Journal of Speech Language and Hearing Research最新文献

Purpose: Conversational latency entails the temporal feature of turn-taking, which is understudied in autistic children. The current study investigated the influences of child-based and parental factors on conversational latency in autistic children with heterogeneous spoken language abilities.

Method: Participants were 46 autistic children aged 4-7 years. We remotely collected 15-min naturalistic language samples in the context of parent-child interactions to characterize both child and parent conversational latency. Conversational latency was operationally defined as the time it took for one individual to respond to their conversational partner using spoken language. Naturalistic language samples were transcribed following the Systematic Analysis for Language Transcripts convention to characterize autistic children's spoken language and parental spoken language input. Autistic children's spoken language was measured using number of different words (NDW). The quality and quantity of parental spoken language input was assessed using NDW, mean length of utterance in morphemes (MLUm), and frequency of words per minute (WPM). Additional child-based factors, including receptive language and socialization skills, were evaluated using the Vineland Adaptive Behavior Scales. Spearman correlation and regression analyses were conducted to investigate the relationships between those child-based and parental factors and child conversational latency.

Results: Older autistic children showed longer conversation latencies. Longer parent conversational latency was associated with longer child conversational latency after controlling for age. Greater parental WPM was associated with shorter child conversational latency after controlling for age. Child conversational latency was not associated with their spoken language, receptive language, or socialization skills. Child conversational latency was not associated with parental NDW and MLUm.

Conclusions: Our findings highlight the interaction loop between autistic children and their parents in everyday interactions. Parents adjusted their timing and quantity of spoken language input to ensure smooth conversational turn-taking when interacting with their autistic children.

Purpose: Investigating stuttering recovery rates can be challenging, as recovery status can change based on self-report, later recovery, or relapse. In this study, we contacted previous child participants from our longitudinal studies (now older children to young adults) who were originally assigned persistence/recovery status guided by clinician and caregiver reports only. Their stuttering status as adolescents and young adults was re-evaluated based on currently assessed clinician and caregiver reports, observable stuttering severity assessments, and self-reports.

Method: Seventy-nine participants were contacted based on their current age and time since their last longitudinal study visit (> 2 years). Of these, 23 participated in this follow-up investigation. Participants and caregivers completed follow-up questionnaires, and participants' speech samples were recorded for offline stuttering disfluency ratings by a speech-language pathologist.

Results: When considering participant and caregiver reports as well as clinician report based on stuttering severity ratings, recovery status changed for nine of the 23 participants (39.13%). All nine self-identified as recovered, although four of the nine were judged to exhibit very mild stuttering. Five of the nine were viewed to be late recovery cases, occurring after the conclusion of the prior longitudinal study. The presence of stuttering behaviors was often reported consistently across clinician and participant/caregiver reports (the basis for "persistence" judgments by the clinician), but in eight cases (34.78%), participants did not self-identify as stutterers despite reported presence of stuttering.

Conclusions: Our results highlight the importance of assessing stuttering beyond early childhood to examine recovery rates. Furthermore, self-reports on stuttering status reveal that the concept of recovery is nuanced: The presence of overt stuttering does not necessarily correlate with self-identification of stuttering. These findings have implications on how best to define stuttering persistence and recovery for future research and clinical practice.

Supplemental material: https://doi.org/10.23641/asha.28654565.

Purpose: Despite recognition of the underlying phonological impairment observed in the logopenic and nonfluent variants of primary progressive aphasia (PPA), there is relatively little treatment research directed toward strengthening phonological skills. In this study, we focused on remediating phonological deficits in logopenic and nonfluent PPA. Specifically, we hypothesized that behavioral intervention intended to strengthen phonological manipulation skills and sound-letter correspondences-coupled with transcranial direct current stimulation (tDCS)-would improve language abilities, especially in the written modality.

Method: Twelve individuals with logopenic or nonfluent variants of PPA and 24 neurotypical adults completed neuropsychological assessment that documented spoken and written language deficits in those with PPA. Phonological skills were consistently impaired in relation to other language processes. Following a double-blind, crossover design, six individuals with PPA were randomized to receive active tDCS with phonological intervention during the first treatment phase, and after a 2-month break, they received a second phase of behavioral intervention paired with sham tDCS. The other six individuals were randomized to receive sham first and active tDCS second. Language skills were evaluated before and after each treatment phase and 2 months after the intervention.

Results: Both treatment groups (tDCS-first and sham-first) made significant improvement in phonological transcoding skills in response to behavioral intervention, but those who received active tDCS first showed stronger gains in phonological manipulation ability. This group also showed positive changes in written narratives, which contained more grammatical sentences with increased meaningful content and more accurate spelling.

Conclusions: These data provide compelling evidence supporting an approach that targets phonological deficits in logopenic and nonfluent PPA. Specifically, we found that improved phonological skills resulted in better functional communication ability (text-level writing) relevant to everyday life. Positive outcomes were strongest when tDCS was combined with behavioral treatment from the beginning, suggesting that this combination may potentiate positive changes that extend beyond the initial stimulation period.

Supplemental material: https://doi.org/10.23641/asha.28598195.

