Parental linguistic support in a home environment is associated with language development of preschool-aged children.

AIM: In today's increasingly digitalised society, there is a growing need for information on how parents can support their children's language development at home. We investigated the associations between three types of parental linguistic support and children's language skills in different domains. METHODS: Between April 2019 and March 2020, 164 children aged between 2.5 and 4.1 years and their parents were recruited via daycare centres in Helsinki. Information on how frequently parents read, told free stories and sang to their children was collected. The children's lexical and grammatical skills and general language ability were assessed using validated instruments. RESULTS: More frequent reading, storytelling and singing were all separately associated with higher-level expressive lexical and general expressive language ability. More frequent reading and storytelling were also associated with higher-level phonological skills. Only reading was associated with receptive skills. The regression analyses revealed that reading had the highest explanatory value for lexical and general language ability after controlling for the effect of background factors. Furthermore, storytelling had the highest explanatory value for grammatical skills. CONCLUSION: The results highlight the benefits of parental reading. However, broad use of all parental linguistic activities is recommended to support the development of children's different language domains.

The development of cortical processing of speech differs between children with cochlear implants and normal hearing and changes with parental singing.

Objective: The aim of the present study was to investigate speech processing development in children with normal hearing (NH) and cochlear implants (CI) groups using a multifeature event-related potential (ERP) paradigm. Singing is associated to enhanced attention and speech perception. Therefore, its connection to ERPs was investigated in the CI group. Methods: The paradigm included five change types in a pseudoword: two easy- (duration, gap) and three difficult-to-detect (vowel, pitch, intensity) with CIs. The positive mismatch responses (pMMR), mismatch negativity (MMN), P3a and late differentiating negativity (LDN) responses of preschoolers (below 6 years 9 months) and schoolchildren (above 6 years 9 months) with NH or CIs at two time points (T1, T2) were investigated with Linear Mixed Modeling (LMM). For the CI group, the association of singing at home and ERP development was modeled with LMM. Results: Overall, responses elicited by the easy- and difficult to detect changes differed between the CI and NH groups. Compared to the NH group, the CI group had smaller MMNs to vowel duration changes and gaps, larger P3a responses to gaps, and larger pMMRs and smaller LDNs to vowel identity changes. Preschoolers had smaller P3a responses and larger LDNs to gaps, and larger pMMRs to vowel identity changes than schoolchildren. In addition, the pMMRs to gaps increased from T1 to T2 in preschoolers. More parental singing in the CI group was associated with increasing pMMR and less parental singing with decreasing P3a amplitudes from T1 to T2. Conclusion: The multifeature paradigm is suitable for assessing cortical speech processing development in children. In children with CIs, cortical discrimination is often reflected in pMMR and P3a responses, and in MMN and LDN responses in children with NH. Moreover, the cortical speech discrimination of children with CIs develops late, and over time and age, their speech sound change processing changes as does the processing of children with NH. Importantly, multisensory activities such as parental singing can lead to improvement in the discrimination and attention shifting toward speech changes in children with CIs. These novel results should be taken into account in future research and rehabilitation.

Screen Time of Preschool-Aged Children and Their Mothers, and Children's Language Development.

Although children's increased screen time has been found to associate with poorer language development, it is open to question which part of language ability screen time specifically associates with. Our aim was to examine the association between children's screen time (alone and together with a parent), mothers' screen time, and the different domains of children's language skills. Mothers reported their children's (N = 164, aged 2.5 to 4.1 years) screen time and their own on a weekday and a day off. Children's lexical, phonological, morphological, receptive, and general language abilities were measured using validated tests. The connections between children's and mothers' screen time and children's language skills were analyzed using correlation analyses and linear regression models. The more the children used screen time alone, or the greater the amount of the mothers' screen time, the weaker the children's lexical and general language abilities when the children's age, maternal education level, and birth order were controlled for. We also found cumulative, negative links to the children's lexical and general language abilities when the amount of their screen time alone and the amount of the mothers' screen time were simultaneously included in the regression model. The results suggest that it is important to restrict both children's screen time spent alone and mothers' screen time.

