Which skills underlie French-speaking children's lexical spelling acquisition in elementary school? Insight from a cross-sectional exploratory network study from Grade 1 to Grade 5.

Learning to spell in an inconsistent orthographic system is a true challenge for primary school children. Previous empirical studies have highlighted three main skills involved in this learning process: phonological skills, morphological skills, and children's sensitivity to graphotactic regularities. However, the literature shows contradictions in the exact nature of the contribution of each skill at different stages of the learning process. So, the aim of our study was to test the contribution of this set of skills in the acquisition of lexical spelling as a function of children's grade level. For this purpose, we assessed these dimensions in a cross-sectional sample of 1101 French-speaking children from Grade 1 to Grade 5. The analyses were conducted using data-driven exploratory network modeling. The results showed (a) a predominant role of phonological skills at the beginning of learning, which tends to decrease with advancing schooling; (b) an increasing contribution of morphological skills from Grade 1 to Grade 5 with a drop in Grade 4, which is the only contribution that continues to increase in Grade 5; and (c) a contribution of the sensitivity to graphotactic regularities that tends to be stable until Grade 4 before decreasing in Grade 5. Our findings show the importance of all three skills in a dynamic process in learning to spell. The implications of these results are discussed in light of the integration of multiple patterns model of learning to spell.

Derivational Morphology Training in French-Speaking, 9- to 14- Year-Old Children and Adolescents With Developmental Dyslexia: Does it Improve Morphological Awaraness, Reading and Spelling Outcome Measures?

Children with developmental dyslexia (DD) display partially preserved morphology skills which they rely upon for reading and spelling. Therefore, we conducted explicit and intensive training of derivational morphology in individuals with DD, ages 9 to 14 years, in order to assess its effect on: morphological awareness, reading (speed and accuracy), and spelling. Our pre-posttest design included a group trained in derivational morphology and a group of children who continued their business-as-usual rehabilitation program with their speech-language therapist. Results showed effects on morphological awareness and on the spelling of complex words, with a large between-group effect size for trained items and a large to moderate effect size for untrained items. All these gains tended to be maintained over time on the delayed posttest, 2 months later. For reading, the results were more contrasted, with large between-group effect sizes for accuracy and speed for trained items, reducing to a small effect for accuracy on the delayed posttest. For untrained items, small effects were observed on accuracy (at both posttests) but not on speed. These results are very promising and argue in favor of using derivational morphology as a medium to improve literacy skills in French-speaking children and adolescents with DD.

Dynamic Assessment of Narrative Skills for Identifying Developmental Language Disorder in Monolingual and Bilingual French-Speaking Children.

PURPOSE: Typically developing (TD) bilingual children usually produce narratives with preserved macrostructure (i.e., narrative scheme) but with impaired microstructure (i.e., language complexity). As for monolingual and bilingual children with developmental language disorder (DLD), they usually produce narratives with both impaired macro- and microstructure. It is therefore difficult to differentiate TD from DLD, on the basis of narrative production, especially in bilingual children. In this study, we examine whether a dynamic assessment (DA) task of narratives, using a pretest­teaching­posttest design, can differentiate TD from DLD, without disadvantaging bilinguals over monolinguals. METHOD: We recruited 118 French-speaking children (Mage = 8;5 [years;months]), with one experimental condition in which children benefited from a teaching phase (30 TD, 18 monolinguals and 12 bilinguals; 30 DLD, 15 monolinguals and 15 bilinguals) and one control condition (58 TD, 31 monolinguals and 27 bilinguals), in which children participated in another activity. In the pre- and posttest, children were asked to tell a story based on a series of pictures. During the teaching phase, an examiner asked children 12 specific questions about the story, targeting macro- and microstructural elements. Scores were attributed to the number of macro- and microstructural elements correctly produced and to the number of specific trained elements (TE) that were produced as a result of training. RESULTS: Scores improved on macrostructure and on the number of TE following teaching for all groups of the experimental condition (TD and DLD), whereas there was no progress in children of the control condition. TD participants and participants with DLD differed on all measures in both pre- and posttest, with no differences between monolinguals and bilinguals. CONCLUSIONS: Our dynamic task led to both improved narrative skills and TD/DLD differentiation, with bilinguals not being disadvantaged. Our study thus supports the existing literature indicating that DA can be used to diagnose narrative deficits in children with DLD.

