Phonology, morphology and speech processing development in Greek-speaking children.

Α psycholinguistic framework for speech processing was adopted to investigate the development of phonological and morphological skills in children learning Greek. It was investigated whether morphological items pose specific challenges in terms of speech processing. Two groups of typically developing children aged 3.0-3.5 years (N = 16) and 4.6-5.0 years (N = 22), respectively, were assessed longitudinally at three assessment points 6 months apart. A range of phonologically based and morphologically based experimental speech processing tasks was administered to address the research question, along with language comprehension and production assessments to ensure that the children were developmentally typical. Stimuli of minimal phonological difference and minimal morphological difference, respectively, were used. Phonologically based experimental stimuli were used to assess performance differences across properties such as voicing, manner and place of articulation, in addition to variation in phonotactic structure. Morphologically based experimental stimuli were used to assess the impact of characteristics such as verb tense and possessive pronouns. Stimuli were incorporated into tasks of real word and nonword auditory discrimination and repetition, to assess input and output processing. Items were matched across tasks so that comparisons could be made. On most of the matched tasks, there was no significant difference in performance accuracy between morphological and phonological conditions. Moreover, a significant relationship was found between domains. It is suggested that morphological items, compared to phonological items, do not pose specific challenges in terms of speech processing. The clinical implications of these findings for assessment and intervention are discussed.

Talking in Time: The development of a self-administered conversation analysis based training programme for cochlear implant users.

Objectives: Training software to facilitate participation in conversations where overlapping talk is common was to be developed with the involvement of Cochlear implant (CI) users. Methods: Examples of common types of overlap were extracted from a recorded corpus of 3.5 hours of British English conversation. In eight meetings, an expert panel of five CI users tried out ideas for a computer-based training programme addressing difficulties in turn-taking. Results: Based on feedback from the panel, a training programme was devised. The first module consists of introductory videos. The three remaining modules, implemented in interactive software, focus on non-overlapped turn-taking, competitive overlaps and accidental overlaps. Discussion: The development process is considered in light of feedback from panel members and from an end of project dissemination event. Benefits, limitations and challenges of the present approach to user involvement and to the design of self-administered communication training programmes are discussed. Conclusion: The project was characterized by two innovative features: the involvement of service users not only at its outset and conclusion but throughout its course; and the exclusive use of naturally occurring conversational speech in the training programme. While both present practical challenges, the project has demonstrated the potential for ecologically valid speech rehabilitation training.

Patient and public involvement in reducing health and care research waste.

PLAIN ENGLISH SUMMARY: As much as 85 % of health research is believed to be wasted because it is not published or reported, the design is poor or does not consider what is already known in the topic area. Although a great deal of work has been done in the UK to reduce research waste, the role of patients and the public has not been discussed.This paper describes a survey, on the role of patients in reducing research waste, which was carried out as part of a larger piece of work on reducing waste in healthcare. The study found that patients were interested in reducing research waste. The key roles they play in research, for example being co-applicants for funding, members of project teams, co-researchers, means they have some shared responsibility for making sure the quality of research is high. This includes finding out what is already known about a topic and getting the study design right before seeking funding, publishing and reporting the results when the study is finished. Recognising where waste happens is part of good management of a research study. ABSTRACT: Background Eighty five per cent of health research expenditure is potentially wasted due to failure to publish research, unclear reporting of research that is published, and the failure of new research studies to systematically review previous research in the same topic area, poor study design and conduct. A great deal of progress has been made to address this issue but the role of patients and the public has not been considered.Main A small survey was undertaken, as part of a larger programme of work on reducing health and care waste, to understand the role of patients in reducing research waste. The study showed that patients are interested in this issue particularly in relation to the prioritisation of research and patient and public involvement.Conclusions Patients undertake key roles in the research process including co-applicancy, project management, or as co-researchers. This brings responsibility for ensuring high quality research and value for money. Responsibility for recognition of the potential for wasteful practices is part of the conduct and operation of research studies.

