Journal of Speech Language and Hearing Research最新文献

Purpose: For non-autistic children, it is well established that linguistic awareness skills support their success with reading and spelling. Few investigations have examined whether these same linguistic awareness skills play a role in literacy development for autistic elementary school-age children. This study serves as a first step in quantifying the phonological, prosodic, orthographic, and morphological awareness skills of autistic children; how these skills compare to those of non-autistic children; and their relation to literacy performance.

Method: We measured and compared the phonological, prosodic, orthographic, and morphological awareness skills of 18 autistic (with average nonverbal IQs) and 18 non-autistic elementary school-age children, matched in age, nonverbal IQ, and real-word reading. The relations between linguistic awareness and the children's word-level literacy and reading comprehension skills were examined, and we explored whether the magnitude of these relations was different for the two groups. Regression analyses indicated the relative contribution of linguistic awareness variables to performance on the literacy measures for the autistic children.

Results: The non-autistic children outperformed the autistic children on most linguistic awareness measures. There were moderate-to-strong relations between performances on the linguistic awareness and literacy measures for the non-autistic children, and most associations were not reliably different from those for the autistic children. Regression analyses indicate that the performance on specific linguistic awareness variables explains unique variance in autistic children's literacy performance.

Conclusion: Although less developed than those of their non-autistic peers, the linguistic awareness skills of autistic elementary school-age children are important for successful reading and spelling.

Purpose: This study aims to introduce an assessment questionnaire based on the International Classification of Functioning, Disability and Health (ICF) to enable quantifiable clinical documentation. The questionnaire assists speech-language therapists (SLTs) in evaluating both non-audiological and audiological rehabilitation outcomes of patients with cochlear implants (CIs).

Method: Six SLTs were recruited to evaluate the effectiveness of CI care using ICF criteria. We carefully selected 20 pertinent ICF criteria, and SLTs received thorough training in how to apply them uniformly. A cohort of 48 patients was evaluated at three distinct time points: presurgery, postsurgery, and 6 months post-initial CI fitting. Patients underwent dedicated speech-language therapy sessions throughout the treatment course.

Results: A total of 144 complete datasets were scrutinized using a two-factor analysis of variance for ranks. Following CI care, patients exhibited substantial improvements in auditory perception, characterized by enhanced sound recognition and speech discrimination. Additionally, patients demonstrated improved attentional focus, proficiency in daily tasks and increased conversational engagement over time. Environmental factors, particularly sound perception, improved markedly, correlating with reported reductions in stress levels. Minimal changes were noted in stress management and communication techniques. Articulatory function, speech functions, and pain perception exhibited the least alteration.

Conclusions: The data extracted from the ICF-based assessments underscore the vital significance of incorporating speech therapy-based metrics to evaluate both non-audiological and audiological factors in assessing the success of CI care within the SLTs domain. This approach proves to be highly relevant both in terms of demonstration and clinical applicability.

Purpose: The purpose of this study was to examine the effectiveness of an augmentative and alternative communication (AAC) intervention package consisting of systematic instruction and aided AAC modeling with speech-output technology on the acquisition, maintenance, and generalization of socio-communicative behaviors in four minimally speaking, preschool-aged, autistic children.

Method: A multiple-probe design across behaviors (i.e., initiating a request for a turn, answering questions, and commenting) replicated across participants was implemented to evaluate the effects of the intervention package on socio-communicative behaviors. Furthermore, a pretreatment and posttreatment multiple-generalization-probe design was used to assess generalization across typically developing peers who were not a part of the intervention. Maintenance data were collected 3 weeks post intervention.

Results: Visual analysis, corroborated by nonoverlapping of all pairs statistics, established a strong functional relationship between the AAC intervention package and all targeted socio-communicative outcomes for two participants. For the other two participants, inconsistent intervention effects were observed. In terms of generalization from interacting with the researcher to typically developing peers, a functional relationship between the intervention and generalization outcomes for all targeted behaviors was established for only one participant (i.e., Aiden).

Conclusion: The outcomes of this study suggest that aided AAC modeling and systematic instruction using a speech-output technology may lead to gains in socio-communicative behaviors in some minimally speaking, preschool-aged, autistic children.

Supplemental material: https://doi.org/10.23641/asha.27091879.

