How Mixed-Effects Modeling Can Advance Our Understanding of Learning and Memory and Improve Clinical and Educational Practice

Validation of the Vanderbilt Classroom Listening Assessment Short Survey for Children With Unilateral Hearing Loss

OBJECTIVES

Children with unilateral hearing loss experience difficulties in classroom listening situations. There are a limited number of validated questionnaires available for monitoring listening development and quantifying the challenges school-aged children with unilateral hearing loss experience. The purpose of this study was to evaluate a survey that describes the classroom listening challenges reported by children with unilateral hearing loss with and without the use of personal hearing devices (air conduction hearing aid, bone conduction hearing aid, cochlear implant, contralateral routing of signals system).

DESIGN

Children aged 9 to 17 years with self-reported unilateral hearing loss completed an online survey about classroom listening difficulties when not using a personal hearing device (n = 1148) or with the use of a personal hearing device (n = 897). The survey includes 15 questions examining different situations common in modern classrooms. Each question includes a picture depicting the described listening situation. Exploratory factor analysis was used to develop subscales and the internal reliability of the subscales was evaluated. To validate the survey, the relationships between survey scores and self-reported hearing difficulties (without a personal hearing device) or type of device (with a personal hearing device) were evaluated using regression analyses.

RESULTS

Factor analysis revealed survey scores for individual items statistically loaded onto three factors. On the basis of these factors, subscales were created, which are related to: (1) listening situations where the talker is faraway from the child, (2) listening situations where the talker is close to the child and they are inside a building, and (3) listening situations where the talker is close to the child and they are outside a building. Regression analyses revealed children reported the greatest difficulty in school settings when the sound of interest was faraway from them. Although scores were generally higher, indicating listening was easier, when children were wearing their personal hearing devices (i.e., air conduction hearing aid, bone conduction hearing aid, contralateral routing of signals system, cochlear implant), situations with faraway signals were still reported as more challenging than were situations where signals were close.

CONCLUSIONS

This set of findings highlights the need to incorporate distance effects into laboratory evaluations that include children with unilateral hearing loss. In addition, the findings support clinical interventions that address talker-to-listener distances, such as preferential seating and remote microphone systems. Last, the results of this study validate the Vanderbilt Classroom Listening Assessment Short Survey for use with children aged 9 to 17 years of age with unilateral self-reported hearing difficulty. The subscales are empirically driven, internally reliable, and focus on three types of listening situations encountered in classrooms. It is important to note that the survey results demonstrate the expected pattern of results, with participants who have greater self-reported hearing difficulty rating classroom listening situations as more difficult than participants with less self-reported hearing difficulty.

Short-term effects of lifestyle modification on vestibular migraine

OBJECTIVE

Our primary purpose was evaluation of early benefits of lifestyle modification on symptoms of vestibular migraine. The secondary purpose was to determine if a patient's global sense of coping relates to outcomes with lifestyle modification.

DESIGN

Prospective observational cohort. Participants completed questionnaires related to dizziness handicap, headache disability, and adherence to lifestyle modifications at baseline and weekly over 30 d. Sense of coping was measured pre-intervention.

STUDY SAMPLE

Thirty-eight patients with vestibular migraine diagnosed in tertiary care setting between 2022 and 2023.

RESULTS

Symptoms were better at all four weeks post-intervention than pre-intervention (p < 0.01), with no difference across weeks two through four (p > 0.10) when symptoms were lowest and stable. By week two, 52% and 18.5% of participants had significant improvement in dizziness and headache compared to published critical difference scores, respectively. Sense of coping was inversely correlated with dizziness (R = -0.53, p < 0.00001) and headache (R = -0.64, p < 0.0001).

CONCLUSIONS

Lifestyle modification reduced dizziness and headache in many vestibular migraineurs in the first two weeks following intervention. Improvement in restful sleep was associated with improvement in symptoms. Sense of coping did not predict improvement but was inversely related to symptoms. Lifestyle modification could be considered as sole management or in addition to pharmacological intervention.

Statistical Learning Among Preschoolers With and Without Developmental Language Disorder: Examining Effects of Language Status, Age, and Prior Learning

PURPOSE

Our goal was to compare statistical learning abilities between preschoolers with developmental language disorder (DLD) and peers with typical development (TD) by assessing their learning of two artificial grammars.

METHOD

Four- and 5-year-olds with and without DLD were compared on their statistical learning ability using two artificial grammars. After learning an aX grammar, participants learned a relatively more complex abX grammar with a nonadjacent relationship between a and X. Participants were tested on their generalization of the grammatical pattern to new sequences with novel X elements that conformed to (aX, abX) or violated (Xa, baX) the grammars.