Phonological awareness development in children with and without spoken language difficulties: A 12-month longitudinal study of German-speaking pre-school children.

PURPOSE: There is strong empirical evidence that English-speaking children with spoken language difficulties (SLD) often have phonological awareness (PA) deficits. The aim of this study was to explore longitudinally if this is also true of pre-school children speaking German, a language that makes extensive use of derivational morphemes which may impact on the acquisition of different PA levels. METHOD: Thirty 4-year-old children with SLD were assessed on 11 PA subtests at three points over a 12-month period and compared with 97 four-year-old typically developing (TD) children. RESULT: The TD-group had a mean percentage correct of over 50% for the majority of tasks (including phoneme tasks) and their PA skills developed significantly over time. In contrast, the SLD-group improved their PA performance over time on syllable and rhyme, but not on phoneme level tasks. Group comparisons revealed that children with SLD had weaker PA skills, particularly on phoneme level tasks. CONCLUSION: The study contributes a longitudinal perspective on PA development before school entry. In line with their English-speaking peers, German-speaking children with SLD showed poorer PA skills than TD peers, indicating that the relationship between SLD and PA is similar across these two related but different languages.

Reducing waste in the NHS: an overview of the literature and challenges for the nursing profession.

Waste in the NHS is estimated to account for 20% of health expenditure. This article examines the literature on reducing waste, analyses some approaches to waste reduction, and identifies the role that nurses and other health professionals can play in developing a sustainable NHS. For the purposes of the article, and to inform nursing practice, the definition of, and discussion about, waste is broader than that outlined by the Department for Environment, Food and Rural Affairs (Defra) controlled waste regulations, and the Royal College of Nursing classification. It includes clinical waste, waste arising out of clinical practice, service delivery and care, infrastructure, and carbon emissions.

Managing resources and reducing waste in healthcare settings.

The NHS is under pressure to increase its effectiveness and productivity. Nurses are tasked with delivering effective and efficient care, as well as improving patient safety, experiences and results. The reduction of waste in service delivery, care and treatment can release time and resources for nurses to engage in direct patient care. Nurses have an important role in reducing waste and influencing other professionals in the healthcare environment to increase their efficiency and productivity.

Rate of multilingual phonological acquisition: Evidence from a cross-sectional study of English-Mandarin-Malay.

Early child multilingual acquisition is under-explored. Using a cross-sectional study approach, the present research investigates the rate of multilingual phonological acquisition of English-Mandarin-Malay by 64 ethnic Chinese children aged 2;06-4;05 in Malaysia--a multiracial-multilingual country of Asia. The aims of the study are to provide clinical norms for speech development in the multilingual children and to compare multilingual acquisition with monolingual and bilingual acquisition. An innovative multilingual phonological test which adopts well-defined scoring criteria drawing upon local accents of English, Mandarin and Malay is proposed and described in this article. This procedure has been neglected in the few existing Chinese bilingual phonological acquisition studies resulting in peculiar findings. The multilingual children show comparable phonological acquisition milestones to that of monolingual and bilingual peers acquiring the same languages. The implications of the present results are discussed. The present findings contribute to the development of models and theories of child multilingual acquisition.

The development of phonological representations in Mandarin-speaking children: Evidence from a longitudinal study of phonological awareness.

Two competing approaches to the analysis of the phonological structure of Mandarin syllables have been put forward. The first and more traditional approach is that a syllable can be segmented into initial consonant, medial glide, nucleus plus coda and tone. The second approach does not distinguish the non-compulsory medial glide as an independent element. To compare and evaluate these two different approaches, the development of phoneme-level awareness was investigated in 67 Mandarin-speaking children in Year 1 of school (mean age: 6;9) and Year 5 (mean age: 10;1). Results showed that at school entry some children were sensitive to glides and to a lesser extent to codas; their number increased by Year 5. This suggests that spoken language experience is enough for some children to acquire the representation of glides and codas; this is consistent with the traditional model of the Mandarin syllable, with both glides and codas as independent elements. However, the children's task performance was generally rather poor, even in Year 5, suggesting that development of phonemic sensitivity in Mandarin speaking children is not substantially improved by increased literacy experience.

