Journal of Speech Language and Hearing Research最新文献

Purpose: The goal of this study was to examine potential mediators of the relationship between developmental language disorder (DLD) status and executive function performance.

Method: Participants included preschoolers, of whom 80 met the diagnostic criteria for DLD and 103 were categorized as having typical language abilities. Participants' nonverbal IQ and receptive vocabulary were assessed via standardized tests, and their executive function was tested using the Dimensional Change Card Sort. Maternal education was collected via caregiver report and served as a measure of socioeconomic status (SES).

Results: Group comparisons confirmed that participants with DLD had lower language scores, nonverbal IQ scores, executive function scores, and SES relative to peers with typical language. Additionally, these variables were significantly positively correlated. Multiple mediation analyses indicated that both nonverbal IQ and receptive vocabulary were significant partial mediators of the effect of DLD status on executive function scores. However, a direct effect of DLD status on executive function remained significant in a model that included the mediators and covaried maternal education.

Conclusions: Group differences in nonverbal IQ and receptive vocabulary can partially explain why children with DLD tend to have lower executive function scores relative to peers with typical language. However, even after accounting for these mediators, there is a significant, large direct effect of DLD status on executive function performance, which suggests that the groups' difference in executive functioning is not fully explained by other variables.

Purpose: Phonetic training has been found to be an effective way on second language (L2) learning, but the evidence is not conclusive regarding the effectiveness of different instructional approaches and possible interactions between language learners, training features, and outcome measures. This study aims to meta-analyze existing studies to provide an accurate estimate of the overall effect and investigate factors that may moderate its effectiveness.

Method: We conducted a systematic search in major databases, identified seven potential moderators, and conducted a random-effects model meta-analysis for each variable.

Results: A comprehensive literature search yielded 65 primary studies that involved 2,793 L2 learners, generating 223 effect sizes for between-groups contrasts. Results showed that phonetic training had a large positive effect on the enhancement of L2 phonetic competence, d = 0.762. Subsequent moderator analyses revealed that perceptual training showed a larger mean effect size compared to production training and combined training; phonetic training at the high school level exhibited the largest mean effect size among all educational levels; phonetic training, either perceptual training or production training, had a greater impact on improving learners' perception competence than production competence; and outcome measured by identification tasks generated the largest effect, followed by the combination of discrimination and identification tasks, subjective perception judgment, and discrimination tasks, while objective acoustic measurement yielded the smallest effect size.

Conclusions: Our study provided a quantitative synthesis of studies investigating the efficacy of L2 phonetic training and examined various moderating variables, which indicated the heterogeneity and limitations of research on this topic. The results highlighted the need for further investigation of the potential factors of L2 phonetic training and the relationship between perception and production.

Purpose: This study aimed to identify how a set of predefined factors modulates phoneme articulation time within a speaker.

Method: We used a custom in-lab system that records lip muscle activity through electromyography signals, aligned with the produced speech, to measure phoneme articulation time. Twenty Spanish-speaking participants (12 females) were evaluated while producing sequences of a consonant-vowel syllable, with each sequence consisting of repeated articulations of either /pa/ or /pu/. Before starting the sequences, participants underwent a priming step with either a fast or slow speech rate. Additionally, the general attentional state level was assessed at the beginning, middle, and end of the protocol. To analyze the variability in the duration of /p/ and vowel articulation, we fitted individual linear mixed-models considering three factors: general attentional state level, priming rate, and coarticulation effects (for /p/, i.e., followed by /a/ or /u/) or phoneme identity (for vowels, i.e., being /a/ or /u/).

Results: We found that the level of general attentional state positively correlated with production time for both the consonant /p/ and the vowels. Additionally, /p/ production was influenced by the nature of the following vowel (i.e., coarticulation effects), while vowel production time was affected by the primed speech rate.