RESULTS

Results revealed an interaction between age and language group. Four-year-olds with and without DLD performed equivalently on the aX and abX grammar tests, and neither of the 4-year-old groups' accuracy scores exceeded chance. In contrast, among 5-year-olds, TD participants scored significantly higher on aX tests compared to participants with DLD, but the groups' abX scores did not differ. Five-year-old participants with DLD did not exceed chance on any test, whereas 5-year-old TD participants' scores exceeded chance on all grammar learning outcomes. Regression analyses indicated that aX performance positively predicted learning outcomes on the subsequent abX grammar for TD participants.

CONCLUSION

These results indicate that preschool-age participants with DLD show deficits relative to typical peers in statistical learning, but group differences vary with participant age and type of grammatical structure being tested.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.26487376.

Capturing the Heterogeneity of Word Learners by Analyzing Persons

Accurately capturing children's word learning abilities is critical for advancing our understanding of language development. Researchers have demonstrated that utilizing more complex statistical methods, such as mixed-effects regression and hierarchical linear modeling, can lead to a more complete understanding of the variability observed within children's word learning abilities. In the current paper, we demonstrate how a person-centered approach to data analysis can provide additional insights into the heterogeneity of word learning ability among children while also aiding researchers' efforts to draw individual-level conclusions. Using previously published data with 32 typically developing and 32 late-talking infants who completed a novel noun generalization (NNG) task to assess word learning biases (i.e., shape and material biases), we compare this person-centered method to three traditional statistical approaches: (1) a t-test against chance, (2) an analysis of variance (ANOVA), and (3) a mixed-effects regression. With each comparison, we present a novel question raised by the person-centered approach and show how results from the corresponding analyses can lead to greater nuance in our understanding of children's word learning capabilities. Person-centered methods, then, are shown to be valuable tools that should be added to the growing body of sophisticated statistical procedures used by modern researchers.

A Word-Learning Intervention Pilot Study Utilizing Principles of Retrieval- and Criterion-Based Learning for Children With Developmental Language Disorder

PURPOSE

Vocabulary knowledge at school entry provides an essential foundation for academic and literacy learning. Thus, school entry is an important timepoint to support word learning by children with developmental language disorder (DLD). Retrieval-based training strategies support both learning and retention of words for individuals with DLD in lab-based research. Additionally, lab-based research with adults with typical development demonstrates that pairing retrieval- and criterion-based training strategies supports learning efficiency. Currently, it is unclear if retrieval- and criterion-based training in word-learning interventions is feasible and effective for children with DLD.

METHOD

In this pilot study, we taught preschool- and kindergarten-age children with DLD (N = 7) words in an intervention format. We implemented retrieval-based training in that children were asked to retrieve and produce the forms and meanings of words. We also implemented a criterion-based approach. Words were targeted until the child retrieved the form and meaning of a word at the beginning of two sessions. We assessed learning at the end of training and retention after 2- and 8-week post-training delays.

RESULTS

The retrieval- and criterion-based approach was effective to support word learning for six of the seven children. Children demonstrated better learning and retention of forms than meanings. Additionally, achieving criterion with a word during training was positively related to post-training retention.

CONCLUSIONS

A retrieval- and criterion-based approach is likely to support word learning during interventions for children with DLD. We include suggestions for future research to improve the effective and efficient implementation of these approaches.

Multilevel factors predict treatment response following semantic feature-based intervention in bilingual aphasia

Semantic feature-based treatments (SFTs) are effective rehabilitation strategies for word retrieval deficits in bilinguals with aphasia (BWA). However, few studies have prospectively evaluated the effects of key parameters of these interventions on treatment outcomes. This study examined the influence of intervention-level (i.e., treatment language and treatment sessions), individual-level (baseline naming severity and age), and stimulus-level (i.e., lexical frequency, phonological length, and phonological neighborhood density) factors on naming improvement in a treated and untreated language for 34 Spanish-English BWA who completed 40 hours of SFT. Results revealed significant improvement over time in both languages. In the treated language, individuals who received therapy in their L1 improved more. Additionally, higher pre-treatment naming scores predicted greater response to treatment. Finally, a frequency effect on baseline naming accuracy and phonological effects on accuracy over time were associated with differential treatment gains. These findings indicate that multilevel factors are influential predictors of bilingual treatment outcomes.

