From Ear to Cortex: A Perspective on What Clinicians Need to Understand About Speech Perception and Language Processing

Early language experience modulates the tradeoff between acoustic-temporal and lexico-semantic cortical tracking of speech

Cortical tracking of speech is relevant for the development of speech perception skills. However, no study to date has explored whether and how cortical tracking of speech is shaped by accumulated language experience, the central question of this study. In 35 bilingual children (6-year-old) with considerably bigger experience in one language, we collected electroencephalography data while they listened to continuous speech in their two languages. Cortical tracking of speech was assessed at acoustic-temporal and lexico-semantic levels. Children showed more robust acoustic-temporal tracking in the least experienced language, and more sensitive cortical tracking of semantic information in the most experienced language. Additionally, and only for the most experienced language, acoustic-temporal tracking was specifically linked to phonological abilities, and lexico-semantic tracking to vocabulary knowledge. Our results indicate that accumulated linguistic experience is a relevant maturational factor for the cortical tracking of speech at different levels during early language acquisition.

I remembered the chorm! Word learning abilities of children with and without phonological impairment

BACKGROUND

Children with phonological impairment present with pattern-based errors in their speech production. While some children have difficulties with speech perception and/or the establishment of robust underlying phonological representations, the nature of phonological impairment in children is still not well understood. Given that phonological and lexical development are closely linked, one way to better understand the nature of the problem in phonological impairment is to examine word learning abilities in children.

AIMS

To examine word learning and its relationship with speech perception, speech production and vocabulary knowledge in children aged 4-5 years. There were two variables of interest: speech production abilities ranging from phonological impairment to typical speech; and vocabulary abilities ranging from typical to above average ('lexically precocious').

METHODS & PROCEDURES

Participants were 49 Australian-English-speaking children aged 48-69 months. Children were each taught four novel non-words (out of a selection of eight) through stories, and word learning was assessed at 1 week post-initial exposure. Word learning was assessed using two measures: confrontation naming and story retell naming. Data were analysed by group using independent-samples t-tests and Mann-Whitney U-tests, and continuously using multiple linear regression.

OUTCOMES & RESULTS

There was no significant difference in word learning ability of children with and without phonological impairment, but regardless of speech group, children with above average vocabulary had significantly better word learning abilities than children with average vocabulary. In multiple linear regression, vocabulary was the only significant predictor of variance in word learning ability.

CONCLUSIONS & IMPLICATIONS

Children with phonological impairment can be lexically precocious and learn new words like their peers without phonological impairment. Contrary to expectations, vocabulary knowledge rather than expressive phonological ability explained variance in measures of word learning. These findings question an assumption that children with phonological impairment have underspecified phonological representations. They also highlight the heterogeneity among children with phonological impairment and the need to better understand the nature of their difficulty learning the phonological system of the ambient language.

WHAT THIS PAPER ADDS

What is already known on the subject There is limited research examining the word learning abilities of children with phonological impairment. Most previous research focuses on word properties such as phonotactic probability and neighbourhood density. Within the existing literature there are different reports and conclusions regarding the word learning abilities of children with phonological impairment and whether their word learning differs from that of children with typically developing speech. What this study adds to existing knowledge This study found that vocabulary was the strongest predictor of word learning across children with and without phonological impairment. There was no significant difference in word learning ability between children with and without phonological impairment. However, children with lexically precocious vocabulary abilities were significantly better at word learning than children with average vocabulary abilities. What are the potential or actual clinical implications of this work? Findings from this study support the importance of assessing and considering measures of word learning-including vocabulary-when working with children with phonological impairment. This study indicates that it is possible to use stories coupled with measures of confrontation naming and story retell to gain deeper insight into children's word learning abilities.

Speech Perception in Quiet and in the Presence of Noise in Children with Autism Spectrum Disorder: A Behavioral Study

Signal-to-noise ratio (SNR) is one of the important parameters to be considered for the effective perception of speech. Many researchers indicate that children with autism spectrum disorder (ASD) have reduced capacity to integrate sensory information across different modalities and show speech understanding difficulty in the presence of background speech or noise. So, this present study was undertaken with the aimed to evaluate and compare the speech perception ability in quiet and in the presence of noise for children with and without ASD and also to compare across different noise conditions. Speech perception in noise was measured for 15 children with ASD and 15 age-matched children without ASD in the age range of 8 to 12 years. The stimulus includes standardized bisyllabic and trisyllabic Kannada words in quiet and at different SNR conditions. The result showed that children with ASD had poor performance in all the listening conditions (quiet, speech babble, and speech noise) and the syllable conditions (bisyllables and trisyllables) compared to children without ASD. When compared across quiet and different SNR conditions for individuals with ASD, the result showed the best performance in quiet conditions followed by different SNR conditions. The performance deteriorated with a decrease in SNR for both groups. Children with ASD showed poor performance in quiet and in the presence of noise compared to children without ASD. Speech perception evaluation in the presence of noise provides a more reliable predictor of the communication difficulty faced by children with ASD than evaluating only in quiet conditions.

