Memória operacional fonológica e suas relações com o desenvolvimento da linguagem infantil

Variability in Receptive Language Development Following Bilateral Cochlear Implantation

OBJECTIVES

The primary aim was to investigate the variability in language development in children aged 5-7.5 years after bilateral cochlear implantation (CI) up to the age of 2 years, and any impact of the age at implantation and additional noncognitive or anatomical disorders at implantation.

DESIGN

Data of 84 congenitally deaf children that had received simultaneous bilateral CI at the age of ≤ 24 months were included in this retrospective study. The results of language comprehension acquisition were evaluated using a standardized German language acquisition test for normal hearing preschoolers and first graders. Data on speech perception of monosyllables and sentences in quiet and noise were added.

RESULTS

In a monosyllabic test, the children achieved a median performance of 75.0 ± 12.88%. In the sentence test in quiet, the median performance was 89 ± 12.69%, but dropped to 54 ± 18.92% in noise. A simple analysis showed a significant main effect of age at implantation on monosyllabic word comprehension (p < .001), but no significant effect of comorbidities that lacked cognitive effects (p = .24). Language acquisition values correspond to the normal range of children with normal hearing. Approximately 25% of the variability in the language acquisition tests is due to the outcome of the monosyllabic speech perception test.

CONCLUSIONS

Congenitally deaf children who were fitted bilaterally in the 1st year of life can develop age-appropriate language skills by the time they start school. The high variability in the data is partly due to the age of implantation, but additional factors such as cognitive factors (e.g., working memory) are likely to influence the variability.

A randomized EPIREMED protocol study on the long-term visuo spatial effects of very preterm children with a working memory deficit

BACKGROUND

Very preterm children generally perform poorly in executive functions and particularly in working memory. Adaptive training tasks encouraging these children to work continuously on their personal working memory capacity can be very useful. Above all in preschool-age children, several cognitive training programs focused on improving working memory capacity. Cogmed is a computerized visuospatial cognitive training program that improves working memory in children and adolescents with attention-deficit/hyperactivity disorder. The main objective is to assess the long-term effects (18 months) of cognitive training (Cogmed) on visuospatial processing in preschool-age very preterm children with working memory impairment.

METHODS

The EPIREMED study is a prospective, randomized, controlled, multicentric trial nested in a population based epidemiological survey. An intervention group (Cogmed cognitive training) and a control group (standard care management) will compare children aged 5½ to 6 years, born between 24- and 34-weeks' gestational age, with a global intelligence quotient > 70 and a working memory index < 85. The study will include 166 children from national study EPIPAGE-2 (Epidemiological Study on Small Gestational Ages). The intervention consists of 25 sessions administered over a 5- to 8-week period. The primary endpoint will be the visuospatial processing, assessed by the score of the visuospatial index: score of the WPPSI-IV (Wechsler Preschool and Primary Scale of Intelligence). The secondary endpoints will allow to assess the executive functions, language and abilities, infant behavior, quality of life assessment, school performance and parental anxiety.

DISCUSSION

This project's primary goal is to demonstrate the necessity of early visuospatial memory assessment within the vulnerable population of very preterm children, and to prove the feasibility and efficacy of computerized cognitive training using online software programs. A better global neuropsychological development improvement (visuospatial processing and other far transfer) can be expected with an improvement in learning and decreased behavioral problems. In the long term, these improvements might also reduce those global costs linked to the consequences of extreme prematurity.

TRIAL REGISTRATION

NCT02757794 (registered on 2nd May 2016 at ClinicalTrial.gov).

Childhood apraxia of speech evaluation in autism spectrum disorders: three clinical cases report

Introduction: Among the communication impairments found in subjects with Autism Spectrum Disorders (ASD), recently the literature has suggested a comorbid relationship with childhood apraxia of speech (CAS). The aim of the present study was to report the CAS assessment of 3 children diagnosed with ASD. Report: The subjects were three children aged 4 to 6 years, with a medical diagnosis of ASD. The language development assessment (LDA) was performed in the subjects, as well as the ABFW vocabulary evaluation and oral praxis (verbal, orofacial, a sequence of movements, and parallel movements) and evaluation of vocal, prosodic, and speech characteristics. All subjects had moderate language delay with better performance in the receptive area. Difficulties in oral praxis tasks were more evident in one of the subjects. Vocal, prosodic and speech features of all the cases were compatible with CAS. Conclusion: In the 3 cases reported, CAS signs were identified with impaired oral motor skills, prosody, and oral praxis, as well as inconsistent speech sound production.