Conclusions: Phoneme duration appears to be influenced by both stable, speaker-specific characteristics (idiosyncratic traits) and internal, state-dependent factors related to the speaker's condition at the time of speech production. While some factors affect both consonants and vowels, others specifically modify only one of these types.

Supplemental material: https://doi.org/10.23641/asha.28608428.

Purpose: A 2017 CATALISE project resulted in consensus on using the term "developmental language disorder" (DLD) to describe children with unexplained language impairment. Since then, it is unclear how researchers have identified DLD and implemented DLD terminology. The current study is a scoping review to better understand the implementation of DLD terminology.

Method: We identified studies (N = 265) published in American Speech-Language-Hearing Association (ASHA) journals between 2017 and 2024 that included individuals with communication difficulties in the area of language not secondary to another etiology. We extracted key information regarding study purpose and participant identification from each publication.

Results: Across all publications, 58% included the term "DLD" to describe their participant(s), 22% included "specific language impairment" (SLI), 12% included "language impairment" (LI), and 8% included other terms. The majority of publications served to better understand the profile of individuals with DLD, evaluate an intervention, or report on a measurement tool related to identification of the condition. There was significant variation in the developmental domains (e.g., cognitive, social, sensory) considered when diagnosing DLD across research publications.

Conclusions: This scoping review demonstrates the adoption and implementation of the term "DLD" in ASHA publications. Future efforts should prioritize increasing the consistency of identification of DLD in research, advocating for use of DLD terminology in clinical contexts, and supporting clinicians' knowledge, identification, assessment, intervention, and advocacy related to DLD.

Supplemental material: https://doi.org/10.23641/asha.28508936.

Purpose: Bilingual children's speech often contains high percentages of disfluencies in both their languages; however, the distribution of disfluency types and the difference across bilinguals' two languages have received insufficient and inconsistent empirical support. The present research aims to profile "typical" bilingual disfluency phenomena while comparing across the two languages and examining the impact of language exposure as well as proficiency.

Method: The current research analyzed disfluency rates and types among 32 bilingual children aged 4-9 years speaking a heritage language (HL; English or Russian) and a societal language (SL; Hebrew). Children's language proficiency was examined using a receptive vocabulary task and a sentence repetition task in both HL and SL. Analyses of three speech samples (spontaneous speech, narrative telling, and narrative retelling) were conducted examining rates and types of stuttering-like disfluencies (SLDs) and other disfluencies (ODs).

Results: The percentage of SLDs was higher in SL than in HL, which was related to the amount of exposure, whereas the percentage of ODs was associated with the proficiency vocabulary score and age of onset of bilingualism. Analysis of individual profiles revealed that nine children had high SLDs in at least one language. This could lead to stuttering overdiagnosis. Children whose SLD rates were high in both languages showed low performance (1 SD below the group level) on proficiency tasks, whereas children with a high percentage of SLDs only in HL had intact proficiency.

Conclusions: The results reveal high individual variation in disfluencies and support the importance of SLD-OD distinction in research on bilingual disfluency. Clinical implications of the research suggest that assessment of bilingual speech should be conducted applying unique criteria, different from the existing monolingual norms.

Purpose: Although there is widespread agreement pertaining to the cognitive processes underlying spoken word production, more generally in aphasia, multiple competing accounts exist regarding the processes involved for verb production, specifically. Some have speculated that suboptimal control of certain item properties (e.g., imageability) may be partially responsible for conflicting reports in the literature, yet there remains a dearth of research on the psychometric validation of verb production tests for aphasia. The purpose of the present study was to investigate the cognitive constructs underlying the Verb Naming Test (VNT), a relatively commonly used verb production test, by expanding upon an item response theory (IRT) modeling framework we previously described.

Method: Using an archival data set of 107 individuals with aphasia, we specified a series of IRT models to investigate whether item covariates (argument structure, imageability), person covariates (aphasia subtype, severity), and their interactions were predictive of VNT item response patterns.