The uses of overlap: carer-child interaction involving a nine-year-old boy with auditory neuropathy.

The subject of this single case study, Ricky, is a nine-year-old boy with a profound hearing loss arising from auditory neuropathy. Despite cochlear implantation at the age of two, his receptive language skills remain very restricted and his speech is unintelligible. Techniques of interactional linguistics are used to analyse recordings of Ricky and his mother during shared book reading. Both participants display competences in managing turn-taking and overlapping talk that enable them to progress the book-reading activity, to talk spontaneously on topically related matters and also to handle issues of phonetic and linguistic repair. Instances of both competitive and non-competitive overlap reveal that Ricky has access to interactionally important prosodic skills. The study thus reinforces the need, when assessing a child's potential to understand and use spoken language, to examine the child's talk from an interactional perspective. It further indicates that overlapping talk is not necessarily a problem; indeed it can be part of a solution to issues of interpersonal understanding that routinely arise in the course of talk-in-interaction.

Tracking change in children with severe and persisting speech difficulties.

Standardised tests of whole-word accuracy are popular in the speech pathology and developmental psychology literature as measures of children's speech performance. However, they may not be sensitive enough to measure changes in speech output in children with severe and persisting speech difficulties (SPSD). To identify the best ways of doing this, we compared a range of commonly used procedures for perceptual phonological and phonetic analysis of developmental speech difficulties. Data are drawn from four children with SPSD, recorded at 4 years and again at 6 years old performing naming and repetition tasks. Measures of speech output included percentage of whole words correct (PWC), percentage of consonants correct (PCC), proportion of whole-word proximity (PWP), phonological pattern (process) analysis and phonetic inventory analysis. Results indicate that PWC captures change only when identical stimuli are used across time points. PCC is a more robust indicator of change, being less affected by the choice of stimuli. PWP also captures change across time and tasks, while appearing to be more sensitive than PCC to psycholinguistic variables. PCC and PWP are thus both potentially useful tools for evaluating speech outcomes.

Pitch contour matching and interactional alignment across turns: an acoustic investigation.

In order to explore the influence of context on the phonetic design of talk-in-interaction, we investigated the pitch characteristics of short turns (insertions) that are produced by one speaker between turns from another speaker. We investigated the hypothesis that the speaker of the insertion designs her turn as a pitch match to the prior turn in order to align with the previous speaker's agenda, whereas non-matching displays that the speaker of the insertion is non-aligning, for example to initiate a new action. Data were taken from the AMI meeting corpus, focusing on the spontaneous talk of first-language English participants. Using sequential analysis, 177 insertions were classified as either aligning or non-aligning in accordance with definitions of these terms in the Conversation Analysis literature. The degree of similarity between the pitch contour of the insertion and that of the prior speaker's turn was measured, using a new technique that integrates normalized F0 and intensity information. The results showed that aligning insertions were significantly more similar to the immediately preceding turn, in terms of pitch contour, than were non-aligning insertions. This supports the view that choice of pitch contour is managed locally, rather than by reference to an intonational lexicon.

Repair in the peer talk of 6-year-old boys.

This article reports a qualitative analysis of linguistic and interactional aspects of repair in naturalistic play, interaction between three 6-year-olds (C, D and F), one of whom (child D) displays some speech and language difficulties. The methodology draws on conversation analysis together with perceptual phonetic observation. The analysis reveals differences in the use of repair strategies. Although all three boys used self-repair, only C and F initiated other repair. Despite child D's reduced intelligibility, phonetic issues were never oriented to in repair initiations by C or F, nor were they self-repaired by D. In general, D, the speaker with the fewest linguistic resources, used collaborative interpersonal strategies to rectify sources of breakdown in conversation.