Links of Prosodic Stress Perception and Musical Activities to Language Skills of Children With Cochlear Implants and Normal Hearing.

OBJECTIVES: A major issue in the rehabilitation of children with cochlear implants (CIs) is unexplained variance in their language skills, where many of them lag behind children with normal hearing (NH). Here, we assess links between generative language skills and the perception of prosodic stress, and with musical and parental activities in children with CIs and NH. Understanding these links is expected to guide future research and toward supporting language development in children with a CI. DESIGN: Twenty-one unilaterally and early-implanted children and 31 children with NH, aged 5 to 13, were classified as musically active or nonactive by a questionnaire recording regularity of musical activities, in particular singing, and reading and other activities shared with parents. Perception of word and sentence stress, performance in word finding, verbal intelligence (Wechsler Intelligence Scale for Children (WISC) vocabulary), and phonological awareness (production of rhymes) were measured in all children. Comparisons between children with a CI and NH were made against a subset of 21 of the children with NH who were matched to children with CIs by age, gender, socioeconomic background, and musical activity. Regression analyses, run separately for children with CIs and NH, assessed how much variance in each language task was shared with each of prosodic perception, the child's own music activity, and activities with parents, including singing and reading. All statistical analyses were conducted both with and without control for age and maternal education. RESULTS: Musically active children with CIs performed similarly to NH controls in all language tasks, while those who were not musically active performed more poorly. Only musically nonactive children with CIs made more phonological and semantic errors in word finding than NH controls, and word finding correlated with other language skills. Regression analysis results for word finding and VIQ were similar for children with CIs and NH. These language skills shared considerable variance with the perception of prosodic stress and musical activities. When age and maternal education were controlled for, strong links remained between perception of prosodic stress and VIQ (shared variance: CI, 32%/NH, 16%) and between musical activities and word finding (shared variance: CI, 53%/NH, 20%). Links were always stronger for children with CIs, for whom better phonological awareness was also linked to improved stress perception and more musical activity, and parental activities altogether shared significantly variance with word finding and VIQ. CONCLUSIONS: For children with CIs and NH, better perception of prosodic stress and musical activities with singing are associated with improved generative language skills. In addition, for children with CIs, parental singing has a stronger positive association to word finding and VIQ than parental reading. These results cannot address causality, but they suggest that good perception of prosodic stress, musical activities involving singing, and parental singing and reading may all be beneficial for word finding and other generative language skills in implanted children.

The Role of Music in Families of Children With Hearing Loss and Normal Hearing in Australia, Finland, and the UK.

The primary aim of this current study was to compare the role, importance and value placed on music by families with normally hearing (NH) children, to those who had a child with a hearing loss (HL) who wore either hearing aids and/or cochlear implants. A secondary aim was to see whether this differed between the countries. Parents of children aged 2-6 years living in Australia, Finland, and the United Kingdom were invited to complete the Role of Music in Families Questionnaire (RMFQ). Two groups of participants were recruited from each country: (i) parents of NH children, and (ii) parents of children with a HL. The RMFQ had seven subsections covering topics such as music participation, attitudes to music, importance of music in the family, and future perspectives on music. Three hundred and twenty-two families of NH children, and 56 families of children with HL completed the questionnaire (Australia: 50 NH, 25 HL; Finland: 242 NH, 21 HL; United Kingdom: 30 NH, 10 HL). Analyses compared between NH and HL groups within each country, and between the three countries for the NH group, and the HL group, independently. Overall, there were few significant differences between the participation levels, role, or importance of music in families with NH children compared to those with a child who had a HL, regardless of whether the families lived in Australia, Finland or the United Kingdom. Children first started to respond to music at similar ages, and overall music participation frequency, and music enjoyment were relatively similar. The importance of music in the family was also similar between the NH and HL groups. In comparing between the countries, Finnish children had a tendency to have higher participation rates in musical activities, with few other differences noted. Overall, the results of this study indicate that children, regardless of hearing levels or country of residence, have similar levels of music engagement and enjoyment, and HL is not seen as a contraindication to music participation and involvement by the parents involved in this study.

Why and how music can be used to rehabilitate and develop speech and language skills in hearing-impaired children.