Development of amplitude modulation, voice onset time, and consonant identification in noise and reverberation

Children's speech understanding is vulnerable to indoor noise and reverberation: e.g., from classrooms. It is unknown how they develop the ability to use temporal acoustic cues, specifically amplitude modulation (AM) and voice onset time (VOT), which are important for perceiving distorted speech. Through three experiments, we investigated the typical development of AM depth detection in vowels (experiment I), categorical perception of VOT (experiment II), and consonant identification (experiment III) in quiet and in speech-shaped noise (SSN) and mild reverberation in 6- to 14-year-old children. Our findings suggested that AM depth detection using a naturally produced vowel at the rate of the fundamental frequency was particularly difficult for children and with acoustic distortions. While the VOT cue salience was monotonically attenuated with increasing signal-to-noise ratio of SSN, its utility for consonant discrimination was completely removed even under mild reverberation. The reverberant energy decay in distorting critical temporal cues provided further evidence that may explain the error patterns observed in consonant identification. By 11-14 years of age, children approached adult-like performance in consonant discrimination and identification under adverse acoustics, emphasizing the need for good acoustics for younger children as they develop auditory skills to process distorted speech in everyday listening environments.

Auditory, Lexical, and Multitasking Demands Interactively Impact Listening Effort

PURPOSE

This study examined the extent to which acoustic, linguistic, and cognitive task demands interactively impact listening effort.

METHOD

Using a dual-task paradigm, on each trial, participants were instructed to perform either a single task or two tasks. In the primary word recognition task, participants repeated Northwestern University Auditory Test No. 6 words presented in speech-shaped noise at either an easier or a harder signal-to-noise ratio (SNR). The words varied in how commonly they occur in the English language (lexical frequency). In the secondary visual task, participants were instructed to press a specific key as soon as a number appeared on screen (simpler task) or one of two keys to indicate whether the visualized number was even or odd (more complex task).

RESULTS

Manipulation checks revealed that key assumptions of the dual-task design were met. A significant three-way interaction was observed, such that the expected effect of SNR on effort was only observable for words with lower lexical frequency and only when multitasking demands were relatively simpler.

CONCLUSIONS

This work reveals that variability across speech stimuli can influence the sensitivity of the dual-task paradigm for detecting changes in listening effort. In line with previous work, the results of this study also suggest that higher cognitive demands may limit the ability to detect expected effects of SNR on measures of effort. With implications for real-world listening, these findings highlight that even relatively minor changes in lexical and multitasking demands can alter the effort devoted to listening in noise.

Reproducibility in Small-N Treatment Research: A Tutorial Using Examples From Aphasiology

PURPOSE

Small-N studies are the dominant study design supporting evidence-based interventions in communication science and disorders, including treatments for aphasia and related disorders. However, there is little guidance for conducting reproducible analyses or selecting appropriate effect sizes in small-N studies, which has implications for scientific review, rigor, and replication. This tutorial aims to (a) demonstrate how to conduct reproducible analyses using effect sizes common to research in aphasia and related disorders and (b) provide a conceptual discussion to improve the reader's understanding of these effect sizes.

METHOD

We provide a tutorial on reproducible analyses of small-N designs in the statistical programming language R using published data from Wambaugh et al. (2017). In addition, we discuss the strengths, weaknesses, reporting requirements, and impact of experimental design decisions on effect sizes common to this body of research.

RESULTS

Reproducible code demonstrates implementation and comparison of within-case standardized mean difference, proportion of maximal gain, tau-U, and frequentist and Bayesian mixed-effects models. Data, code, and an interactive web application are available as a resource for researchers, clinicians, and students.

CONCLUSIONS

Pursuing reproducible research is key to promoting transparency in small-N treatment research. Researchers and clinicians must understand the properties of common effect size measures to make informed decisions in order to select ideal effect size measures and act as informed consumers of small-N studies. Together, a commitment to reproducibility and a keen understanding of effect sizes can improve the scientific rigor and synthesis of the evidence supporting clinical services in aphasiology and in communication sciences and disorders more broadly. Supplemental Material and Open Science Form: https://doi.org/10.23641/asha.21699476.

Identifying an Appropriate Picture Stimulus for a Bangla Picture Description Task

PURPOSE

The absence of culture- and language-specific aphasia assessment in Bangla underscores a critical problem in communication sciences and disorders. Aphasia occurs in ~41% of Bangla-speaking stroke survivors. In the past 40 years, stroke incidence has doubled in low- and middle-income countries, such as Bangladesh and India, where there are ~250 million native Bangla speakers. This study aims to initiate the first step toward identifying an appropriate picture stimulus for the Bangla picture description task (PDT) intended for inclusion in a Bangla aphasia assessment. Researchers have reported the importance of cultural relevance and three visuographic variables of a picture (high-context, color, and photograph vs. black-and-white line drawing) for faster comprehension and comprehensive language production in people with aphasia and neurologically healthy adults.