Effects of working memory intervention on students with reading comprehension difficulties

ABSTRACT Purpose: to investigate the effectiveness of a working memory-based intervention proposal for reading comprehension. Methods: 43 children divided into two groups according to their performance in a reading comprehension test - G1: children with reading comprehension difficulty; G2: children with no difficulties. All the children were evaluated regarding reading, writing, sentence reading comprehension, and phonological working memory - PWM (repetition of pseudo-words and digits). After this evaluation, children from G1 participated in an intervention program (15 meetings) that stimulated the PWM. Following the intervention, all the children were reevaluated. The results were compared intra- and intergroup, and pertinent statistical tests were applied, by adopting the significance level lower than 0.05%. Results: after the intervention program, the children of G1 showed a significant improvement in all tests. In the intergroup analysis, at the time of evaluation, G1 was different from G2 in reading, writing and reading comprehension. In the reevaluation, G1 equaled G2 in reading and got closer to G2 in writing and reading comprehension. Conclusion: PWM training brought benefits to children with academic difficulties. Thus, these strategies could be used in the classroom, aiming to promote learning.

Relationship between working memory and comprehension and expression of grammar in Farsi-speaking children with cochlear implants

OBJECTIVES

Grammar is one of the most fundamental components of language and working memory (WM) is one of the most important cognitive features. These two skills play a vital role in learning, literacy and communication. Children with cochlear implants (CIs) experience delays in both of these skills. The aim of this study was to investigate the relationship between these two skills in children with CIs.

SUBJECTS AND METHODS

The sample consisted of 20 Farsi-speaking children with CIs. WM was estimated by forward and backward auditory digit spans (FBS and BDS) from the Persian (Farsi) version of the Wechsler Intelligence Scale for Children, 4th edition. The comprehension of grammar by participants was evaluated using the Persian Syntax Comprehension Test. Grammar expression was assessed using the Photographic Expressive Persian Grammar Test. Pearson's correlation and simple linear regression were used for data analysis.

RESULTS

The results of linear regression and correlation showed a strong correlation between comprehension of grammar and FDS (r = 0.61; p = 0.004) was obtained, between BDS and comprehension of grammar (r = 0.161; p = 0.080). FDS and expression of grammar (r = 0.163; p = 0.222) showed a positive but insignificant correlation.

CONCLUSION

The results indicate that WM decisively effects grammar. Enhancement of the phonological loop can improve grammar, especially comprehension of grammar. The effect of the central executive in grammar requires further research.

The influence of morphological awareness on reading and writing: a systematic review

Purpose

this study aimed to perform a systematic review of national and international studies about the relationship between morphological awareness, reading/writing, reading comprehension, and spelling.

Research strategies

a search for national and international literature was carried out using databases Medline (via PubMed) and Portal de Periódicos da Capes (Eric, PsycINFO, LILACS, SciELO) from August to September 2015.

Selection criteria

the inclusion criteria were: studies that answered the guiding question and addressed the subject matter established by the descriptors and keywords. Studies with animals, laboratories, opinion/expert pieces, case series, case reports and review studies were excluded.

Data analysis

the following markers were considered: type and objective of the study, the skills related to morphological awareness (reading, writing, reading comprehension and spelling), tests performed, and their main results.

Results

the search carried out in the pre-established databases with descriptors and free terms resulted in 203 articles. The search in PubMed resulted in 81 studies, and in Portal de Periódicos Capes, 122. Of the total, 154 were excluded according to the title and abstract, whereas 39 were excluded upon reading the full text. This allowed for the analysis of 10 articles.

Conclusion

children with better scores in the morphological awareness test show better results in reading and writing across all school grades.