This paper presents evidence for a strong connection between the development of speech and language skills and musical activities of children and adolescents with hearing impairment and/or cochlear implants. This conclusion is partially based on findings for typically hearing children and adolescents, showing better speech and language skills in children and adolescents with musical training, and importantly, showing increases of speech and language skills in children and adolescents taking part in musical training. Further, studies of hearing-impaired children show connections between musical skills, involvement in musical hobbies, and speech and language skills. Even though the field is still lacking large-scale randomised controlled trials on the effects of musical interventions on the speech and language skills of children and adolescents with hearing impairments and cochlear implants, the current evidence seems enough to urge speech therapists, music therapists, music teachers, parents, and children and adolescents with hearing impairments and/or cochlear implants to start using music for enhancing speech and language skills. For this reason, we give our recommendations on how to use music for language skill enhancement in this group.

The MMN as a viable and objective marker of auditory development in CI users.

In the present article, we review the studies on the use of the mismatch negativity (MMN) as a tool for an objective assessment of cochlear-implant (CI) functioning after its implantation and as a function of time of CI use. The MMN indexes discrimination of different sound stimuli with a precision matching with that of behavioral discrimination and can therefore be used as its objective index. Importantly, these measurements can be reliably carried out even in the absence of attention and behavioral responses and therefore they can be extended to populations that are not capable of behaviorally reporting their perception such as infants and different clinical patient groups. In infants and small children with CI, the MMN provides the only means for assessing the adequacy of the CI functioning, its improvement as a function of time of CI use, and the efficiency of different rehabilitation procedures. Therefore, the MMN can also be used as a tool in developing and testing different novel rehabilitation procedures. Importantly, the recently developed multi-feature MMN paradigms permit the objective assessment of discrimination accuracy for all the different auditory dimensions (such as frequency, intensity, and duration) in a short recording time of about 30 min. Most recently, such stimulus paradigms have been successfully developed for an objective assessment of music perception, too.

Interplay between singing and cortical processing of music: a longitudinal study in children with cochlear implants.

Informal music activities such as singing may lead to augmented auditory perception and attention. In order to study the accuracy and development of music-related sound change detection in children with cochlear implants (CIs) and normal hearing (NH) aged 4-13 years, we recorded their auditory event-related potentials twice (at T1 and T2, 14-17 months apart). We compared their MMN (preattentive discrimination) and P3a (attention toward salient sounds) to changes in piano tone pitch, timbre, duration, and gaps. Of particular interest was to determine whether singing can facilitate auditory perception and attention of CI children. It was found that, compared to the NH group, the CI group had smaller and later timbre P3a and later pitch P3a, implying degraded discrimination and attention shift. Duration MMN became larger from T1 to T2 only in the NH group. The development of response patterns for duration and gap changes were not similar in the CI and NH groups. Importantly, CI singers had enhanced or rapidly developing P3a or P3a-like responses over all change types. In contrast, CI non-singers had rapidly enlarging pitch MMN without enlargement of P3a, and their timbre P3a became smaller and later over time. These novel results show interplay between MMN, P3a, brain development, cochlear implantation, and singing. They imply an augmented development of neural networks for attention and more accurate neural discrimination associated with singing. In future studies, differential development of P3a between CI and NH children should be taken into account in comparisons of these groups. Moreover, further studies are needed to assess whether singing enhances auditory perception and attention of children with CIs.

The perception of prosody and associated auditory cues in early-implanted children: the role of auditory working memory and musical activities.

OBJECTIVE: To study prosodic perception in early-implanted children in relation to auditory discrimination, auditory working memory, and exposure to music. DESIGN: Word and sentence stress perception, discrimination of fundamental frequency (F0), intensity and duration, and forward digit span were measured twice over approximately 16 months. Musical activities were assessed by questionnaire. STUDY SAMPLE: Twenty-one early-implanted and age-matched normal-hearing (NH) children (4-13 years). RESULTS: Children with cochlear implants (CIs) exposed to music performed better than others in stress perception and F0 discrimination. Only this subgroup of implanted children improved with age in word stress perception, intensity discrimination, and improved over time in digit span. Prosodic perception, F0 discrimination and forward digit span in implanted children exposed to music was equivalent to the NH group, but other implanted children performed more poorly. For children with CIs, word stress perception was linked to digit span and intensity discrimination: sentence stress perception was additionally linked to F0 discrimination. CONCLUSIONS: Prosodic perception in children with CIs is linked to auditory working memory and aspects of auditory discrimination. Engagement in music was linked to better performance across a range of measures, suggesting that music is a valuable tool in the rehabilitation of implanted children.

