their speech perception difficulties.

Relationships between Categorical Perception of Phonemes, Phoneme Awareness, and Visual Attention Span in Developmental Dyslexia

We tested the hypothesis that the categorical perception deficit of speech sounds in developmental dyslexia is related to phoneme awareness skills, whereas a visual attention (VA) span deficit constitutes an independent deficit. Phoneme awareness tasks, VA span tasks and categorical perception tasks of phoneme identification and discrimination using a d/t voicing continuum were administered to 63 dyslexic children and 63 control children matched on chronological age. Results showed significant differences in categorical perception between the dyslexic and control children. Significant correlations were found between categorical perception skills, phoneme awareness and reading. Although VA span correlated with reading, no significant correlations were found between either categorical perception or phoneme awareness and VA span. Mediation analyses performed on the whole dyslexic sample suggested that the effect of categorical perception on reading might be mediated by phoneme awareness. This relationship was independent of the participants’ VA span abilities. Two groups of dyslexic children with a single phoneme awareness or a single VA span deficit were then identified. The phonologically impaired group showed lower categorical perception skills than the control group but categorical perception was similar in the VA span impaired dyslexic and control children. The overall findings suggest that the link between categorical perception, phoneme awareness and reading is independent from VA span skills. These findings provide new insights on the heterogeneity of developmental dyslexia. They suggest that phonological processes and VA span independently affect reading acquisition.

Review of neural rehabilitation programs for dyslexia: how can an allophonic system be changed into a phonemic one?

Neural investigations suggest that there are three possible core deficits in dyslexia: phonemic, grapho-phonemic, and graphemic. These investigations also suggest that the phonemic deficit resides in a different mode of speech perception which is based on allophonic (subphonemic) units rather than phonemic units. Here we review the results of remediation methods that tap into each of these core deficits, and examine how the methods that tap into the phonemic deficit might contribute to the remediation of allophonic perception. Remediation of grapho-phonemic deficiencies with a new computerized phonics training program (GraphoGame) might be able to surpass the limits of classical phonics training programs, particularly with regard to reading fluency. Remediation of visuo-graphemic deficiencies through exposure to enhanced letter spacing is also promising, although children with dyslexia continued to read more slowly than typical readers after this type of training. Remediation of phonemic deficiencies in dyslexia with programs based solely on phonemic awareness has a limited impact on reading. This might be due to the persistence of a covert deficit in phonemic perception. Methods based on slowed speech enhance the perception not only of phonemic features but also of allophonic features, and this is probably why they have not been found to be effective in meta-analyses. Training of phonemic perception with a perceptual fading paradigm, a method that improves precision in identification and discrimination around phonemic boundaries, has yielded promising results. However, studies with children at risk for dyslexia and dyslexic adults have found that even when behavioral data do not reflect allophonic perception, it can nevertheless be present in neural recordings. Further investigations should seek to confirm that the perceptual fading paradigm is beneficial for reading, and that it renders perception truly phonemic.

Atypical audio-visual speech perception and McGurk effects in children with specific language impairment

Audiovisual speech perception of children with specific language impairment (SLI) and children with typical language development (TLD) was compared in two experiments using /aCa/ syllables presented in the context of a masking release paradigm. Children had to repeat syllables presented in auditory alone, visual alone (speechreading), audiovisual congruent and incongruent (McGurk) conditions. Stimuli were masked by either stationary (ST) or amplitude modulated (AM) noise. Although children with SLI were less accurate in auditory and audiovisual speech perception, they showed similar auditory masking release effect than children with TLD. Children with SLI also had less correct responses in speechreading than children with TLD, indicating impairment in phonemic processing of visual speech information. In response to McGurk stimuli, children with TLD showed more fusions in AM noise than in ST noise, a consequence of the auditory masking release effect and of the influence of visual information. Children with SLI did not show this effect systematically, suggesting they were less influenced by visual speech. However, when the visual cues were easily identified, the profile of responses to McGurk stimuli was similar in both groups, suggesting that children with SLI do not suffer from an impairment of audiovisual integration. An analysis of percent of information transmitted revealed a deficit in the children with SLI, particularly for the place of articulation feature. Taken together, the data support the hypothesis of an intact peripheral processing of auditory speech information, coupled with a supra modal deficit of phonemic categorization in children with SLI. Clinical implications are discussed.

Differential phonological awareness skills in children with classic galactosemia: a descriptive study of four cases

Educational achievement, which for individuals with the metabolic disorder classic galactosemia (GAL) is significantly lower than in the wider population, correlates with self-reported quality of life. Phonological awareness skills underpin the development of literacy, and although literacy is a key contributor to successful academic outcomes, no study to date has investigated phonological awareness skills in children with GAL. This study investigated phonological awareness (PA) in four school-aged children with the disorder, two of whom were siblings. Age range for the children was 7 years 7 months to 9 years 2 months. Each child was assessed with the Phonological Awareness criterion-referenced subtest from the Clinical Evaluation of Language Fundamentals-Fourth Edition. Included in the data for analysis was each child's performance measures obtained from their most recent assessment of cognitive and lexical development. A number of descriptive analyses were undertaken on the data. One child, who met her age criterion for PA, had cognitive and lexical development skills in the average range. The remaining three children failed to meet their age criteria. Although these three children presented with clinically similar cognitive and lexical development skills, disparate PA skills were identified. The PA skills of one of the sibling pair were notably more advanced than his older sibling. The limitations of relying on behavioural test results in children with GAL to predict those most at risk of reduced skill development are discussed in terms future research directions.