The language-cognition interface in atypical development: Support for an integrative approach.

BACKGROUND: Links between the mastery of complex syntax and more general cognitive abilities (e.g., working memory [WM] and attention) are widely reported for both typically developing children and children with atypical language development, such as developmental language disorder (DLD). These observations have resulted in debates about whether the locus of breakdown in populations with known syntactic impairment is situated in a specific language system or a more general cognitive system. Recently, a hybrid model of language acquisition, the Parallel Combination Approach (PCA), in which both domain-specific and domain-general processes contribute to language development, was put forward. SUMMARY: Our review, which is the first to examine the validity of the PCA, compares a body of our own work investigating the language-cognition interface in various populations: children with specific learning difficulties (SLD), attention deficit hyperactivity disorder (ADHD) and DLD. We report findings from two cross-sectional studies (Studies 1 and 2), one priming study (Study 3) and two training studies (Studies 4 and 5). The results confirm a close link between WM, attention, and syntax, in line with domain-general approaches to language impairment. However, certain findings within this review also reveal that impaired general skills can be found alongside intact syntax, providing support for domain-specific approaches. While these results may initially appear contradictory, we argue that they are perfectly in line with the predictions made by the PCA. KEY MESSAGES: Study 1confirms that clinicians should assess syntax in children with SLD to avoid the missed diagnosis of comorbid DLD. Studies 2-3 offer perspectives on the differential diagnosis of ADHD and DLD and highlight the advantages of using probe tests and dynamic assessment when evaluating children with suspected syntactic impairment. Studies 4-5 describe a novel, empirically validated WM training program that has been shown to lead to syntactic improvements on clinical markers of DLD. Finally, the PCA is also clinically relevant as it underscores that children with the same diagnostic label can present dissimilar cognitive profiles with different sources of breakdown. Collectively, The various studies highlight the intricacy of the relationship between syntax and cognition, which cannot be easily described by traditional single-disciplinary frameworks.

The contribution of visual and linguistic cues to the production of passives in ADHD and DLD: evidence from thematic priming.

This study investigated how thematic priming via visual and linguistic cues influences the choice of syntactic voice in healthy French-speaking adults and in French-speaking children with typical and atypical development. In particular, we focused on children with attention deficit hyperactivity disorder (ADHD) and developmental language disorder (DLD), two clinical groups with documented syntactic difficulties. Twenty adults (M= 24;7) and 60 children aged 6-11 (20 typically developing, 20 with DLD and 20 with ADHD) were presented with agent or patient cues that progressively increased in strength over three conditions: a no cue condition, a visual cue condition with two cue types (perceptual vs. referential) and a linguistic cue condition with two cue types (topicalization of the agent/patient with and without subsequent sentence initiation). Results showed that all participants produced more passives after having been presented with a patient cue, regardless of cue type (cue > no cue), but linguistic cues facilitated the production of passives significantly more than visual cues (linguistic cue > visual cue). We also found that children with DLD were more sensitive than children with ADHD to visual cues (DLD > ADHD), which were more implicit than the linguistic cues and may have required more attentional resources. The opposite pattern (ADHD > DLD) was true for the linguistic cues, which required syntactic processing. These findings highlight how the development of dynamic tools using cue modality and cue sensitivity might be useful for discriminating children with and without syntactic impairment.

Training Syntax to Enhance Theory of Mind in Children with ASD.

Preschool children with neurotypical development (ND) trained on sentential complements ("X thinks/says that") improve their Theory of Mind (ToM) performance. Can complementation training also enhance ToM in children with Autism Spectrum Disorder (ASD)? Thirty-three children with ASD (Mage = 8;11) and 20 younger ND peers (Mage = 4;3) were trained on sentential complements (4-6 weeks, 2-3 times per week, via the DIRE i-Pad App). Pre-training and post-training comparisons show that (1) training boosted both complementation and ToM performance across groups; (2) improvements remained 4-6 weeks after training ended; (3) participants with milder ASD symptoms made most gains. Training on sentential complements thus seems beneficial for addressing ToM difficulties in children with ASD, especially those with milder symptoms.

A new dynamic word learning task to diagnose language disorder in French-speaking monolingual and bilingual children.