Alterações de linguagem e processamento auditivo: revisão de literatura

RESUMO Há interdependência entre os processos auditivos e de linguagem, e o bom desempenho de um deles contribui para o adequado funcionamento do outro. O objetivo do presente artigo foi realizar uma revisão de literatura baseada em estudos nacionais e internacionais de forma sistemática. Tal revisão buscou verificar a relação entre alterações do processamento auditivo e alterações de linguagem. A pesquisa bibliográfica utilizou como bases de dados Pubmed e Web of Science, no período de maio a junho de 2014. Os critérios de inclusão utilizados foram: artigos que respondiam à pergunta norteadora e atendiam à temática estabelecida pelos descritores. Excluíram-se os estudos com animais, laboratoriais, artigos de opinião/autoridade, série de caso e relato de caso. A escolha dos artigos se deu por meio de um protocolo criado para a elaboração do presente estudo. Para isto, utilizaram-se os seguintes aspectos: autor, ano, local, delineamento, amostra, faixa etária, testes utilizados e resultados. A busca realizada por meio de descritores e termos livres revelou 259 artigos nas bases de dados pré-estabelecidas. Na Pubmed a pesquisa resultou em 187 estudos e 67 na Web of Science. Do total, 161 foram excluídos pelo título e resumo e 36 pela leitura do texto completo. Isso possibilitou a análise de 11 artigos. Foi observado que crianças com prejuízos no desenvolvimento linguístico apresentaram desempenho inferior nos testes auditivos, quando comparadas àquelas com desenvolvimento típico.

Phonological short-term memory and phonological awareness in students from the Elementary School

OBJECTIVES

To characterize and compare the performance of students at the beginning and at the end of the elementary school in Short-Term Phonological Memory (STPM) and Phonological Awareness (PA).

METHODS

We assessed 80 students of both the genders who showed adequate linguistic and academic performance. The sample comprised 40 students in 1st grade and 40 in 5th grade from a public state school with mean age of 6.2 and 9.8 years, respectively. The STPM was assessed using a standardized test of Pseudoword Repetition. PA was assessed through a Sequential Assessment Test (CONFIAS).

RESULTS

No difference was found between the students of 1st and 5th years in STPM both in total score and concerning the similarity of the pseudowords. Regarding PA, there was a significant difference among the percentage distribution of correct answers in syllabic and phonemic tasks, and the students from 5th grade presented better performance.

CONCLUSION

At the beginning and at the end of the elementary school, there is no difference in STPM performance. On the other hand, there is difference in PA, which highlights the influence of schooling on PA development. The correlation between STPM and PA only in 5th-year students suggests that, at the beginning of literacy, STPM cannot be considered as a predictor to children's performance in PA. Nevertheless, as the schooling advances, there is influence of PA on STPM.

Early lexical and phonological acquisition and its relationships

PURPOSE

Verifying likely relationships between lexical and phonological development of children aged between 1 year to 1 year, 11 months and 29 days, who were enrolled in public kindergarten schools of Santa Maria (RS).

METHODS

The sample consisted of 18 children of both genders, with typical language development and aged between 1 year to 1 year, 11 months and 29 days, separated in three age subgroups. Visual recordings of spontaneous speech of each child were collected and then lexical analysis regarding the types of the said lexical items and phonological assessment were performed. The number of sounds acquired and partially acquired were counted together, and the 19 sounds and two all phones of Brazilian Portuguese were considered. To the statistical analysis, the tests of Kruskal-Wallis and Wilcoxon were used, with significance level of prelace_LT0.05.

RESULTS

When compared the means relating to the acquired sounds and mean of the acquired and partially acquired sounds percentages, there was difference between the first and the second age subgroup, and between the first and the third subgroup. In the comparison of the said lexical items means among the age subgroups, there was difference between the first and the second subgroup, and between the first and the third subgroup again. In the comparison between the said lexical items and acquired and partially acquired sounds in each age subgroup, there was difference only in the age subgroup of 1 year and 8 months to 1 year, 11 months and 29 days, in which the sounds highlighted.

CONCLUSION

The phonological and lexical domains develop as a growing process and influence each other. The Phonology has a little advantage.

Tarefas que avaliam a memória operacional na infância e adolescência: uma revisão sistemática da literatura

A Memória Operacional (MO) é um componente das funções executivas essenciais para o desenvolvimento cognitivo da criança. Ela tem efeitos sobre a aprendizagem e as tarefas diárias. O objetivo foi revisar a literatura para identificar as principais tarefas que foram utilizadas para avaliar a MO e a qualidade psicométrica. Foi realizada uma revisão da literatura em bancos de dados (Pubmed, Medline, Lilacs, SciELO). Foram analisados 44 artigos que utilizaram tarefas que avaliaram a alça fonológica e/ou esboço visuoespacial. A partir das análises dos artigos foram descritas um total de 20 diferentes tarefas para avaliar a MO. Com a revisão sistemática foi possível descrever diferentes tarefas a partir de um modelo cognitivo. No entanto, são necessários estudos psicométricos, para validação das medidas dentro do modelo teórico e o refinamento sobre o entendimento da MO.

A duração da pausa silente difere entre palavras de classe aberta ou fechada?