METHOD

Ninety-six neurologically healthy native Bangla speakers of three age groups (young 19-30, middle age 40-55, and older 65-89 years) were recruited to compare spontaneous language production for four selected culturally related and nonrelated picture stimuli with and without the three visuographic variables. Five linguistic variables were used to analyze the language samples.

RESULTS

The results demonstrated a significant (a) picture type effect for moving-average type-token ratio, words per minute (WPM), and mean length of utterance in morphemes (MLU) and (b) age group effect for WPM, MLU, and complexity index.

CONCLUSIONS

This study suggests that a culturally related high-context color photograph is the optimal choice for the Bangla PDT. This study also indicates reduced fluency, grammatical complexity, and syntactic complexity in healthy Bangla-speaking adults aged 65 years and above.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22233664.

Linear Mixed-Model Analysis Better Captures Subcomponents of Attention in a Small Sample Size of Persons With Aphasia

PURPOSE

Although there are several reports of attention deficits in aphasia, studies are typically limited to a single component within this complex domain. Furthermore, interpretation of results is affected by small sample size, intraindividual variability, task complexity, or nonparametric statistical models of performance comparison. The purpose of this study is to explore multiple subcomponents of attention in persons with aphasia (PWA) and compare findings and implications from various statistical methods-nonparametric, mixed analysis of variance (ANOVA), and linear mixed-effects model (LMEM)-when applied to a small sample size.

METHOD

Eleven PWA and nine age- and education-matched healthy controls (HCs) completed the computer-based Attention Network Test (ANT). ANT examines the effects of four types of warning cues (no, double, central, spatial) and two flanker conditions (congruent, incongruent) to provide an efficient way to assess the three subcomponents of attention (alerting, orienting, and executive control). Individual response time and accuracy data from each participant are considered for data analysis.

RESULTS

Nonparametric analyses showed no significant differences between the groups on the three subcomponents of attention. Both mixed ANOVA and LMEM showed statistical significance on alerting effect in HCs, orienting effect in PWA, and executive control effect in both PWA and HCs. However, LMEM analyses additionally highlighted significant differences between the groups (PWA vs. HCs) for executive control effect, which were not evident on either ANOVA or nonparametric tests.

CONCLUSIONS

By considering the random effect of participant ID, LMEM was able to show deficits in alerting and executive control ability in PWA when compared to HCs. LMEM accounts for the intraindividual variability based on individual response time performances instead of relying on measures of central tendencies.

Performance on stochastic figure-ground perception varies with individual differences in speech-in-noise recognition and working memory capacity

Speech recognition in noisy environments can be challenging and requires listeners to accurately segregate a target speaker from irrelevant background noise. Stochastic figure-ground (SFG) tasks in which temporally coherent inharmonic pure-tones must be identified from a background have been used to probe the non-linguistic auditory stream segregation processes important for speech-in-noise processing. However, little is known about the relationship between performance on SFG tasks and speech-in-noise tasks nor the individual differences that may modulate such relationships. In this study, 37 younger normal-hearing adults performed an SFG task with target figure chords consisting of four, six, eight, or ten temporally coherent tones amongst a background of randomly varying tones. Stimuli were designed to be spectrally and temporally flat. An increased number of temporally coherent tones resulted in higher accuracy and faster reaction times (RTs). For ten target tones, faster RTs were associated with better scores on the Quick Speech-in-Noise task. Individual differences in working memory capacity and self-reported musicianship further modulated these relationships. Overall, results demonstrate that the SFG task could serve as an assessment of auditory stream segregation accuracy and RT that is sensitive to individual differences in cognitive and auditory abilities, even among younger normal-hearing adults.

Rethinking the Statistical Analysis of Neuromechanical Data

Researchers in neuromechanics should upgrade their statistical toolbox. We propose linear mixed-effects models in place of commonly used statistical tests to better capture subject-specific baselines and treatment-associated effects that naturally occur in neuromechanics. Researchers can use this approach to handle sporadic missing data, avoid the assumption of conditional independence in observations, and successfully model complex experimental protocols.

Still Searching for Understanding: The Importance of Diverse Research Designs, Methods, and Perspectives

BACKGROUND

Evidence-based medicine and evidence hierarchies have been widely adopted and have strongly influenced decision making across many fields, including clinical aphasiology. However, questions remain about the creation, usefulness, and validity of current evidence hierarchies.