Reading Skills in Children With Suspected Childhood Apraxia of Speech and Children With Reading Disorders: Same or Different?

PURPOSE

The primary aim of this study was to compare decoding and literacy-related skills of children with suspected childhood apraxia of speech (sCAS) to children with reading disorders (RD) and no history of speech sound disorder (RD-no SSD) to determine if the groups differ in decoding and the endophenotypes that contribute to RD. We also explored the association between language impairment (LI) and decoding and literacy-related skills within the participant group with sCAS.

METHOD

Participants were school-age children and adolescents, 8-14 years of age, with a diagnosis of sCAS (n = 13) or RD-no SSD (n = 16). The sCAS and RD-no SSD groups were compared on measures of single-word decoding, oral language, motor-speech skills, phonological processing, and speech-in-noise perception, employing t tests and analysis of covariance. The sCAS + LI and sCAS-only groups were compared on similar measures using t tests.

RESULTS

Compared to the RD-no SSD group, the sCAS group performed significantly worse on measures of phonological processing, multisyllable word repetition, diadochokinetic rate, and speech-in-noise perception. The groups did not differ on measures of single-word decoding, with mean scores for both groups falling below average. All participants with sCAS + LI demonstrated deficits in literacy and literacy-related skills compared to a smaller percentage of the sCAS-only group.

CONCLUSIONS

Children with sCAS and children with RD-no SSD demonstrate similar impairments in literacy. However, the endophenotypes underlying these difficulties can differ between the groups. Deficits in skills needed for literacy may require specifically tailored interventions to address reading difficulties for children with sCAS, especially for those with comorbid LI.

Environmental noise, brain structure, and language development in children

While excessive noise exposure in childhood has been associated with reduced language ability, few studies have examined potential underlying neurobiological mechanisms that may account for noise-related differences in language skills. In this study, we tested the hypotheses that higher everyday noise exposure would be associated with 1) poorer language skills and 2) differences in language-related cortical structure. A socioeconomically diverse sample of children aged 5-9 (N = 94) completed standardized language assessments. High-resolution T1-weighted magnetic resonance imaging (MRI) scans were acquired, and surface area and cortical thickness of the left inferior frontal gyrus (IFG) and left superior temporal gyrus (STG) were extracted. Language Environmental Analysis (LENA) was used to measure levels of exposure to excessive environmental noise over the course of a typical day (n = 43 with complete LENA, MRI, and behavioral data). Results indicated that children exposed to excessive levels of noise exhibited reduced cortical thickness in the left IFG. These findings add to a growing literature that explores the extent to which home environmental factors, such as environmental noise, are associated with neurobiological development related to language development in children.

Listening-Based Communication Ability in Adults With Hearing Loss: A Scoping Review of Existing Measures

Introduction

Hearing loss in adults has a pervasive impact on health and well-being. Its effects on everyday listening and communication can directly influence participation across multiple spheres of life. These impacts, however, remain poorly assessed within clinical settings. Whilst various tests and questionnaires that measure listening and communication abilities are available, there is a lack of consensus about which measures assess the factors that are most relevant to optimising auditory rehabilitation. This study aimed to map current measures used in published studies to evaluate listening skills needed for oral communication in adults with hearing loss.

Methods

A scoping review was conducted using systematic searches in Medline, EMBASE, Web of Science and Google Scholar to retrieve peer-reviewed articles that used one or more linguistic-based measure necessary to oral communication in adults with hearing loss. The range of measures identified and their frequency where charted in relation to auditory hierarchies, linguistic domains, health status domains, and associated neuropsychological and cognitive domains.

Results

9121 articles were identified and 2579 articles that reported on 6714 discrete measures were included for further analysis. The predominant linguistic-based measure reported was word or sentence identification in quiet (65.9%). In contrast, discourse-based measures were used in 2.7% of the articles included. Of the included studies, 36.6% used a self-reported instrument purporting to measures of listening for communication. Consistent with previous studies, a large number of self-reported measures were identified (n = 139), but 60.4% of these measures were used in only one study and 80.7% were cited five times or fewer.