Results: Across all models, covariates that were most strongly associated with lexical-semantic processing (imageability, aphasia severity) were significant predictors. In contrast, covariates that were most strongly associated with morphosyntactic processing (argument structure, aphasia subtype) were minimally predictive.

Conclusions: VNT item response patterns appear to be primarily explained by covariates representing lexical-semantic processing. In particular, we identified an important role of imageability, a covariate not controlled for in the VNT's item design, which both aligns with a body of prior research and further illustrates the challenge of differentiating morphosyntactic processing from lexical and semantic processes during word production.

Supplemental material: https://doi.org/10.23641/asha.28664669.

Trial design: This is a randomized multisite noninferiority comparative-effectiveness clinical trial with three parallel branches comparing a best-practices audiologist-fit method to two experimental self-fit (person-fit) methods. Outcomes were measured at 6 weeks and 6 months post-fit.

Method: Participants: Five hundred eighty-four participants met the following inclusion criteria and enrolled: (a) age between 50 and 79 years; (b) never used or tried hearing aids previously; (c) can speak, read, and understand English well; (d) willing to purchase the study hearing aids for $650/pair; (e) no diagnosis of a memory or cognitive impairment; (f) 25-item Hearing Handicap Inventory for the Elderly (HHIE) score > 4; (g) Montreal Cognitive Assessment score ≥ 23; and (h) not excluded due to specific audiometric criteria. The audiometric exclusion criteria, based on air-conduction pure-tone thresholds, were as follows: (a) thresholds at all frequencies (250-8000 Hz) < 20 dB HL, for both ears (no hearing loss); (b) pure-tone average for 500, 1000, 2000, and 4000 Hz (PTA4) in the better ear > 50 dB HL (greater than moderate hearing loss); and (c) interaural difference > 20 dB at three or more frequencies or ≥ 40 dB at 500 or 1000 Hz. Interventions: Three groups received the same hearing aids fitted either by an audiologist using best practices (Group AB) or by themselves using one of two efficacious self-fit methods (Groups CD and EF). Objectives: The effectiveness of each of the self-fit methods, CD and EF, was hypothesized to be noninferior to the professional-fit method, AB. Outcomes: The primary outcome measure was the global score from the Profile of Hearing Aid Benefit (PHAB), and the secondary outcome measure was the benefit score (unaided - aided) for the 25-item HHIE. Randomization: Participants were stratified into one of three hearing loss categories based on better-ear PTA4: normal (≤ 20 dB HL), mild (20.1-35 dB HL), or moderate (35.1-50 dB HL). The random assignment of sequential enrollees within each hearing loss category to the three treatment groups made use of a site-specific pregenerated randomization list produced from a random-numbers table. Blinding: It was not possible to blind the participants as to the fitting method used, but the research personnel assessing the outcomes were blinded to the treatment group.

Results: Numbers randomized: The 584 enrollees were randomized to one of the three treatment groups: AB (n = 190), CD (n = 193), and EF (n = 201).

Trial status: The trial began on November 1, 2020, and 6-month outcomes were obtained from the last participant on March 29, 2024. Numbers analyzed: At the 6-week measurement interval, outcome measures were completed for 182 AB, 172 CD, and 178 EF participants, representing 91.1% of the 584 individuals who enrolled. At the 6-month interval, completed outcomes were available for 166 AB, 148 C

Purpose: Owing to mucosal waves, the oscillatory glottis is ideally expected to be convergent during opening and divergent during closing. However, this does not necessarily hold for voice disorders. Here, we pave the way for recognizing COnvergent-DIvergent (CODI) waveforms quantitatively and study the kinematic conditions in which they occur.