Objetivo Verificar se o tempo médio das pausas silentes difere para a classe das palavras (aberta ou fechada) e se há diferença entre esse tempo para crianças em desenvolvimento típico de linguagem e crianças com distúrbio específico de linguagem (DEL), em cada tipo de palavra. Métodos Participaram da pesquisa 40 crianças em desenvolvimento típico de linguagem e 20 com DEL, com idade variando entre 7 e 10 anos. Cada sujeito elaborou 15 narrativas, baseadas em uma sequência de quatro cenas cada. Após a transcrição das amostras, as palavras foram classificadas como de classe aberta (substantivo, adjetivo, verbo, advérbio e numeral), ou fechada (artigo, preposição, pronome, conjunção e interjeição). Em um segundo momento, as amostras foram submetidas a um software para análise das pausas silentes, que permitiu o levantamento do tempo (milissegundos) das pausas imediatamente anteriores a cada uma dessas categorias gramaticais. Resultados Em ambos os grupos, a pausa silente foi mais longa quando precedia as palavras de classe fechada, sendo que o grupo com DEL, em geral, apresentou pausas silentes mais longas que seus pares. Conclusão A duração da pausa silente varia conforme a classe gramatical da palavra que será enunciada, sendo menor quando precede palavras de classe aberta. Além disso, o fato de os indivíduos com DEL apresentarem pausas silentes mais longas que seus pares, confirma a menor velocidade de seu processamento linguístico.

Computer-assisted training of phoneme-grapheme correspondence for children who are deaf and hard of hearing: effects on phonological processing skills

OBJECTIVE

Examine deaf and hard of hearing (DHH) children's phonological processing skills in relation to a reference group of children with normal hearing (NH) at two baselines pre intervention. Study the effects of computer-assisted phoneme-grapheme correspondence training in the children. Specifically analyze possible effects on DHH children's phonological processing skills.

METHODS

The study included 48 children who participated in a computer-assisted intervention study, which focuses on phoneme-grapheme correspondence. Children were 5, 6, and 7 years of age. There were 32 DHH children using cochlear implants (CI) or hearing aids (HA), or both in combination, and 16 children with NH. The study had a quasi-experimental design with three test occasions separated in time by four weeks; baseline 1 and 2 pre intervention, and 3 post intervention. Children performed tasks measuring lexical access, phonological processing, and letter knowledge. All children were asked to practice ten minutes per day at home supported by their parents.

RESULTS

NH children outperformed DHH children on the majority of tasks. All children improved their accuracy in phoneme-grapheme correspondence and output phonology as a function of the computer-assisted intervention. For the whole group of children, and specifically for children with CI, a lower initial phonological composite score was associated with a larger phonological change between baseline 2 and post intervention. Finally, 18 DHH children, whereof 11 children with CI, showed specific intervention effects on their phonological processing skills, and strong effect sizes for their improved accuracy of phoneme-grapheme correspondence.

CONCLUSION

For some DHH children phonological processing skills are boosted relatively more by phoneme-grapheme correspondence training. This reflects the reciprocal relationship between phonological change and exposure to and manipulations of letters.

Diferença entre span verbal e visual nos gêneros: estudo piloto

OBJETIVO: avaliar a memória de trabalho analisando a capacidade de retenção de estímulos auditivos (span verbal) e visuais (span visual) e estabelecer a relação com o gênero (masculino e feminino). MÉTODO: participaram deste estudo 20 crianças entre seis anos e cinco meses e sete anos, sendo 10 sujeitos do sexo masculino e 10 sujeitos do sexo feminino. Todos os sujeitos foram submetidos às provas de avaliação do span verbal e visual em ordem direta e inversa. RESULTADOS: apenas na prova de palavras dissílabas com fonologia semelhante e semântica diferente do span verbal, houve variância significante entre os gêneros. As crianças do sexo feminino apresentaram melhor desempenho em relação ao outro gênero, bem como maior capacidade de retenção de palavras dissílabas com fonologia e semântica diferentes. No span visual (ordem direta e inversa) as crianças do sexo masculino obtiveram melhor desempenho, apesar de não ter diferenças significantes. Em relação à idade não houve diferença de retenção de estímulos. CONCLUSÃO: as crianças do sexo feminino, neste estudo, apresentaram tendência à melhor desempenho do span verbal e as crianças do sexo masculino tendência a melhor desempenho no span visual. No entanto, o estudo é limitado devido ao reduzido número de participantes na amostra.