Discussion

Current measures used in published studies to assess listening abilities relevant to oral communication target a narrow set of domains. Concepts of communicative interaction have limited representation in current measurement. The lack of measurement consensus and heterogeneity amongst the assessments limit comparisons across studies. Furthermore, extracted measures rarely consider the broader linguistic, cognitive and interactive elements of communication. Consequently, existing measures may have limited clinical application if assessing the listening-related skills required for communication in daily life, as experienced by adults with hearing loss.

Cross-Language Transfer and Attentional Control in Early Bilingual Speech

PURPOSE

This study investigated the roles of cross-language transfer of first language (L1) and attentional control in second-language (L2) speech perception and production of sequential bilinguals, taking phonological overlap into account.

METHOD

Twenty-five monolingual Dutch-speaking and 25 sequential bilingual Turkish-Dutch-speaking 3- and 4-year-olds were tested using picture identification tasks for speech perception in L1 Turkish and L2 Dutch, single-word tasks for speech production in L1 and L2, and a visual search task for attentional control. Phonological overlap was manipulated by dividing the speech tasks into subsets of phonemes that were either shared or unshared between languages.

RESULTS

In Dutch speech perception and production, monolingual children obtained higher accuracies than bilingual peers. Bilinguals showed equal performance in L1 and L2 perception but scored higher on L1 than on L2 production. For speech perception of shared phonemes, linear regression analyses revealed no direct effects of attention and L1 on L2. For speech production of shared phonemes, attention and L1 directly affected L2. When exploring unshared phonemes, direct effects of attentional control on L2 were demonstrated not only for speech production but also for speech perception.

CONCLUSIONS

The roles of attentional control and cross-language transfer on L2 speech are different for shared and unshared phonemes. Whereas L2 speech production of shared phonemes is also supported by cross-language transfer of L1, L2 speech perception and production of unshared phonemes benefit from attentional control only. This underscores the clinical importance of considering phonological overlap and supporting attentional control when assisting young sequential bilinguals' L2 development.

Defining the Role of Attention in Hierarchical Auditory Processing

Communication in noise is a complex process requiring efficient neural encoding throughout the entire auditory pathway as well as contributions from higher-order cognitive processes (i.e., attention) to extract speech cues for perception. Thus, identifying effective clinical interventions for individuals with speech-in-noise deficits relies on the disentanglement of bottom-up (sensory) and top-down (cognitive) factors to appropriately determine the area of deficit; yet, how attention may interact with early encoding of sensory inputs remains unclear. For decades, attentional theorists have attempted to address this question with cleverly designed behavioral studies, but the neural processes and interactions underlying attention's role in speech perception remain unresolved. While anatomical and electrophysiological studies have investigated the neurological structures contributing to attentional processes and revealed relevant brain-behavior relationships, recent electrophysiological techniques (i.e., simultaneous recording of brainstem and cortical responses) may provide novel insight regarding the relationship between early sensory processing and top-down attentional influences. In this article, we review relevant theories that guide our present understanding of attentional processes, discuss current electrophysiological evidence of attentional involvement in auditory processing across subcortical and cortical levels, and propose areas for future study that will inform the development of more targeted and effective clinical interventions for individuals with speech-in-noise deficits.

Vowel Context Effects on Consonant Repetition in Early Words

Purpose Consonant repetitions within words are a well-attested speech error pattern in children's early speech acquisition. We investigated the role of intervening vowel context in understanding speech forms containing consonant repetitions in early words. Intrasyllabic consonant-vowel (CV) sequences within consonant-vowel-consonant (CVC) and consonant-vowel-consonant-vowel (CVCV) forms containing consonant repetitions were analyzed to evaluate whether children's lack of independent movement control for the tongue in word-level sequences might contribute to these observed speech patterns. Method Spontaneous speech data produced by 10 typically developing children learning American English were analyzed longitudinally from the onset of word use to 36 months. Overall patterns and word shape effects for nine CV combinations occurring in their CVC and CVCV word shapes that contained repeated nonadjacent consonants and the intervening vowel were analyzed. Results Three CV combinations-coronal-front vowel, labial-central vowel, and dorsal-back vowel-occurred at above-chance levels. Preference for these CV patterns was strong in CVCV but not in CVC word shapes. These CV combinations occurred frequently at all time periods analyzed for CVCV's while decreasing across time for CVC's. Conclusions Analysis of intrasyllabic patterns within word forms containing consonant repetitions revealed that consonant repetitions in many early words occurred at above-chance levels in the context of articulatorily compatible vowels. Results suggest that children's production system capacities are an important contributing principle accounting for vowel context effects within word forms containing consonant repetitions during earliest speech acquisition.