Purpose: Retrieval practice has been shown to assist the word learning of children with developmental language disorder (DLD). Although this has been true for learning new verbs as well as new nouns and adjectives, these children's overall verb learning has remained quite low. In this preregistered study, we presented novel verbs in transitive sentences with varying subjects/agents and objects/patients to determine if recall could be improved and if retrieval practice continued to be facilitative.

Method: Fourteen children with DLD aged 4-5 years and 13 same-age peers with typical language development (TD) learned eight novel verbs over two sessions. Half of the novel verbs were presented with spacing between study and retrieval trials, and half were presented with the same frequency in study trials without the opportunity for retrieval. All novel verbs were presented in sentences such as, "The woman is deeking the shoe." Children's ability to recall and use the novel verbs in the same sentence structure was tested after the second session and 1 week later. The children were also required to use the novel verbs in bare-stem form in a new structure, as in, "That woman likes to deek the towel."

Results: Both groups of children showed increased recall relative to a previous novel verb study. The children with TD showed the expected advantages of spaced retrieval over repeated study and could use the novel verbs in the new morphological form and sentence structure. The children with DLD, however, showed an advantage for spaced retrieval only shortly after the learning period. These children had great difficulty changing the novel verbs to a bare stem and using them in a new structure.

Conclusion: Although spaced retrieval assists children's novel verb recall, children with DLD in particular require additional help using these verbs with morphological and syntactic flexibility.

Purpose: This study aimed to investigate the vocal characteristics of children with cerebral palsy (CP) and anarthria using the stage model of vocal development.

Method: Vocal characteristics of 39 children with CP and anarthria around 4 years of age were analyzed from laboratory-based caregiver-child interactions. Perceptual coding analysis was conducted using the Stark Assessment of Early Vocal Development-Revised to examine vocal complexity, volubility, and consonant diversity.

Results: Children predominately produced vocalizations corresponding to the two earliest stages of vocal development characterized by vowel-like utterances. They showed a limited attainment of consonantal features with low consonant diversity and variably low vocal rates.

Conclusions: Our results demonstrate that underlying neurological impairments resulting in an anarthric status in children with CP affect the progression of speech motor development and their ability to advance beyond early vocal stages. These findings highlight the importance of considering alternative communication modalities for children demonstrating similar vocal characteristics beyond expected periods of development.

Purpose: The purpose of this tutorial is to (a) provide an updated review of the literature pertaining to proposed early features of childhood apraxia of speech (CAS), (b) discuss the findings of recent treatment studies of infants and toddlers with suspected CAS (sCAS), and (c) present evidence-based strategies and tools that can be used for the identification of and intervention for infants and toddlers with sCAS or at high risk for the disorder.

Method: Since Davis and Velleman's (2000) seminal work on assessment and intervention in infants and toddlers with sCAS, limited research has guided clinicians in the complex task of identifying and treating early speech motor difficulties prior to a definitive diagnosis of CAS. Following the structure of Davis and Velleman, we explore the proposed early characteristics of CAS with reference to contemporary research. Next, we describe the limited treatment studies that have investigated intervention for infants and toddlers at risk of or suspected of having CAS. Finally, we present practical suggestions for integrating this knowledge into clinical practice.

Conclusions: Many of the originally proposed correlates of CAS in infants and toddlers now have research supporting their presence. However, questions remain about the developmental trajectory of the disorder. Although limited in number and restricted by lack of experimental control, emerging treatment studies can help guide clinicians in providing appropriate intervention to infants and toddlers with sCAS who need not wait for a definitive diagnosis to initiate intervention.

Purpose: The aim of this study was to describe changes in speech intelligibility and interrater and intrarater reliability of naive listeners' ratings of words produced by young children diagnosed with childhood apraxia of speech (CAS) over a period of motor-based intervention (dynamic temporal and tactile cueing [DTTC]).

Method: A total of 120 naive listeners (i.e., listeners without experience listening to children with speech and/or language impairments; age range: 18-45 years) orthographically transcribed single-word productions by five children (age range: 2;6-3;11 [years;months]) across three time points over an intervention period (baseline, post-treatment, maintenance). Changes in intelligibility and interrater and intrarater reliability were examined within and across time points.

Results: Speech intelligibility significantly increased in children with CAS over the course of treatment, and these gains were also maintained at 6 weeks posttreatment. There was poor-to-fair consistency between listeners (interrater reliability) and excellent consistency within listeners (intrarater reliability) in ratings of speech intelligibility within and across time points.