Tools to effectively assess the language performance of bilingual children are lacking. Static tests assessing vocabulary knowledge (e.g., naming task) are not appropriate for testing bilingual children due to different types of bias. Alternative methods have been developed to diagnose bilingual children, including measuring language learning (e.g., word learning) through dynamic assessment. Research conducted with English-speaking children indicates that DA of word learning is effective in diagnosing language disorders in bilingual children. In this study, we examine whether a dynamic word learning task, using shared-storybook reading, can differentiate French-speaking (monolingual and bilingual) children with developmental language disorder (DLD) from those with typical development (TD). Sixty children (4-8 years), 43 with TD and 17 with DLD, participated: 30 were monolinguals and 25 were bilinguals. The dynamic word-learning task used a shared-storybook reading context. The children had to learn four non-words, paired with novel objects, as well as their semantic characteristics (a category and a definition) during the reading of a story. Post-tests assessed the recall of the phonological form and the semantic features of the objects. Phonological and semantic prompts were given if the child was unable to name or describe the objects. Results indicated that children with DLD performed less well than those with TD on phonological recall, leading to fair sensitivity and good specificity at delayed post-test for young children (4-6 years). Semantic production did not differentiate the two groups: all children performed well at this task. In sum, children with DLD have more difficulties encoding the phonological form of the word. Our findings suggest that a dynamic word learning task using shared-storybook reading is a promising approach for diagnosing lexical difficulties in young French-speaking, monolingual and bilingual, children.

A Preliminary Examination of the Impact of Working Memory Training on Syntax and Processing Speed in Children with ASD.

In addition to deficits in pragmatics, children with autism spectrum disorders (ASD) have weaknesses in complex syntax and working memory (WM). These two deficits may be closely related. Previous work investigated the effects of WM training in developmental language disorders and showed significant improvement in both WM and syntax. The current study tests the impact of 12 h of WM training across 8 weeks in 30 children with ASD, aged 5 to 11. Results showed direct improvements on untrained WM tasks, as well as transfer effects to syntax and processing speed. Stronger WM led to better syntactic abilities. While they must be replicated, these exciting results provide impetus for further studies of WM interventions.

Working memory training in children with developmental language disorder: Effects on complex syntax in narratives.

This study assesses the impact of a working memory training program on the syntactic complexity of the spontaneous speech of French-speaking children with Developmental Language Disorder (DLD). Thirty-nine 6- to 12-year-old children with DLD were allocated to a WM training (DLDMM, N = 20) or an active control group (DLDSQULA, N = 19). The computerized training sessions took place three times a week, yielding 12 training hours per participant. Syntactic complexity was assessed in storytelling, measuring mean length of utterances, use of embedded clauses and rate of errors in complex utterances. The performance of participants with DLD was first compared to previous spontaneous data of 40 typically-developing (TD) children of the same age. Then, intragroup (pre- vs. post-test) and intergroup (DLDMM vs. DLDSQULA) comparisons were made to assess the impact of the working memory training on the language measures. Global results confirmed syntactic impairment in children with DLD, as opposed to TD children, with large differences for the use of embedded clauses. Findings also suggested gains in the mastery of embedded clauses in children who participated in the WM training, whereas no gains were observed in the DLD control group. These findings confirm deficits in complex syntax in children with DLD, in particular in embedded clauses, and may encourage the clinical use of language sample analysis, which provides an ecological account of children's language performance. While our results should be replicated on a larger scale, they also suggest positive transfer effects of working memory training on the capacity of participants with DLD to produce embedded clauses, in line with previous studies showing a positive effect of WM training on tasks of expressive syntax. It thus seems that working memory training can yield benefits for language, which leaves open the door to new therapeutic approaches for children with DLD.

Syntactic Strategy Training for Theory of Mind in Deaf Children.

Children who are deaf or hard of hearing (DHH) show delays in Theory of Mind (ToM) development. Complement sentences such as "Eliane says that Santa Clause exists" influence ToM performance. Can a training program targeting sentential complements enhance ToM? Twenty-one French-speaking DHH children (Mage = 8 years 11 months) with delays in ToM and sentential complements completed a first series of tests (T0). Children were tested again to control for maturation effects (T1), after which they were included in a 6- to 8-week training program targeting complements with verbs of communication. Post-training tests (T2) assessed if the training yielded improvements on complements (direct effect) and ToM (transfer effect). While no gains were noted in the absence of training (at T1), results indicate post-training (T2) improvements in complements and ToM tasks, suggesting that the acquisition of sentential complements provides a tool to represent subjective truths and boosts ToM reasoning in DDH children.