Cortical tracking of speech in noise accounts for reading strategies in children

Humans' propensity to acquire literacy relates to several factors, including the ability to understand speech in noise (SiN). Still, the nature of the relation between reading and SiN perception abilities remains poorly understood. Here, we dissect the interplay between (1) reading abilities, (2) classical behavioral predictors of reading (phonological awareness, phonological memory, and rapid automatized naming), and (3) electrophysiological markers of SiN perception in 99 elementary school children (26 with dyslexia). We demonstrate that, in typical readers, cortical representation of the phrasal content of SiN relates to the degree of development of the lexical (but not sublexical) reading strategy. In contrast, classical behavioral predictors of reading abilities and the ability to benefit from visual speech to represent the syllabic content of SiN account for global reading performance (i.e., speed and accuracy of lexical and sublexical reading). In individuals with dyslexia, we found preserved integration of visual speech information to optimize processing of syntactic information but not to sustain acoustic/phonemic processing. Finally, within children with dyslexia, measures of cortical representation of the phrasal content of SiN were negatively related to reading speed and positively related to the compromise between reading precision and reading speed, potentially owing to compensatory attentional mechanisms. These results clarify the nature of the relation between SiN perception and reading abilities in typical child readers and children with dyslexia and identify novel electrophysiological markers of emergent literacy.

Parental Language Input to Children With Hearing Loss: Does It Matter in the End?

Purpose Parental language input (PLI) has reliably been found to influence child language development for children at risk of language delay, but previous work has generally restricted observations to the preschool years. The current study examined whether PLI during the early years explains variability in the spoken language abilities of children with hearing loss at those young ages, as well as later in childhood. Participants One hundred children participated: 34 with normal hearing, 24 with moderate losses who used hearing aids (HAs), and 42 with severe-to-profound losses who used cochlear implants (CIs). Mean socioeconomic status was middle class for all groups. Children with CIs generally received them early. Method Samples of parent-child interactions were analyzed to characterize PLI during the preschool years. Child language abilities (CLAs) were assessed at 48 months and 10 years of age. Results No differences were observed across groups in how parents interacted with their children. Nonetheless, strong differences across groups were observed in the effects of PLI on CLAs at 48 months of age: Children with normal hearing were largely resilient to their parents' language styles. Children with HAs were most influenced by the amount of PLI. Children with CIs were most influenced by PLI that evoked child language and modeled more complex versions. When potential influences of preschool PLI on CLAs at 10 years of age were examined, those effects at preschool were replicated. When mediation analyses were performed, however, it was found that the influences of preschool PLI on CLAs at 10 years of age were partially mediated by CLAs at preschool. Conclusion PLI is critical to the long-term spoken language abilities of children with hearing loss, but the style of input that is most effective varies depending on the severity of risk for delay.

Speech Perception Skills of Children With Speech Sound Disorders: A Systematic Review and Meta-Analysis

Purpose The aim of this study was to conduct a systematic review and meta-analysis to investigate whether preschool- and early school-age children with speech sound disorders (SSDs) have difficulties with speech perception. Method Systematic searching of 8 electronic databases identified 73 eligible studies across 71 articles examining the speech perception skills of children with SSDs. The findings and methodological characteristics of each study were reviewed, and the reporting of methodological information in each article was rated. A meta-analysis was conducted with studies that used the most common type of speech perception assessment task-lexical and/or phonetic judgment tasks. Results Across 60 of 73 studies, some or all children with SSDs were reported to have difficulties with speech perception. The meta-analysis showed a significant difference between children with SSDs and children with typically developing speech on lexical and/or phonetic judgment tasks. Conclusion Results from the meta-analysis demonstrate that children with SSDs have difficulties with speech perception. This appears to be the case for some but not all children with SSDs. The findings from this systematic review and meta-analysis also provide insight into the complex range of methodological issues involved in the study of speech perception in children with SSDs and the need for further research. Supplemental Material https://doi.org/10.23641/asha.9808361.