AIMS

This article builds on ideas about scientific approaches and evidence originally shared by Elman (1995, 1998, 2006). This article reviews the history of evidence hierarchies and argues that improving the diversity of research designs, methods, and perspectives will improve understanding of the numerous and complex variables associated with aphasia intervention. Researchers and clinicians are encouraged to synthesize diverse types of scientific evidence. It is hoped that this article will stimulate thought and foster discussion in order to encourage high-caliber research of all types.

MAIN CONTRIBUTION

Concepts from a wide variety of fields including philosophy of science, research design and methodology, and precision medicine are brought together in an attempt to focus research on the scientific understanding of aphasia treatment effects.

CONCLUSION

It is hoped that by incorporating diverse research designs, methods, and perspectives, clinical aphasiologists will become better able to provide effective, personalized treatments, ensuring that each person with aphasia is able to improve their communication ability and quality of life.

Rapid but specific perceptual learning partially explains individual differences in the recognition of challenging speech

Perceptual learning for speech, defined as long-lasting changes in speech recognition following exposure or practice occurs under many challenging listening conditions. However, this learning is also highly specific to the conditions in which it occurred, such that its function in adult speech recognition is not clear. We used a time-compressed speech task to assess learning following either brief exposure (rapid learning) or additional training (training-induced learning). Both types of learning were robust and long-lasting. Individual differences in rapid learning explained unique variance in recognizing natural-fast speech and speech-in-noise with no additional contribution for training-induced learning (Experiment 1). Rapid learning was stimulus specific (Experiment 2), as in previous studies on training-induced learning. We suggest that rapid learning is key for understanding the role of perceptual learning in online speech recognition whereas longer training could provide additional opportunities to consolidate and stabilize learning.

Word Learning by Preschool-Age Children: Differences in Encoding, Re-Encoding, and Consolidation Across Learners During Slow Mapping

PURPOSE

Children with typical development vary in how much experience they need to learn words. This could be due to differences in the amount of information encoded during periods of input, consolidated between periods of input, or both. Our primary purpose is to identify whether encoding, consolidation, or both, drive individual differences in the slow-mapping process.

METHOD

Four- to 6-year-old children (N = 43) were trained on nine form-referent pairs across consecutive days. Children's ability to name referents was assessed at the beginning and end of each session. Word learning was assessed 1 month after training to determine long-term retention.

RESULTS

Children with varying language knowledge and skills differed in their ability to encode words. Specifically, children varied in the number of words learned and the phonological precision of word forms at the end of the initial training session. Children demonstrated similarities in re-encoding in that they refined representations at a similar rate during subsequent sessions. Children did not differ in their ability to consolidate words between sessions, or in their ability to retain words over the 1-month delay.

CONCLUSIONS

The amount of experience children need to learn words is primarily driven by the amount of information encoded during the initial experience. When provided with high-quality instruction, children demonstrate a similar ability to consolidate and retain words. Critically, word learning instruction in educational settings must include repeated explicit instruction with the same words to support learning in children with typical development and varying language skills.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19606150.

Voice Handicap Index Changes After Microflap Surgery for Benign Vocal Fold Lesions Are Not Associated With Recommended Absolute Voice Rest Duration

PURPOSE

Voice rest is frequently prescribed after phonosurgery, but optimal type and duration for voice outcomes have not been demonstrated. Studies to date have been characterized by heterogeneity in surgical procedures and laryngeal diagnoses. We sought to analyze the effect of recommended absolute voice rest duration on outcomes of microflap surgery for benign vocal fold lesions. A secondary purpose was to identify patient factors associated with postoperative voice outcomes.

METHOD

Forty-three patients were included in this retrospective review of patients aged 18 years and above who underwent direct microlaryngoscopy with microflap for vocal fold polyp or cyst over a 5-year period at a multidisciplinary voice center. Duration of recommended postoperative absolute voice rest was classified as less than 7 days, 7 days, and more than 7 days. Demographic and vocal hygiene data and voice treatment history were collected. Outcome measures consisted of one pre- and two postoperative Voice Handicap Index (VHI) scores. Effects of recommended voice rest on outcomes were analyzed using mixed models for repeated measures. Effects of patient factors on outcomes were analyzed as exploratory measures. Stroboscopy ratings were analyzed descriptively.

RESULTS

Thirteen patients were recommended 7 days of absolute voice rest, 15 were recommended less than 7 days, and 15 were recommended more than 7 days. Postoperatively, VHI scores significantly improved for all patients. Voice rest as a continuous variable was associated with the Functional subscale score in the short term, but there was no effect on VHI total score and no longer term effect of voice rest on any outcome. Age, sex, and preoperative voice therapy were associated with at least one VHI subscale score on at least one time point.

CONCLUSION

VHI outcomes of microflap surgery for polyps and cysts do not differ by duration of recommended absolute postoperative voice rest.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19178459.