Music and speech prosody: a common rhythm.

Disorders of music and speech perception, known as amusia and aphasia, have traditionally been regarded as dissociated deficits based on studies of brain damaged patients. This has been taken as evidence that music and speech are perceived by largely separate and independent networks in the brain. However, recent studies of congenital amusia have broadened this view by showing that the deficit is associated with problems in perceiving speech prosody, especially intonation and emotional prosody. In the present study the association between the perception of music and speech prosody was investigated with healthy Finnish adults (n = 61) using an on-line music perception test including the Scale subtest of Montreal Battery of Evaluation of Amusia (MBEA) and Off-Beat and Out-of-key tasks as well as a prosodic verbal task that measures the perception of word stress. Regression analyses showed that there was a clear association between prosody perception and music perception, especially in the domain of rhythm perception. This association was evident after controlling for music education, age, pitch perception, visuospatial perception, and working memory. Pitch perception was significantly associated with music perception but not with prosody perception. The association between music perception and visuospatial perception (measured using analogous tasks) was less clear. Overall, the pattern of results indicates that there is a robust link between music and speech perception and that this link can be mediated by rhythmic cues (time and stress).

Children's brain responses to sound changes in pseudo words in a multifeature paradigm.

OBJECTIVE: The multifeature mismatch negativity (MMN) paradigm has previously been used to study MMN responses to changes in tones or isolated syllables. We tested 4-12 year old children's MMNs to changes in a naturally produced pseudo word context. METHODS: We studied preschoolers' (under the age of 7 years, N = 15, mean age 5 years 4 months) and school childrens' (over the age of 7 years, N = 15, mean age 9 years 3 months) MMNs to five types of changes (vowel duration, fundamental frequency, gap, intensity, vowel identity) in the middle syllable of a pseudo word [tɑtɑtɑ] using a multifeature paradigm. RESULTS: Vowel duration and gap changes elicited larger frontocentral MMN responses than other change types and the vowel identity change also produced an early positive p-MMR. The presence of the MMN was also determined at the individual level, and it was found that vowel duration and gap deviants produced MMNs in most of the participants. CONCLUSIONS: The current study shows that children's neural speech sound discrimination can be assessed in a word context in a short recording time (30 min) by using the multifeature paradigm. SIGNIFICANCE: A paradigm which can be used to investigate the discrimination of several change types of speech-sounds in a natural context can be useful for investigating speech development and deficits.

Cortical processing of musical sounds in children with Cochlear Implants.

OBJECTIVE: We studied the neurocognitive mechanisms of musical instrument sound perception in children with Cochlear Implants (CIs) and in children with normal hearing (NH). METHODS: ERPs were recorded in a new multi-feature change-detection paradigm. Three magnitudes of change in fundamental frequency, musical instrument, duration, intensity increments and decrements, and presence of a temporal gap were presented amongst repeating 295 Hz piano tones. Independent Component Analysis was utilized to remove artifacts caused by the Cochlear Implants. RESULTS: The ERPs were similar in the two groups across all perceptual dimensions except for intensity increment deviants. CI children had smaller and earlier P1 responses compared to controls, and their MMN responses showed less accurate neural detection of changes of musical instrument, sound duration, and temporal structure. P3a responses suggested that poor neural detection of musical instruments affected their involuntary attention shift. CONCLUSIONS: The similarities of neurocognitive processing are surprising in the light of the limited auditory input provided by the CI, suggesting that many types of changes are adequately processed by the CI children. SIGNIFICANCE: Our results indicate that CI children's auditory cortical functioning may be enhanced, and difficulties in auditory perception and in attention switching towards sound events alleviated, by multisensory musical activities.