Restoration and Efficiency of the Neural Processing of Continuous Speech Are Promoted by Prior Knowledge

Sufficiently noisy listening conditions can completely mask the acoustic signal of significant parts of a sentence, and yet listeners may still report the perception of hearing the masked speech. This occurs even when the speech signal is removed entirely, if the gap is filled with stationary noise, a phenomenon known as perceptual restoration. At the neural level, however, it is unclear the extent to which the neural representation of missing extended speech sequences is similar to the dynamic neural representation of ordinary continuous speech. Using auditory magnetoencephalography (MEG), we show that stimulus reconstruction, a technique developed for use with neural representations of ordinary speech, works also for the missing speech segments replaced by noise, even when spanning several phonemes and words. The reconstruction fidelity of the missing speech, up to 25% of what would be attained if present, depends however on listeners' familiarity with the missing segment. This same familiarity also speeds up the most prominent stage of the cortical processing of ordinary speech by approximately 5 ms. Both effects disappear when listeners have no or little prior experience with the speech segment. The results are consistent with adaptive expectation mechanisms that consolidate detailed representations about speech sounds as identifiable factors assisting automatic restoration over ecologically relevant timescales.

Masked Speech Recognition and Reading Ability in School-Age Children: Is There a Relationship?

PURPOSE

The relationship between reading (decoding) skills, phonological processing abilities, and masked speech recognition in typically developing children was explored. This experiment was designed to evaluate the relationship between phonological processing and decoding abilities and 2 aspects of masked speech recognition in typically developing children: (a) the ability to benefit from temporal and spectral modulations within a noise masker and (b) the masking exerted by a speech masker.

METHOD

Forty-two typically developing 3rd- and 4th-grade children with normal hearing, ranging in age from 8;10 to 10;6 years (mean age = 9;2 years, SD = 0.5 months), completed sentence recognition testing in 4 different maskers: steady-state noise, temporally modulated noise, spectrally modulated noise, and two-talker speech. Children also underwent assessment of phonological processing abilities and assessments of single-word decoding. As a comparison group, 15 adults with normal hearing also completed speech-in-noise testing.

RESULTS

Speech recognition thresholds varied between approximately 3 and 7 dB across children, depending on the masker condition. Compared to adults, performance in the 2-talker masker was relatively consistent across children. Furthermore, decreasing the signal-to-noise ratio had a more precipitously deleterious effect on children's speech recognition in the 2-talker masker than was observed for adults. For children, individual differences in speech recognition threshold were not predicted by phonological awareness or decoding ability in any masker condition.

CONCLUSIONS

No relationship was found between phonological awareness and/or decoding ability and a child's ability to benefit from spectral or temporal modulations. In addition, phonological awareness and/or decoding ability was not related to speech recognition in a 2-talker masker. Last, these data suggest that the between-listeners variability often observed in 2-talker maskers for adults may be smaller for children. The reasons for this child-adult difference need to be further explored.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.5913547.

The speech perception skills of children with and without speech sound disorder

PURPOSE

To investigate whether Australian-English speaking children with and without speech sound disorder (SSD) differ in their overall speech perception accuracy. Additionally, to investigate differences in the perception of specific phonemes and the association between speech perception and speech production skills.

METHOD

Twenty-five Australian-English speaking children aged 48-60 months participated in this study. The SSD group included 12 children and the typically developing (TD) group included 13 children. Children completed routine speech and language assessments in addition to an experimental Australian-English lexical and phonetic judgement task based on Rvachew's Speech Assessment and Interactive Learning System (SAILS) program (Rvachew, 2009). This task included eight words across four word-initial phonemes-/k, ɹ, ʃ, s/.

RESULTS

Children with SSD showed significantly poorer perceptual accuracy on the lexical and phonetic judgement task compared with TD peers. The phonemes /ɹ/ and /s/ were most frequently perceived in error across both groups. Additionally, the phoneme /ɹ/ was most commonly produced in error. There was also a positive correlation between overall speech perception and speech production scores.

CONCLUSIONS

Children with SSD perceived speech less accurately than their typically developing peers. The findings suggest that an Australian-English variation of a lexical and phonetic judgement task similar to the SAILS program is promising and worthy of a larger scale study.

Lexical and phonological variability in preschool children with speech sound disorder

PURPOSE

The authors of this study examined relationships between measures of word and speech error variability and between these and other speech and language measures in preschool children with speech sound disorder (SSD).

METHOD

In this correlational study, 18 preschool children with SSD, age-appropriate receptive vocabulary, and normal oral motor functioning and hearing were assessed across 2 sessions. Experimental measures included word and speech error variability, receptive vocabulary, nonword repetition (NWR), and expressive language. Pearson product–moment correlation coefficients were calculated among the experimental measures.

RESULTS

The correlation between word and speech error variability was slight and nonsignificant. The correlation between word variability and receptive vocabulary was moderate and negative, although nonsignificant. High word variability was associated with small receptive vocabularies. The correlations between speech error variability and NWR and between speech error variability and the mean length of children's utterances were moderate and negative, although both were nonsignificant. High speech error variability was associated with poor NWR and language scores.