Word Learning by Preschool-Age Children With Developmental Language Disorder: Impaired Encoding and Robust Consolidation During Slow Mapping

Purpose Learning novel words, including the specific phonemes that make up word forms, is a struggle for many individuals with developmental language disorder (DLD). Building robust representations of words includes encoding during periods of input and consolidation between periods of input. The primary purpose of the current study is to determine differences between children with DLD and with typical development (TD) in the encoding and consolidation of word forms during the slow mapping process. Method Preschool-age children (DLD = 9, TD = 9) were trained on nine form-referent pairs across multiple consecutive training days. Children's ability to name referents at the end of training days indicated their ability to encode forms. Children's ability to name referents at the beginning of training days after a period of overnight sleep indicated their ability to consolidate forms. Word learning was assessed 1 month after training to determine long-term retention of forms. Results Throughout training, children with DLD produced fewer forms correctly and produced forms with less phonological precision than children with TD. Thus, children with DLD demonstrated impaired encoding. However, children with and without DLD demonstrated a similar ability to consolidate forms between training days and to retain forms across a 1-month delay. Conclusions Difficulties with word form learning are primarily driven by deficits in encoding for children with DLD. Clinicians and educators can support encoding by providing children with adequate exposures to target words via robust training that occurs across multiple sessions. Supplemental Material https://doi.org/10.23641/asha.16746454.

Younger and older adults show non-linear, stimulus-dependent performance during early stages of auditory training for non-native English

Older adults often report difficulty understanding speech produced by non-native talkers. These listeners can achieve rapid adaptation to non-native speech, but few studies have assessed auditory training protocols to improve non-native speech recognition in older adults. In this study, a word-level training paradigm was employed, targeting improved recognition of Spanish-accented English. Younger and older adults were trained on Spanish-accented monosyllabic word pairs containing four phonemic contrasts (initial s/z, initial f/v, final b/p, final d/t) produced in English by multiple male native Spanish speakers. Listeners completed pre-testing, training, and post-testing over two sessions. Statistical methods, such as growth curve modeling and generalized additive mixed models, were employed to describe the patterns of rapid adaptation and how they varied between listener groups and phonemic contrasts. While the training protocol failed to elicit post-test improvements for recognition of Spanish-accented speech, examination of listeners' performance during the pre-testing period showed patterns of rapid adaptation that differed, depending on the nature of the phonemes to be learned and the listener group. Normal-hearing younger and older adults showed a faster rate of adaptation for non-native stimuli that were more nativelike in their productions, while older adults with hearing impairment did not realize this benefit.

Bayesian Generalized Linear Mixed-Model Analysis of Language Samples: Detecting Patterns in Expository and Narrative Discourse of Adolescents With Traumatic Brain Injury

Purpose Generalized linear mixed-model (GLMM) and Bayesian methods together provide a framework capable of handling a wide variety of complex data commonly encountered across the communication sciences. Using language sample analysis, we demonstrate the utility of these methods in answering specific questions regarding the differences between discourse patterns of children who have experienced a traumatic brain injury (TBI), as compared to those with typical development. Method Language samples were collected from 55 adolescents ages 13-18 years, five of whom had experienced a TBI. We describe parameters relating to the productivity, syntactic complexity, and lexical diversity of language samples. A Bayesian GLMM is developed for each parameter of interest, relating these parameters to age, sex, prior history (TBI or typical development), and socioeconomic status, as well as the type of discourse sample (compare-contrast, cause-effect, or narrative). Statistical models are thoroughly described. Results Comparing the discourse of adolescents with TBI to those with typical development, substantial differences are detected in productivity and lexical diversity, while differences in syntactic complexity are more moderate. Female adolescents exhibited greater syntactic complexity, while male adolescents exhibited greater productivity and lexical diversity. Generally, our models suggest more advanced discourse among adolescents who are older or who have indicators of higher socioeconomic status. Differences relating to lecture type were also detected. Conclusions Bayesian and GLMM methods yield more informative and intuitive results than traditional statistical analyses, with a greater degree of confidence in model assumptions. We recommend that these methods be used more widely in language sample analysis. Supplemental Material https://doi.org/10.23641/asha.14226959.

Age Effects of Bone Conduction Vibration Vestibular-evoked Myogenic Potentials (VEMPs) Using B81 and Impulse Hammer Stimuli

OBJECTIVE

Recently developed, the Radioear B81 bone oscillator allows for higher bone conduction vibration output; however, normative data are lacking regarding its use in vestibular-evoked myogenic potential (VEMP) testing. The purpose of this study was to examine the effect of age on cervical and ocular VEMP (c- and oVEMP) responses using the B81 and to compare with air conduction stimuli (ACS) and impulse hammer (IH) VEMP response characteristics.