Method: We simulated 3,125 laryngoscopic glottal waveforms using a kinematic vocal fold (VF) model and synthetic kymograms. We independently varied the oscillatory amplitudes of the upper and lower VF margins, A_U and A_L (0.1 to 1.1 mm), vertical phase difference (VPD; 0° to 125°), glottal halfwidth H_W (-0.05 to 1.2 mm), and prephonatory glottal convergence angle ψ_CVG (-15° to 35°) to simulate normal and disordered conditions. We introduced the upper and lower margin quotients, Q_U and Q_L, quantifying the proportion of time when the upper margin is at the glottal edge during the opening, and when the lower margin is at the glottal edge during the closing, respectively. A CODI waveform was defined as the case when Q_U = Q_L = 1.

Results: The likelihood of obtaining the CODI waveform was highest when A_U and A_L were similar, ψ_CVG was close to 0, H_W was below 0.45 mm, and VPD was larger than 50°. In 88% of the simulated cases, the waveforms did not fulfill the CODI conditions. In these cases, either the lower margin was hidden during some portion of the closing phase or the upper margin was not at the glottal edge during some portion of the opening phase.

Conclusion: The study provides the basis for a better understanding of the variability of glottal waveforms and the appearance of mucosal waves related to VF kinematics.

Purpose: The Language ENvironment Analysis (LENA) is a technological tool designed for comprehensive recordings and automated analysis of young children's daily language and auditory environments. LENA recordings play a crucial role in both clinical interventions and research, offering insights into the amount of spoken language children are exposed to in their homes, including adult word count (AWC) and child vocalization count (CVC). Although LENA was initially developed for American English, it has been validated in various other languages. This study aimed to evaluate the reliability of LENA in a Swedish context by comparing its automatic estimates with human transcriptions.

Method: Thirty-six children aged 11-29 months participated in the validation study. A total of 540 min (9 hr) of recordings were transcribed by one experienced speech-language pathologist and two special educators. Interrater agreement over 150 min was notably higher for CVC (intraclass correlation coefficient [ICC] = .97, 95% confidence interval [CI] [.91, .99], r = .96, p < .001) compared to AWC, which yielded an ICC of .82 (95% CI [.15, .96], r = .80, p = .006).

Results: Both estimated CVC and AWC (n = 36) were significantly correlated with human transcriptions (r = .79 and .82, respectively; p < .001).

Conclusions: The findings align with prior validation studies, indicating that LENA is suitable for use in a Swedish context, particularly for families with children aged 11-29 months. Nonetheless, additional validation studies are necessary, particularly focusing on younger infants, to enhance our understanding of the tool's reliability in preverbal children and their caregivers.

Purpose: The purpose of this study was to evaluate the construct validity of three sentence-focused diversity measures, intransitive verb diversity, transitive verb diversity, and third person (3P) subject diversity, using two methods: (a) group differentiation of late-talking (LT) toddlers from peers with typically developing (TD) language and (b) associations with established measures of language development. A secondary purpose was to determine whether 3P subject diversity was more strongly associated with intransitive verbs than transitive verbs.

Method: Examiner-child language samples from 58 LT toddlers and 82 TD toddlers (ages 24-30 months) were collected using a structured language sampling protocol. Transcripts were coded to obtain measures of intransitive verb diversity, transitive verb diversity, and 3P subject diversity as well as mean length of utterance (MLU) and number of different words (NDW). We used nonparametric tests to examine differences between groups and associations between measures within each group. We also conducted an exploratory analysis using a generalized linear mixed model to determine the strength of associations for intransitive and transitive verb diversity with 3P subject diversity.

Results: All sentence-focused diversity measures were significantly different between groups. They were also positively related to MLU, NDW, and to each other within each group. Both intransitive verb diversity and transitive verb diversity were significantly associated with 3P subject diversity, after accounting for NDW; however, the strength of association observed between intransitive verb diversity and 3P subject diversity was nearly twice as large.

Conclusions: These findings provide new evidence that sentence-focused diversity measures are valid indicators of early language development and that intransitive verbs have a stronger association with diverse 3P subjects than transitive verbs. The value of adopting measures of verb and subject diversity with LT toddlers is discussed.

Supplemental material: https://doi.org/10.23641/asha.28577747.