CONCLUSION

High word variability may reflect unstable lexical representations, whereas high speech error variability may reflect indistinct phonological representations. Preschool children with SSD who show abnormally high levels of different types of speech variability may require slightly different approaches to intervention.

Peeling the Onion of Auditory Processing Disorder: A Language/Curricular-Based Perspective

Purpose

This article addresses auditory processing disorder (APD) from a language-based perspective. The author asks speech-language pathologists to evaluate the functionality (or not) of APD as a diagnostic category for children and adolescents with language-learning and academic difficulties. Suggestions are offered from a curriculum-relevant/strategic-based language approach that places APD symptoms within a broader framework and takes into account the complex interaction among the language knowledge, skills, and strategies needed for academic success.

Method

Using the metaphor of peeling an onion to get to its core, the author demonstrates how auditory perceptual processing is influenced by and dependent on language abilities. Examples of curricular content are used to highlight the language savvy needed by students with language-learning disabilities (LLDs) to access the curriculum.

Conclusion

At the heart of the article is the question of what is (or are) the most effective way(s) to treat problems defined as “auditory” in nature. The article concludes with 10 suggestions that remind clinicians to consider the usefulness of viewing auditory processing problems as isolated events that can be “fixed.” Practical guidelines for creating authentic and functional intervention targets at school-age levels are also provided.

Spoken Language Processing Model: Bridging Auditory and Language Processing to Guide Assessment and Intervention

Purpose

This article outlines the author’s conceptualization of the key mechanisms that are engaged in the processing of spoken language, referred to as the spoken language processing model. The act of processing what is heard is very complex and involves the successful intertwining of auditory, cognitive, and language mechanisms. Spoken language processing disorders occur when a breakdown in any of these mechanisms impacts an individual’s ability to effectively process and use the information that is heard. The symptoms vary depending on the underlying deficit(s). The primary purpose of this article is to provide the reader with a basic understanding of these mechanisms, and, in turn, enable readers to (a) review the literature concerning processing disorders with discernment and (b) have a foundation for developing a test battery to derive composite profiles of individuals' processing abilities.

Method

A review of the literature, overview of the spoken language processing model, and suggested approach to diagnostic assessment are presented.

Conclusion

Spoken language processing can break down due to a myriad of underlying causes. Central auditory nervous system deficits can impact not only the initial processing of stimuli but possibly the development of effective language skills. On the other hand, deficits in various cognitive and language mechanisms can similarly impact the auditory processing of speech stimuli. Therefore, it is critical to understand how these mechanisms interact and contribute to the processing of speech stimuli.

Relationship between speech perception in noise and phonological awareness skills for children with normal hearing

OBJECTIVES

Speech perception difficulties experienced by children in adverse listening environments have been well documented. It has been suggested that phonological awareness may be related to children's ability to understand speech in noise. The goal of this study was to provide data that will allow a clearer characterization of this potential relation in typically developing children. Doing so may result in a better understanding of how children learn to listen in noise as well as providing information to identify children who are at risk for difficulties listening in noise.

DESIGN

Thirty-six children (5 to 7 yrs) with normal hearing participated in the study. Three phonological awareness tasks (syllable counting, initial consonant same, and phoneme deletion), representing a range of skills, were administered. For perception in noise tasks, nonsense syllables, monosyllabic words, and meaningful sentences with three key words were presented (50 dB SPL) at three signal to noise ratios (0, +5, and +10 dB).

RESULTS

Among the speech in noise tasks, there was a significant effect of signal to noise ratio, with children performing less well at 0-dB signal to noise ratio for all stimuli. A significant age effect occurred only for word recognition, with 7-yr-olds scoring significantly higher than 5-yr olds. For all three phonological awareness tasks, an age effect existed with 7-year-olds again performing significantly better than 5-yr-olds. However, when examining the relation between speech recognition in noise and phonological awareness skills, no single variable accounted for a significant part of the variance in performance on nonsense syllables, words, or sentences. However, there was an association between vocabulary knowledge and speech perception in noise.

CONCLUSIONS

Although phonological awareness skills are strongly related to reading and some children with reading difficulties also demonstrate poor speech perception in noise, results of this study question a relation between phonological awareness skills and speech perception in moderate levels of noise for typically developing children with normal hearing from 5 to 7 yrs of age. Further research in this area is needed to examine possible relations among the many factors that affect both speech perception in noise and the development of phonological awareness.

Use of acoustic cues by children with cochlear implants

PURPOSE

This study examined the use of different acoustic cues in auditory perception of consonant and vowel contrasts by profoundly deaf children with a cochlear implant (CI) in comparison to age-matched children and young adults with normal hearing.