DESIGN

c- and oVEMP were completed with ACS, B81, and IH stimuli in healthy participants (age range = 10 to 87 years, n = 85).

RESULTS

Regardless of stimulus type, c- and oVEMP amplitudes and response rates decreased with age. For cVEMP response rates, ACS performed better or equal to B81, which was superior to the IH. For cVEMP corrected amplitude, ACS had significantly higher amplitudes compared with B81 and IH. There was no difference in cVEMP corrected amplitude between B81 and IH. For oVEMP, response rates were comparable between stimuli with the largest disparity in response rates occurring in the oldest groups where IH outperformed both ACS and B81. For oVEMP amplitude, IH had significantly higher amplitudes compared with B81 and ACS. There was no difference in oVEMP amplitude between B81 and ACS.

CONCLUSIONS

Age significantly affected c- and oVEMP amplitudes regardless of stimulus type (ACS, B81, IH). All stimuli are appropriate for eliciting c- and oVEMP in the young individuals. While ACS resulted in higher cVEMP corrected amplitudes, either ACS or B81 are appropriate for older individuals. However, for oVEMPs, higher response rates and larger amplitudes were noted for IH followed by B81 and ACS. Overall, the B81 performed well across the lifespan for c- and oVEMPs and may be a reasonable bone conduction vibration option for patients with absent ACS VEMPs, but at this time is not recommended as a replacement to ACS.

Museum program design supports parent-child engineering talk during tinkering and reminiscing

This study focused on tinkering, a playful form of open-ended problem solving that is being widely adopted in science, technology, engineering, and mathematics (STEM) education as a way of encouraging children's engagement in disciplinary practices of engineering. Nevertheless, the design of exhibits and programs and the nature of children's interactions with adults can determine whether and to what extent tinkering engenders participation in engineering practices such as testing and redesign. Researchers and museum practitioners worked together using design-based research methods to develop and test tinkering programs that could best support engineering learning. Two of the programs specified what families' engineering projects should do and provided exhibit spaces for testing and iterating the design (i.e., function-focused programs), and two programs did not. A total of 61 families with 6- to 8-year-old children (M_age = 7.07 years; 25 female) were observed during one of the programs and when reminiscing immediately after tinkering. Parent-child interaction patterns associated with understanding and remembering events-parent-child joint hands-on engagement and joint talk-and engineering design process talk were measured. All four programs were similar in terms of parent-child joint engagement. Compared with families who did not participate in function-focused programs, families who did talked more about the engineering design process during tinkering and when reminiscing. Parent-child engineering talk during tinkering mediated the association between the program design and engineering talk when reminiscing. Implications for research on children's learning and museum practice are discussed.

Effect of a single lateral diffuse reflection on spatial percepts and speech intelligibility

This study examines the influence of an early lateral reflection on spatial perceptual attributes and speech reception. To this aim, a diffuse reflection is compared with a specular one. Although diffusive surfaces have widespread applications in room acoustics design, the knowledge of the perceptual and behavioral outcomes of these surfaces has yet to be fully developed. Two experiments were conducted to investigate how the reflection type, its temporal delay, and its azimuth affect spatial percepts (source distance, width, and focus) and speech intelligibility (SI) in diffuse stationary noise. The experimental setup included ecological elements: field measurements, a speaker-like source directivity, and real flat and diffusive surfaces. The results indicate that the presence of a single diffuse reflection reduces the perceived distance of a frontal speech source and makes it clearer. SI is higher with a diffuse reflection than with a specular one. Perceptual and behavioral outcomes both depend on the angle of reflection given the frequency- and angular-dependent properties of the diffusing surface and the directivity of the speech source. The results are interpreted with reference to loudness and binaural cues and to the precedence effect. Implications of the findings for acoustic design are also discussed.

Effects of Gap Position on Perceptual Gap Detection Across Late Childhood and Adolescence

The ability to detect a silent gap within a sound is critical for accurate speech perception, and gap detection has been shown to have an extended developmental trajectory. In certain conditions, the detectability of the gap decreases as the gap is placed closer to the beginning of the signal. Early in development, the detection of gaps shortly after signal onset may be especially difficult due to immaturities in the encoding and perception of rapidly changing sounds. The present study explored the development of gap detection from age 8 to 19 years, specifically when the temporal placement of the gap varied. Performance improved with age for all temporal placements of the gap, demonstrating a gradual maturation of gap detection abilities throughout adolescence. Younger adolescents did not benefit from increasing gap onset times, while older adolescents' thresholds gradually improved as gap onset time lengthened. Regardless of age, listeners learned between the two testing days but did not improve within days. Younger adolescents had poorer thresholds for the last block of testing on the second day, returning to baseline performance despite learning between days. These data support earlier studies showing that gaps are harder to detect near stimulus onset and confirm that gap detection abilities continue to mature into adolescence. The data also suggest that younger adolescents do not receive the same benefit of increasing gap onset time and respond differently to repeated testing than older adolescents and young adults.

