Predicting speech-sound disorder outcomes in school-age children with hearing loss: The VicCHILD experience.

BACKGROUND: Congenital hearing loss is the most common birth anomaly, typically influencing speech and language development, with potential for later academic, social and employment impacts. Yet, surprisingly, the nuances of how speech is affected have not been well examined with regards to the subtypes of speech-sound disorder (SSD). Nor have the predictors of speech outcome been investigated within a sizeable population cohort. AIMS: (1) To describe the subtypes and prevalence of SSD in children with hearing loss. (2) To determine which characteristics of hearing loss predict the presence of SSD. METHODS & PROCEDURES: A total of 90 children (5-12 years of age) with permanent hearing loss were recruited from an Australian population cohort. Children completed a standardized speech assessment to determine the presence and subtype of SSD. Logistic regression was used to determine the predictors of speech outcome. Demographic, developmental and hearing-related predictors were examined. OUTCOMES & RESULTS: The prevalence of speech disorder overall was 58%, with the most common subtype being phonological delay in 49% of the sample. Factors most predictive of speech disorder were being male, younger and a bimodal user (i.e., using both a hearing aid and a cochlear implant). CONCLUSIONS & IMPLICATIONS: This is the first study, in a sizeable cohort, to describe the prevalence and predictive factors for SSD associated with hearing loss. Clinically, it could be beneficial to implement earlier targeted phonological interventions for children with hearing loss. What this paper adds What is already known on this subject Speech issues are common in children with hearing loss; however, the breakdown of subtypes of SSD (e.g., articulation versus phonological disorder) have not been previously described in a population cohort. This distinction is relevant, as each subtype calls for specific targeted intervention. Studies examining factors predictive of speech outcomes, across a range of hearing levels, are also lacking in a population cohort. What this paper adds to existing knowledge Data suggest the most common type of SSD in children with hearing loss is phonological delay. Males, younger children, and bimodal users were at greater risk of having a subtype of SSD. What are the potential or actual clinical implications of this work? The results are clinically pertinent as the speech diagnosis determines the targeted treatment. Phonological delay is responsive to treatment, and early targeted intervention may improve prognosis for speech outcomes for children with hearing loss.

Individual differences in executive control relate to metaphor processing: an eye movement study of sentence reading.

Metaphors are common elements of language that allow us to creatively stretch the limits of word meaning. However, metaphors vary in their degree of novelty, which determines whether people must create new meanings on-line or retrieve previously known metaphorical meanings from memory. Such variations affect the degree to which general cognitive capacities such as executive control are required for successful comprehension. We investigated whether individual differences in executive control relate to metaphor processing using eye movement measures of reading. Thirty-nine participants read sentences including metaphors or idioms, another form of figurative language that is more likely to rely on meaning retrieval. They also completed the AX-CPT, a domain-general executive control task. In Experiment 1, we examined sentences containing metaphorical or literal uses of verbs, presented with or without prior context. In Experiment 2, we examined sentences containing idioms or literal phrases for the same participants to determine whether the link to executive control was qualitatively similar or different to Experiment 1. When metaphors were low familiar, all people read verbs used as metaphors more slowly than verbs used literally (this difference was smaller for high familiar metaphors). Executive control capacity modulated this pattern in that high executive control readers spent more time reading verbs when a prior context forced a particular interpretation (metaphorical or literal), and they had faster total metaphor reading times when there was a prior context. Interestingly, executive control did not relate to idiom processing for the same readers. Here, all readers had faster total reading times for high familiar idioms than literal phrases. Thus, executive control relates to metaphor but not idiom processing for these readers, and for the particular metaphor and idiom reading manipulations presented.