Executive Functions and Morphosyntax: Distinguishing DLD From ADHD in French-Speaking Children.

Attention deficit hyperactivity disorder (ADHD) is commonly associated with deficits in executive functions executive functions (EF), but children with this disorder frequently demonstrate co-occurring morphosyntactic impairment when assessed using standardized tests. On the other hand, children with developmental language disorder (DLD), a population defined by impaired linguistic functioning, are often diagnosed with comorbid EF deficits. We investigated EF and morphosyntax in 60 French-speaking children aged six to 12: 20 with typical development (TD), 20 with ADHD, and 20 with DLD. To obtain an EF profile for the different cognitive groups, we used standardized tests to assess lower-order EF skills, (i) selective attention and (ii) short-term memory capacity, and higher-order EF skills, (i) working memory capacity and (ii) attention shifting. To test morphosyntax, we used (i) a standardized omnibus test that elicited a variety of complex structures and (ii) a more fine-grained probe test that assessed the production of third person object clitic pronouns, a clinical marker of DLD in French. Children with ADHD and DLD were associated with different EF and morphosyntactic profiles: children in the ADHD group demonstrated higher-order EF weakness and difficulty on the omnibus morphosyntax task, whereas children with DLD showed both lower- and higher-order limitations and struggled with both morphosyntax tasks. Our findings indicate that deficits in morphosyntax are not characteristic of ADHD but that the performance of children with ADHD can mimic morphosyntactic impairment when all-encompassing omnibus tests evaluating various and unpredictable structures are used. If morphosyntax is tested using reliable markers of atypical language development and external cognitive-load factors are optimally reduced, there are significant discrepancies in the observed ADHD-DLD outcomes. Clinical implications that include perspectives for the differential diagnosis of ADHD and DLD are discussed.

Training Complements for Belief Reasoning in Developmental Language Disorder.

Purpose Children with developmental language disorder (DLD) experience difficulties with an important Theory of Mind milestone, namely, false belief (FB) reasoning. Their FB success relates to mastery of a linguistic structure that is also challenging for them, namely, sentential complements (e.g., Claire says/thinks [that Santa Claus exists]). Training typically developing (TD) children on complements has been shown to boost complements and, in turn, enhance FB, but such training has never been explored with children with DLD, which is the aim of the current study. Method Fifty French-speaking children followed a novel training program: 30 with DLD (M age = 7;3) and 20 TD (M age = 4;3). They engaged in iPad applications targeting complementation with verbs of communication (e.g., say, shout, answer) during eight to 12 sessions lasting 30 min. Training commenced within 1-2 weeks of pretests and ceased 1-2 weeks before immediate posttests. After immediate posttests, the majority of children were available to be tested with follow-up tests after 4-6 weeks of no training. Results Findings revealed that both TD and DLD groups benefited from the training to significantly improve their complementation and FB scores. The gains achieved during immediate posttests were moreover maintained 6-8 weeks after training ceased, as revealed by preserved levels of performance during follow-up posttests. Conclusion This research thus suggests new avenues for therapeutic interventions for children with DLD, namely, the incorporation of a program directly training complements, which holds the promise of a double benefit, both for these structures and for Theory of Mind.

Relationship between working memory and complex syntax in children with Developmental Language Disorder.

Some theories of Developmental Language Disorder (DLD) explain the linguistic deficits observed in terms of limitations in non-linguistic cognitive systems such as working memory. The goal of this research is to clarify the relationship between working memory and the processing of complex sentences by exploring the performance of 28 French-speaking children with DLD aged five to fourteen years and 48 typically developing children of the same age in memory and linguistic tasks. We identified predictive relationships between working memory and the comprehension and repetition of complex sentences in both groups. As for syntactic measures in spontaneous language, it is the complex spans that explain the major part of the variance in the control children. In children with DLD, however, simple spans are predictive of these syntactic measures. Our results thus reveal a robust relationship between working memory and syntactic complexity, with clinical implications for the treatment of children with DLD.

The Impact of Grammar on Mentalizing: A Training Study Including Children With Autism Spectrum Disorder and Developmental Language Disorder.