Phonology, Semantics, and the Comprehension-Expression Gap in Emerging Lexicons

Purpose Children come to understand many words by the end of their 1st year of life, and yet, generally by 12 months, only a few words are said. In this study, we investigated which linguistic factors contribute to this comprehension-expression gap the most. Specifically, we asked the following: Are phonological neighborhood density, semantic neighborhood density, and word frequency (WF) significant predictors of the probability that words known (understood) by children would appear in their spoken lexicons? Method Monosyllabic words in the active (understood and said) and passive (understood, not said) lexicons of 201 toddlers were extracted from the Dutch Communicative Development Inventory (Zink & Lejaegere, 2002) parent-completed forms. A generalized linear mixed-effects model was applied to the data. Results Phonological neighborhood density and WF were independently and significantly associated with whether or not a known word would be in children's spoken lexicons, but semantic neighborhood density was not. There were individual differences in the impact of WF on the probability that known words would be said. Conclusion The novel findings reported here have 2 major implications. First, they indicate that the comprehension-expression gap exists partly because the phonological distributional properties of words determine how readily words can be phonologically encoded for word production. Second, there are likely subtle and complex individual differences in how and when the statistical properties of the ambient language impact on children's emerging lexicons that might best be explored via longitudinal sampling of word knowledge and use.

Impact of Background Noise Fluctuation and Reverberation on Response Time in a Speech Reception Task

Purpose This study examines the effects of reverberation and noise fluctuation on the response time (RT) to the auditory stimuli in a speech reception task. Method The speech reception task was presented to 76 young adults with normal hearing in 3 simulated listening conditions (1 anechoic, 2 reverberant). Speechlike stationary and fluctuating noise were used as maskers, in a wide range of signal-to-noise ratios. The speech-in-noise tests were presented in a closed-set format; data on speech intelligibility and RT (time elapsed from the offset of the auditory stimulus to the response selection) were collected. A slowing down in RTs was interpreted as an increase in listening effort. Results RTs slowed down in the more challenging signal-to-noise ratios, with increasing reverberation and for stationary compared to fluctuating noise, consistently with a fluctuating masking release scheme. When speech intelligibility was fixed, it was found that the estimated RTs were similar or faster for stationary compared to fluctuating noise, depending on the amount of reverberation. Conclusions The current findings add to the literature on listening effort for listeners with normal hearing by indicating that the addition of reverberation to fluctuating noise increases RT in a speech reception task. The results support the importance of integrating noise and reverberation to provide accurate predictors of real-world performance in clinical settings.

Noise, Age, and Gender Effects on Speech Intelligibility and Sentence Comprehension for 11- to 13-Year-Old Children in Real Classrooms

The present study aimed to investigate the effects of type of noise, age, and gender on children’s speech intelligibility (SI) and sentence comprehension (SC). The experiment was conducted with 171 children between 11 and 13 years old in ecologically-valid conditions (collective presentation in real, reverberating classrooms). Two standardized tests were used to assess SI and SC. The two tasks were presented in three listening conditions: quiet; traffic noise; and classroom noise (non-intelligible noise with the same spectrum and temporal envelope of speech, plus typical classroom sound events). Both task performance accuracy and listening effort were considered in the analyses, the latter tracked by recording the response time (RT) using a single-task paradigm. Classroom noise was found to have the worst effect on both tasks (worsening task performance accuracy and slowing RTs), due to its spectro-temporal characteristics. A developmental effect was seen in the range of ages (11–13 years), which depended on the task and listening condition. Gender effects were also seen in both tasks, girls being more accurate and quicker to respond in most listening conditions. A significant interaction emerged between type of noise, age and task, indicating that classroom noise had a greater impact on RTs for SI than for SC. Overall, these results indicate that, for 11- to 13-year-old children, performance in SI and SC tasks is influenced by aspects relating to both the sound environment and the listener (age, gender). The presence of significant interactions between these factors and the type of task suggests that the acoustic conditions that guarantee optimal SI might not be equally adequate for SC. Our findings have implications for the development of standard requirements for the acoustic design of classrooms.