Conclusions: Motor-based intervention increases speech intelligibility following a period of DTTC treatment. Variability among naive listeners of speech intelligibility was also present, with intrarater reliability (within listeners) yielding greater consistency than interrater reliability (between listeners). The implications for including naive listeners as raters of speech intelligibility for research and clinical purposes are discussed.

This article introduces the Journal of Speech, Language, and Hearing Research Special Issue: Selected Papers From the 2022 Apraxia Kids Research Symposium. The field of childhood apraxia of speech (CAS) has developed significantly in the past 15 years, with key improvements in understanding of basic biology including genetics, neuroscience, and computational modelling; development of diagnostic tools and methods; diversity of evidence-based interventions with increasingly rigorous experimental designs; and understanding of impacts beyond impairment-level measures. Papers in this special issue not only review and synthesize the some of the substantial progress to date but also present novel findings addressing critical research gaps and adding to the overall body of knowledge. A second aim of this prologue is to report the current research needs in CAS, which arose from symposium discussions involving researchers, clinicians, and Apraxia Kids community members (including parents of children with CAS). Four primary areas of need emerged from discussions at the symposium. These were: (a) What questions should we ask? (b) Who should be in the research? (c) How do we conduct the research? and (d) How do we move from research to practice? Across themes, symposium attendees emphasized the need for CAS research to better account for the diversity of people with CAS and improve the timeliness of implementation of high-level evidence-based practice across the lifespan. It is our goal that the articles and prologue discussion in this special issue provide an appreciation of advancements in CAS research and an updated view of the most pressing needs for future research.

Background: Speech and language are interconnected systems, and language disorder often co-occurs with childhood apraxia of speech (CAS) and non-CAS speech sound disorders (SSDs). Potential trade-off effects between speech and language in connected speech in children without overt language disorder have been less explored.

Method: Story retell narratives from 24 children (aged 5;0-6;11 [years;months]) with CAS, non-CAS SSD, and typical development were analyzed in Systematic Analysis of Language Transcripts (SALT) regarding morphosyntactic complexity (mean length of C-unit in words [MLCU]), lexical diversity (moving-average type-token ratio [MATTR]), and linguistic accuracy (any linguistic error/bound morpheme omissions) and compared to 128 age-matched children from the SALT database. Linear and mixed-effects logistic regressions were performed with speech accuracy (percent phonemes correct [PPC]) and diagnostic group as predictors of the narrative variables.

Results: PPC predicted all narrative variables. Poorer PPC was associated with lower MLCU and MATTR as well as a higher likelihood of linguistic errors. Group differences were only observed for the error variables. Comparison to the SALT database indicated that 13 of 16 children with CAS and SSD showed a higher-than-expected proportion of linguistic errors, with a small proportion explained by individual speech errors only.

Conclusions: The high occurrence of linguistic errors, combined with the relationship between PPC and linguistic errors in children with CAS/SSD, suggests a trade-off between speech accuracy and language output. Longitudinal studies are needed to investigate whether children with SSDs without language disorder show more language difficulties over time as linguistic demands increase.

Purpose: Advancements in genetic testing and analysis have allowed improved identification of the genetic basis of childhood apraxia of speech, a rare speech presentation. This study aimed to understand speech-language pathologists' (SLPs') consideration of incorporation of genetics in clinical practice using a theory-informed qualitative approach.

Method: Semistructured interviews were conducted with 12 pediatric SLPs using a behavior change theory (Theoretical Domains Framework [TDF]) within a case study describing a child with complex co-occurring features, including childhood apraxia of speech. Interviews focused on three stages of the patient journey (prereferral, referral, and postreferral). Interviews were analyzed to identify barriers and enablers to considering incorporation of genetics in current clinical practice. Barriers and enablers were grouped and mapped onto a contextually relevant TDF-coded analysis framework.

Results: Barriers were identified across several TDF domains, through all stages of the patient journey. Lack of confidence, relevance, and level of experience were most common prereferral, and connection to and awareness of genetics services and contextual factors were barriers in the referral stage. Perception of professional role, knowledge, and beliefs about effects on families were barriers postreferral. Associated enablers were also identified, including seeing value in genetic diagnosis, support from other health care professionals, supervision, and relationships with genetics services.

Conclusions: Results of this qualitative study highlight barriers and enablers to incorporating genetics into speech-language pathology clinical practice. These findings will assist in the development of theory-informed implementation strategies to support SLPs into the future.

Supplemental material: https://doi.org/10.23641/asha.24112800.