METHOD

A speech sound categorization task in an XAB format was administered to 15 children ages 5-6 with a CI (mean age at implant: 1;8 [years;months]), 20 normal-hearing age-matched children, and 21 normal-hearing adults. Four contrasts were examined: //-/a/, /i/-/i/, /bu/-/pu/, and /fu/-/su/. Measures included phoneme endpoint identification, individual cue reliance, cue weighting, and classification slope.

RESULTS

The children with a CI used the spectral cues in the /fu/-/su/ contrast less effectively than the children with normal hearing, resulting in poorer phoneme endpoint identification and a shallower classification slope. Performance on the other 3 contrasts did not differ significantly. Adults consistently showed steeper classification slopes than the children, but similar cue-weighting patterns were observed in all 3 groups.

CONCLUSIONS

Despite their different auditory input, children with a CI appear to be able to use many acoustic cues effectively in speech perception. Most importantly, children with a CI and normal-hearing children were observed to use similar cue-weighting patterns.

Phonemic awareness and early spelling skills in urban Australian Aboriginal and non-Aboriginal children

This study investigated the phonological awareness and early spelling skills of 10 Australian Aboriginal and 10 non-Aboriginal children in their first year of schooling at urban schools. Phonological awareness was assessed using a standardized test (the Queensland University Inventory of Literacy), and children completed a standard spelling task that required them to generate spelling attempts in response to 12 line drawings of familiar animals. Spelling was analysed using the Spelling Scoring Sensitivity procedure. All children performed within the normal range for scores on the QUIL. However, as a group, Aboriginal children performed more poorly than their non-Aboriginal peers. Statistically significant differences were found on the subtests non-word spelling, non-word reading, and phoneme segmentation. Both formal scoring and informal observations were used to examine the spelling skills of participants. Possible explanations of the differences between groups are discussed in terms of health and cultural factors, and implications for the education of Aboriginal children are suggested.

Atypical long-latency auditory event-related potentials in a subset of children with specific language impairment

It has been proposed that specific language impairment (SLI) is the consequence of low-level abnormalities in auditory perception. However, studies of long-latency auditory ERPs in children with SLI have generated inconsistent findings. A possible reason for this inconsistency is the heterogeneity of SLI. The intraclass correlation (ICC) has been proposed as a useful statistic for evaluating heterogeneity because it allows one to compare an individual's auditory ERP with the grand average waveform from a typically developing reference group. We used this method to reanalyse auditory ERPs from a sample previously described by Uwer, Albrecht and von Suchodoletz (2002). In a subset of children with receptive SLI, there was less correspondence (i.e. lower ICC) with the normative waveform (based on the control grand average) than for typically developing children. This poorer correspondence was seen in responses to both tone and speech stimuli for the period 100-228 ms post stimulus onset. The effect was lateralized and seen at right- but not left-sided electrodes.

Effect of Age and Cognition on Childhood Speech in Noise Perception Abilities

This research on children's speech in noise and cognitive abilities aimed to determine the age-related trends in speech in noise perception abilities and the relationship between speech in noise perception and cognitive abilities. Monosyllabic distinguishable (consonant-vowel-consonant) words was the most recognisable word category, followed by monosyllabic confusable words (consonant-vowel-consonant), disyllabic non-words (/aCa/) and monosyllabic syllables (/Ca/), demonstrating that phoneme distinctiveness and a reduction in word confusability contribute to their recognition. Older children outperformed younger children on all speech in noise tasks, indicating that there are age-related trends in speech in noise abilities. Children with higher cognitive abilities did not outperform children with lower cognitive abilities on speech in noise tasks, indicating that the ability to hear speech in noise may be an intrinsic feature of the auditory system that matures with age.

Treatment Decisions for Children With Speech–Sound Disorders

Purpose

In this article, I consider how research, clinical expertise, client values, a clinician’s theoretical perspective, and service delivery considerations affect the decisions that clinicians make to treat children with speech–sound disorders (SSD).

Method

After reviewing the research on phonological treatment, I discuss how a clinician’s theoretical perspective influences goal selection. Five perspectives are considered: (a) normative; (b) bottom-up, discrete skill; (c) language-based; (d) broad-based; and (e) complexity-based. The literature on treatment efficiency is then considered, followed by a discussion of service delivery factors, client values, and clinician factors.