Purpose: The lexical selection hypothesis posits that first words added to a toddler's spoken vocabulary will be predominantly those beginning with early developing consonant phonemes. Using this framework, we evaluated the relationship between word form and lexical selection among late talkers and two typical comparison groups.

Method: An online database of MacArthur-Bates Communicative Developmental Inventories was used to extract the American English Words and Sentences Form (MB-CDI:WS). Inventories were divided into three groups: (a) a late talkers group (LTs; n = 202), (b) a typically developing age-matched group (TDA; n = 1,238), and (c) a younger, typically developing language-matched group (TDL; n = 196) matched on expressive language to the LTs. The first phoneme in each word produced by every toddler on the MB-CDI:WS was coded as early, middle, or late developing. The proportion of spoken words starting with phonemes in each developmental category was calculated. Mixed-effects models were used to evaluate group differences.

Results: All three groups' spoken vocabularies consisted mostly of words beginning with early developing phonemes. LTs and TDLs used more words beginning with early developing consonants than TDAs. TDAs had a higher proportion of words starting with middle- and late- developing phonemes than LTs and TDL groups. The LTs group produced a significantly smaller proportion of words beginning with middle-developing phonemes compared to the TDL group.

Conclusions: Initial phonemes produced in the lexicons of LTs are, in general, similar to both language-matched and age-matched typical toddlers and reflect lexical selection. Clinical implications of these findings will be discussed.

Purpose: This study aimed to determine the minimally detectable changes (MDCs) and minimal clinically important differences (MCIDs) of auditory-perceptual ratings of voice quality using the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) scales (i.e., Overall Severity, Roughness, Breathiness, Strain).

Method: Participants (n = 63) included patients diagnosed with phonotraumatic vocal fold lesions who underwent either voice therapy or laryngeal surgery and reported posttreatment voice improvements. Nine expert voice-specialized speech-language pathologists rated the pre- and posttreatment voice samples using CAPE-V scales (i.e., via 100-mm visual analog scales with included textual labels for severity). Separately, raters judged the magnitude of perceived change between pre- and posttreatment samples using Jaeschke's Global Ratings of Change Scale, which served as the anchor for MCID calculations. Intrarater reliability and the standard error of measurement were used to calculate MDCs at the 95% confidence interval for each dimension. Receiver operating characteristic curves were used to identify MCID thresholds, which were defined as values that optimized sensitivity and specificity while also exceeding the MDC.

Results: MDC values, representing thresholds for determining whether a true change has occurred, were 14.9 mm for Overall Severity, 14.6 mm for Roughness, 12.1 mm for Breathiness, and 18.7 mm for Strain. MCID thresholds, representing thresholds for determining clinically meaningful change, were 16.5 mm for Overall Severity, 16.5 mm for Roughness, and 15.5 mm for Breathiness. All potential MCID thresholds for Strain were smaller than the MDC value; thus, a valid MCID threshold was not obtained.

Conclusions: This study represents the first known attempt to establish MDC and MCID thresholds for auditory-perceptual ratings of voice quality. The thresholds provide guidance for determining whether real and meaningful changes in voice quality have occurred in patients undergoing treatment for phonotraumatic voice disorders. Future research should explore these values across various voice disorder populations and severity levels and incorporate patient-reported outcomes as anchors to enhance clinical decision making and treatment outcomes in voice rehabilitation.

Purpose: Children who have late language emergence, or are late talkers (LTs), have substantially lower vocabulary levels than their peers, on average. Notably, differences in how researchers define who comprises LTs can lead to inconsistencies across findings. The current study examined how the number of children identified as LTs differs when using different parameters for identification in a low-socioeconomic status (SES) sample.

Method: Low-SES mothers (n = 238) completed the MacArthur-Bates Communicative Development Inventories: Words and Sentences (CDI:WS) as part of a larger longitudinal study. Using percentile scores, children were identified as LTs or non-LTs using different sets of parameters. Descriptive and chi-square analyses were used to examine how the different parameters changed the percentages of children identified as LTs.

Results: Depending on the parameters used, the prevalence of LTs in our low-SES sample ranged from 28% to 43%, which is higher than the prevalence in population-based studies (10%-20%). Using 3rd edition norms by sex for children ages 24-30 months and using a 10th percentile cutoff value, the prevalence of LTs was 29%.

Conclusions: Reporting and agreeing upon the most robust parameters for LT identification is critical both for (a) research replicability and comparison across studies and (b) researchers and practitioners to accurately identify LTs and provide the appropriate support to them and their families.

Supplemental material: https://doi.org/10.23641/asha.28710995.

Purpose: Auditory lifestyle, which refers to the variety, range, and types of auditory environments individuals encounter in their daily lives, can affect individuals' daily communication functions and moderate the outcomes of hearing interventions. This study aimed to determine the factors associated with adult cochlear implant (CI) users' auditory lifestyle.

Method: This observational study included 209 adult CI users. The factors examined included sex, age, social network characteristics, geographical location of residence, cognitive functioning, and speech recognition performance. The Auditory Lifestyle and Demand Questionnaire was used to measure participants' auditory lifestyle. Associations between variables were analyzed using regression models and structural equation modeling.