Avaliação da memória operacional fonológica e impulsividade de usuários de drogas atendidos em um Centro de Atenção Integrada à Saúde Mental

OBJETIVO: avaliar a memória operacional fonológica e relacionar com a impulsividade de pacientes em tratamento no Centro de Atenção Integrada à Saúde Mental. MÉTODO: 29 usuários: 21 do gênero masculino e 8 do feminino, usuários de substâncias psicoativas, com 37,9±10,5 anos de idade e 10,59±3,53 anos de escolaridade; e 30 voluntários: 19 do gênero masculino e 11 do feminino, com 32,4±11,9 anos de idade e 11,07±3,29 anos de escolaridade, sem histórico psiquiátrico ou de dependência química foram convocados à avaliação de: 1) memória operacional para palavras e pseudo-palavras; 2) impulsividade em seus fatores de segunda ordem (impulsividade atencional, motora e de não planejamento). RESULTADOS: o desempenho dos usuários de substâncias psicoativas na avaliação da memória em comparação ao grupo controle foi pior tanto no span auditivo de palavras e pseudo-palavras como também no número total de recordação de palavras e pseudo-palavras. Na avaliação da impulsividade, os usuários apresentaram escores elevados em contraposição aos sujeitos controle em todos os subtipos de impulsividade, inclusive no total. Na análise de correlação dos dados não foram encontradas relações entre os escores de impulsividade e memória. CONCLUSÃO: : este padrão de respostas indica comprometimento da memória operacional fonológica provavelmente independente do alto nível de impulsividade apresentado pelos usuários de drogas. Estas análises contribuem para propor estratégias de tratamento direcionadas às alterações detectadas.

Aspectos perinatais, cognitivos e sociais e suas relações com as dificuldades de aprendizagem

OBJETIVO: analisar quais aspectos perinatais, cognitivos e sociais são fatores de risco para dificuldade s de aprendizagem em leitura, escrita e aritmética. MÉTODO: participaram desse estudo 45 crianças (média de 8,3 anos). Preliminarmente, os responsáveis de cada criança responderam a um questionário para coleta de informações a respeito da gestação, do nascimento e do desenvolvimento da criança, além dos aspectos sociais que a envolvem. O desempenho das crianças em tarefas de leitura, escrita, aritmética, consciência fonológica, memória fonológica e processamento auditivo foram avaliados. Para a análise das relações entre as variáveis independentes (fatores perinatais, cognitivos e sociais) e as dependentes (leitura, escrita e aritmética) utilizou-se como método estatístico a Regressão Logística. RESULTADOS: a consciência fonológica foi fator de risco para a leitura (OD = 42; p-valor 0,02), para a escrita (OD = 10,8; p-valor 0,01) e para a aritmética (OD = 42; p-valor 0,002). A memória fonológica foi significante para a leitura (OD = 24; p-valor 0,04) e para a aritmética (OD = 4; p-valor 0,04). Observa-se também, que a escolaridade materna elevada funciona como proteção para problemas escolares (OD = 0,3; p-valor >0,001) ou para intensificar essas dificuldades (OD = 2,3; >0,001). Não houve relação entre peso ao nascimento, prematuridade e outras variáveis com desempenho escolar. CONCLUSÕES: crianças que possuem alterações de consciência fonológica e de memória fonológica ou, que são filhas e/ou convivem com pessoas de baixa escolaridade, são crianças com maiores chances de apresentarem dificuldades de aprendizagem.

Language and cognitive outcomes in internationally adopted children

This study focuses on the association between language skills and core cognitive processes relative to the duration of institutionalization in children adopted from orphanages abroad. Participants in the adoptive group (n = 46) had arrived in the United States between the ages of 2 and 84 months (mean = 24 months), and had been living in the United States for 1–9 years. Drawing on both experimental and standardized assessments, language skills of the international adoptees differed as a function of length of time spent in an institution and from those of 24 nonadopted controls. Top-down cognitive assessments including measures of explicit memory and cognitive control differed between adopted and nonadopted children, yet differences between groups in bottom-up implicit learning processes were unremarkable. Based on the present findings, we propose a speculative model linking language and cognitive changes to underlying neural circuitry alterations that reflect the impact of chronic stress, due to adoptees' experience of noncontingent, nonindividualized caregiving. Thus, the present study provides support for a relationship between domain-general cognitive processes and language acquisition, and describes a potential mechanism by which language skills are affected by institutionalization.