Training on complements in English, German, and Mandarin has been reported to trigger improvements on both complements and Theory of Mind (ToM), with typically developing (TD) pre-schoolers on the verge of developing these skills (Hale and Tager-Flusberg, 2003; Lohmann and Tomasello, 2003; Shuliang et al., 2014). In the current study, we build on the idea that increasing mastery of complementation holds the promise of enhancing ToM, and seek (i) to replicate the positive effects observed in previous work for this effect in French-speaking TD children, and (ii) to pilot extending this to clinical children, more specifically those with Autism Spectrum Disorder (ASD) and Developmental Language Disorder (DLD), through exploring whether improvement in the latter, clinical groups follows that of the TD group. Sixty children with ToM difficulties, 16 with ASD (aged 5;6-11;8), 20 with DLD (aged 4;8-9;0) and 24 typically developing children aged (2;9-5;3 years), participated in a 4-week training program. Half received training targeting sentential complements and half received a control training targeting lexical skills. Complementation training, but not lexical training, led to a significant direct increase in complements, and also had the indirect effect of significantly boosting belief reasoning. TD and clinical groups followed the same patterns of performance. These results confirm previous findings in other languages for TD, and further suggest promising new directions for therapeutic programs addressing ToM delays in populations of different aetiologies, namely the incorporation of a motivating training on complementation.

The Effect of Working Memory Training on a Clinical Marker of French-Speaking Children With Developmental Language Disorder.

Purpose Our work investigates the production of 3rd-person accusative clitic pronouns in French-speaking typically developing (TD) children and children with developmental language disorder (DLD) following a novel working memory (WM) training program (12 hrs of effective training) that specifically targets the components of WM that have been shown to be impaired in children with DLD and to be directly related to the mastery of clitics (Delage & Frauenfelder, submitted for publication; Durrleman & Delage, 2016). Method Sixteen TD children aged 5-12 years and 26 age-matched children with DLD completed our 8-week WM training program. Furthermore, an age-matched control group of 16 TD children and 17 children with DLD followed a scholastic training regime matched for intensity and frequency. Syntax and WM were assessed prior to and following the WM/scholastic training. Results Significant posttraining WM gains were found in TD children and children with DLD who took part in the WM training, and the production rate of 3rd-person accusative clitics significantly increased in children with DLD following the WM training. No significant WM or syntax gains were observed in the control group. Conclusion These findings are noteworthy as Melby-Lervåg and Hulme's (2013) meta-analysis concluded that existing WM training programs show short-lived generalized effects to other comparable measures of WM, but that there is no evidence that such training generalizes to less directly related tasks. That our study led to gains in skills that were not trained (i.e., syntax) suggests that a WM training regime that is firmly grounded in theory and that targets the specific mechanisms shown to underpin the acquisition of syntax may indeed provide effective remediation for children with DLD.

Developmental dyslexia and specific language impairment: distinct syntactic profiles?

Recent work exploring syntax in developmental dyslexia (DD) has identified morphosyntactic deficits, striking parallelisms between children with DD and specific language impairment (SLI). The question remains open if the underlying causes for such deficits are related to difficulties in phonology, which is affected in DD, or to working memory, as has been previously reported for SLI. We focus on the production of third person accusative clitic pronouns (ACC3) and of homophonous definite determiners in French-speaking children with DD and SLI as well as typically developing (TD) controls. If syntactic complexity modulates performance of DD children, as has already been shown for SLI, we predict children with DD to perform significantly worse on ACC3 compared to definite determiners, which are homophonous but syntactically simpler. In addition, if impairment in ACC3 stems from phonology or working memory difficulties, we expect ACC3 performance in both clinical groups to relate to performance on non-word repetition or forward/backward digit spans. We studied 2 groups of 21 children and adolescents, with DD and SLI (7-15 years) and age-matched TD controls. Results reveal significant weaknesses with ACC3 in DD and SLI groups compared to TD controls, but no difficulty for homophonous definite determiners, confirming a deficit relating specifically to syntactic complexity. As for links to phonology and working memory, a single correlation emerged between ACC3 and the backward digit span in SLI, but not in DD, suggesting different underlying sources for syntactic deficits in these populations. Clinical implications of these results are discussed.

MacroH2A1.1 regulates mitochondrial respiration by limiting nuclear NAD+ consumption.