Implications

I believe like M. Ylvisaker (2004) that treatment decisions are influenced the most by the changes that occur in client behaviors. These changes must, however, be experimentally validated, which is not always easy to do. M. Ylvisaker suggests that validation could take the form of trial therapy, diagnostic teaching, or dynamic assessment, but it may also be important to show that the treatment provided, not some other variable, was primarily responsible for the behavioral change (A. Tyler, personal communication, January 11, 2006).

Correlates of phonological awareness in preschoolers with speech sound disorders

PURPOSE

The purpose of this study was to examine the relationships among variables that may contribute to poor phonological awareness (PA) skills in preschool-aged children with speech sound disorders (SSD).

METHOD

Ninety-five 4- and 5-year-old children with SSD were assessed during the spring of their prekindergarten year. Linear structural equation modeling was used to compare the fit of 2 models of the possible relationships among PA, speech perception, articulation, receptive vocabulary, and emergent literacy skills.

RESULTS

Half the children had significant difficulty with speech perception and PA despite demonstrating receptive language skills within or above the average range. The model that showed the best fit to the data indicated that speech perception is a pivotal variable that has a direct effect on PA and an indirect effect that is mediated by vocabulary skills. Articulation accuracy did not have a direct impact on PA. Emergent literacy skills were predicted by PA abilities.

CONCLUSIONS

Children with SSD are at greatest risk of delayed PA skills if they have poor speech perception abilities and/or relatively poor receptive vocabulary skills. Children with SSD should receive assessments of their speech perception, receptive vocabulary, PA, and emergent literacy skills.

The role of early language experience in the development of speech perception and phonological processing abilities: evidence from 5-year-olds with histories of otitis media with effusion and low socioeconomic status

This study tested the hypothesis that early language experience facilitates the development of language-specific perceptual weighting strategies believed to be critical for accessing phonetic structure. In turn, that structure allows for efficient storage and retrieval of words in verbal working memory, which is necessary for sentence comprehension. Participants were forty-nine 5-year-olds, evenly distributed among four groups: those with chronic otitis media with effusion (OME), low socio-economic status (low-SES), both conditions (both), or neither condition (control). All children participated in tasks of speech perception and phonological awareness. Children in the control and OME groups participated in additional tasks examining verbal working memory, sentence comprehension, and temporal processing. The temporal-processing task tested the hypothesis that any deficits observed on the language-related tasks could be explained by temporal-processing deficits. Children in the three experimental groups demonstrated similar results to each other, but different from the control group for speech perception and phonological awareness. Children in the OME group differed from those in the control group on tasks involving verbal working memory and sentence comprehension, but not temporal processing. Overall these results supported the major hypothesis explored, but failed to support the hypothesis that language problems are explained to any extent by temporal-processing problems.

LEARNING OUTCOMES

As a result of this activity, the participant will be able to (1) Explain the relation between language experience and the development of mature speech perception strategies, phonological awareness, verbal working memory, and syntactic comprehension. (2) Name at least three populations of individuals who exhibit delays in the development of mature speech perception strategies, phonological awareness, verbal working memory, and syntactic comprehension, and explain why these delays exist for each group. (3) Point out why perceptual strategies for speech are different for different languages. (4) Describe Baddeley's model [A.D. Baddeley, The development of the concept of working memory: implications and contributions of neuropsychology, in: G. Vallar, T. Shallice (Eds.), Neuropsychological Impairments of Short-term Memory, Cambridge University Press, New York, 1990, p. 54] of verbal working memory.

Semantic Deficits in Children With Language Impairments

Children with language impairments demonstrate a broad range of semantic difficulties, including problems with new word acquisition, storage and organization of known words, and lexical access/retrieval. Unfortunately, assessments of children’s semantic skills are often limited to measures of receptive and expressive vocabulary size. As a result, the semantic deficits of these children may not receive the attention they need. This article explores the word-learning, lexical storage, and lexical access skills of children with language impairments and the theories that account for their performance. Our review culminates with specific recommendations for speech-language pathologists to improve the breadth of their semantic assessments.

A Meme’s Eye View of Speech-Language Pathology

In this article, the reason why certain terms, labels, and ideas prevail, whereas others fail to gain acceptance, will be considered. Borrowing the concept of "meme" from the study of evolution of ideas, it will be clear why language-based and phonological disorders have less widespread appeal than, for example, auditory processing and sensory integration disorders. Discussion will also center on why most speech-language pathologists refer to themselves as speech therapists or speech pathologists, and why it is more desirable to have dyslexia than to have a reading disability. In a meme’s eye view, science and logic do not always win out because selection favors ideas (memes) that are easy to understand, remember, and copy. An unfortunate consequence of these selection forces is that successful memes typically provide superficially plausible answers for complex questions.