Results: Regression models indicated that CI users who had larger social networks, were younger or middle aged, and possessed better speech recognition abilities were more likely to experience a diverse and demanding auditory lifestyle. Additionally, sex, age, and cognitive functioning (memory) were associated with the size and diversity of social networks. Finally, structural equation modeling revealed that while age and speech recognition performance were directly related to auditory lifestyle, the impact of age and sex on auditory lifestyle was mediated by the size of social networks.

Conclusions: Sex, age, size of social networks, and speech recognition ability are associated with CI users' auditory lifestyle. This research highlights the significance of taking into account the demographics and social network characteristics of adult CI users when assessing the auditory environments they experience in their daily lives.

Purpose: The main aim of the systematic review and meta-analysis was to evaluate the effectiveness of language interventions for school-aged children who are d/Deaf and hard of hearing (DHH). We focused on studies targeting meaning-based aspects of language, such as vocabulary, grammar, and narrative skills. We included randomized controlled trials and quasi-experiments with a control group and a pre-post design. A secondary aim was to describe the characteristics of effective interventions identified in the systematic review.

Method: The review was preregistered in PROSPERO (ID CRD42021236085). We searched 10 academic databases for peer-reviewed journal articles reporting language interventions for children who are DHH aged 6-12 years. We assessed the quality of included studies using Critical Appraisal Skills Programme checklists. A meta-analysis was conducted on the overall effect of interventions. In addition, we calculated separate effect sizes for vocabulary and morphosyntactic knowledge.

Results: We identified 14 studies totaling 794 children. Quality assessment revealed concerns of risk of bias in most studies because study characteristics were not comprehensively reported. The meta-analyses of language interventions revealed a large main effect of g = 0.79. Subdomain analyses revealed similar effects for morphosyntactic knowledge g = 0.81 and vocabulary g = 0.71.

Conclusions: Few high-quality studies examine the effects of language interventions for children who are DHH. However, the studies that exist reveal robust effects, especially for morphosyntactic abilities. Intervention approaches were diverse, and the largest intervention effects were found in studies with a randomized controlled design and near-transfer outcome measures closely aligned with the intervention content. Future studies should adhere to established guidelines for reporting results from controlled experimental study designs.

Purpose: Treatment of Underlying Forms (TUF) is a training program grounded in linguistic theory and aiming to boost complex sentences production in people with agrammatism. Language treatment studies in aphasia confirmed TUF efficacy and led to the formulation of the Complexity Account of Treatment Efficacy (CATE). According to CATE, which relies on the primitive distinction between A- and A'-structures, training complex sentences induces an improvement on simpler structures, but no generalization occurs between different types of syntactic movement. This experiment provides the first adaptation of TUF in Italian and investigates the cross-linguistic validity of training efficacy and its generalization pattern.

Method: Using a single-subject experimental design, five participants with chronic poststroke agrammatism underwent intensive training for object relatives. Performance on trained and untrained object relatives (A'-structures), object clefts (simpler A'-structures), and passive sentences (A-structures) was measured at multiple time points, that is, pre- and posttreatment, during the training, and at follow-up. A standardized assessment of aphasia was also administered pre- and posttreatment.

Results: The results reported a robust improvement in the production of trained and untrained object relatives in all five participants, a generalization to object clefts in four participants, and, unexpectedly, a generalization to passives in three participants. All participants showed improved comprehension on all these structures. A general linguistic improvement was also found in the standardized testing of aphasia, especially in morphosyntactic abilities.

Conclusions: The findings confirmed the efficacy of the Italian adaptation of TUF for object relatives supporting its use in the clinical practice. To explain the generalization to passives in Italian but not in the English version of TUF, we propose an amendment of CATE that takes the syntactic operation of Internal Merge as a primitive (keeping the A vs. A' distinction as a modulating factor).

Purpose: High-speed videoendoscopy was used to investigate how underlying laryngeal motor control strategies differ in individuals with and without hyperfunctional voice disorders (HVDs). Three laryngeal kinematic measures were defined to characterize laryngeal motor control: kinematic stiffness, spatiotemporal index, and asymmetry index.

Method: Twenty-eight adults with HVDs and 28 age- and sex-matched controls produced repeated utterances of /ifi/ at three different gesture rates (50, 65, and 80 beats per minute) and three self-induced vocal effort levels (mild, moderate, and maximum effort) to elicit a range of linguistic contexts for the vocal targets produced. The glottal angle profiles of /ifi/ productions were extracted to calculate three kinematic measures of laryngeal motor control: kinematic stiffness (estimating laryngeal muscle tension), spatiotemporal index (estimating production variability), and asymmetry index (estimating movement asymmetry).

Results: Individuals with HVDs exhibited statistically significantly higher kinematic stiffness during varying effort levels and higher spatiotemporal indices and asymmetry indices compared to controls, indicating higher laryngeal muscle tension, production variability, and movement asymmetry, respectively.

Conclusion: Laryngeal kinematics suggest differing underlying motor control strategies in individuals with HVD relative to controls, which may inform better understanding of the etiology of HVDs.

Supplemental material: https://doi.org/10.23641/asha.28550387.