Histone variants are structural components of eukaryotic chromatin that can replace replication-coupled histones in the nucleosome. The histone variant macroH2A1.1 contains a macrodomain capable of binding NAD+-derived metabolites. Here we report that macroH2A1.1 is rapidly induced during myogenic differentiation through a switch in alternative splicing, and that myotubes that lack macroH2A1.1 have a defect in mitochondrial respiratory capacity. We found that the metabolite-binding macrodomain was essential for sustained optimal mitochondrial function but dispensable for gene regulation. Through direct binding, macroH2A1.1 inhibits basal poly-ADP ribose polymerase 1 (PARP-1) activity and thus reduces nuclear NAD+ consumption. The resultant accumulation of the NAD+ precursor NMN allows for maintenance of mitochondrial NAD+ pools that are critical for respiration. Our data indicate that macroH2A1.1-containing chromatin regulates mitochondrial respiration by limiting nuclear NAD+ consumption and establishing a buffer of NAD+ precursors in differentiated cells.

Transcriptional Coactivator and Chromatin Protein PC4 Is Involved in Hippocampal Neurogenesis and Spatial Memory Extinction.

Although the elaborate combination of histone and non-histone protein complexes defines chromatin organization and hence regulates numerous nuclear processes, the role of chromatin organizing proteins remains unexplored at the organismal level. The highly abundant, multifunctional, chromatin-associated protein and transcriptional coactivator positive coactivator 4 (PC4/Sub1) is absolutely critical for life, because its absence leads to embryonic lethality. Here, we report results obtained with conditional PC4 knock-out (PC4(f/f) Nestin-Cre) mice where PC4 is knocked out specifically in the brain. Compared with the control (PC4(+/+) Nestin-Cre) mice, PC4(f/f) Nestin-Cre mice are smaller with decreased nocturnal activity but are fertile and show no motor dysfunction. Neurons in different areas of the brains of these mice show sensitivity to hypoxia/anoxia, and decreased adult neurogenesis was observed in the dentate gyrus. Interestingly, PC4(f/f) Nestin-Cre mice exhibit a severe deficit in spatial memory extinction, whereas acquisition and long term retention were unaffected. Gene expression analysis of the dorsal hippocampus of PC4(f/f) Nestin-Cre mice revealed dysregulated expression of several neural function-associated genes, and PC4 was consistently found to localize on the promoters of these genes, indicating that PC4 regulates their expression. These observations indicate that non-histone chromatin-associated proteins like PC4 play a significant role in neuronal plasticity.

Expression of Nucleolin Affects Microtubule Dynamics.

Nucleolin is present in diverse cellular compartments and is involved in a variety of cellular processes from nucleolar structure and function to intracellular trafficking, cell adhesion and migration. Recently, nucleolin has been localized at the mature centriole where it is involved in microtubule nucleation and anchoring. Although this new function of nucleolin linked to microtubule regulation has been identified, the global effects of nucleolin on microtubule dynamics have not been addressed yet. In the present study, we analyzed the roles of nucleolin protein levels on global microtubule dynamics by tracking the EB3 microtubule plus end binding protein in live cells. We have found that during microtubule growth phases, nucleolin affects both the speed and life time of polymerization and by analyzing catastrophe events, we showed that nucleolin reduces catastrophe frequency. This new property of nucleolin was then confirmed in a cold induced microtubule depolymerization experiment in which we have found that cold resistant microtubules were totally destabilized in nucleolin depleted cells. Altogether, our data demonstrate a new function of nucleolin on microtubule stabilization, thus bringing novel insights into understanding the multifunctional properties of nucleolin in healthy and cancer cells.

Cortical electrophysiological markers of language abilities in children with hearing AIDS: a pilot study.

OBJECTIVE: To investigate cortical auditory evoked potentials (CAEPs) in pediatric hearing aid (HA) users, with and without language impairment. DESIGN: CAEPs were measured in 11 pediatric HA users (age: 8-12 years) with moderate bilateral sensorineural hearing loss (HL); participants were classified according to language ability. CAEPs were also measured for a control group of 11 age-matched, normal-hearing (NH) children. RESULTS: HL children without language impairment exhibited normal CAEPs. HL children with language impairment exhibited atypical temporal CAEPs, characterized by the absence of N1c; frontocentral responses displayed normal age-related patterns. CONCLUSION: Results suggest that abnormal temporal brain function may underlie language impairment in pediatric HA users with moderate sensorineural HL.