Development of a test battery for assessing phonological awareness in German-speaking children.

The development of phonological awareness (PA), the ability to reflect on the sound structure of words independent of their meaning, has been extensively explored in English-speaking children. However, this is not the case for other languages. The aim of this study was to develop a comprehensive PA test battery for German-speaking preschool children, considering psycholinguistic, linguistic, and cognitive aspects and to carry out analyses of its psychometric properties. Cross-sectional data from a sample of 55 children (CA 4;0-6;11 years) were collected. Preliminary findings confirm validity and reliability of the test battery, and support previous findings that PA develops from larger to smaller linguistic units. Phoneme-level tasks were consistently associated with letter knowledge. The new instrument is a promising tool for basic research (e.g. cross-linguistic comparisons of PA development) as well as for clinical and educational practice (e.g. planning speech and language therapy or literacy-oriented intervention).

Investigating prosodic ability in Williams syndrome.

This paper investigates whether people with Williams syndrome (WS) have prosodic impairments affecting their expression and comprehension of four main uses of intonation. Two adolescent males with WS were assessed using the PEPS-C battery, which considers prosodic abilities within a psycholinguistic framework, assessing prosodic form and function in both the input and output domains. The performances of the subjects with WS were compared with control data for age and language-comprehension matched children. The results revealed significant prosodic impairment affecting all areas of the profile. Crucially, however, different profiles of strengths and weaknesses were revealed for the two subjects. The results support the growing view that WS is a heterogeneous population in terms of linguistic abilities.

Phonological therapy within a psycholinguistic framework: promoting change in a child with persisting speech difficulties.

BACKGROUND: Single case studies are a valuable means of providing information about the outcomes of speech and language intervention. Many previous studies have used phonological analysis as a theoretical basis, while others have used psycholinguistic models. The present study combines these approaches to assessment, intervention and evaluation of outcomes. AIMS: The aim of the research was to determine if intensive psycholinguistically based intervention could result in (a) specific and (b) generalized improvements in the speech production of a child with severe and persisting phonological difficulties. METHODS AND PROCEDURES: A single subject research design was used with pre- and post-intervention assessment carried out. Assessment took place at two levels: the macro level focused on global change in the child's speech processing system using psycholinguistic speech profiling and phonological analyses; the micro assessment focused on specific, treated (and matched control) stimuli. There were three phases of intervention with a total of 30 hours of therapy. OUTCOMES AND RESULTS: Micro evaluation showed significant changes in Katy's single word and connected speech production--as well as in other areas such as spelling and auditory discrimination of closely related real word pairs. Macro evaluation revealed significant improvement in speech severity indices (PCC, PPC), and gains in her ability to discriminate between closely related real word pairs. These changes were maintained at follow-up seven months after intervention had ceased. CONCLUSIONS: Specific and intensive intervention brought about significant improvements in this child's speech, spelling and auditory discrimination at the micro level, and in speech and auditory discrimination at a macro level. The macro level assessments reveal persisting core deficits requiring further focused intervention before changes can be observed more widely. When carefully defined and evaluated, speech and language intervention can have positive outcomes for children with severe and persisting speech difficulties.

Intonation development from five to thirteen.

Research undertaken to date suggests that important developments in the understanding and use of intonation may take place after the age of 5;0. The present study aims to provide a more comprehensive account of these developments. A specially designed battery of prosodic tasks was administered to four groups of thirty children, from London (U.K.), with mean ages of 5;6, 8;7, 10;10 and 13;9. The tasks tap comprehension and production of functional aspects of intonation, in four communicative areas: CHUNKING (i.e. prosodic phrasing), AFFECT, INTERACTION and FOCUS. Results indicate that there is considerable variability among children within each age band on most tasks. The ability to produce intonation functionally is largely established in five-year-olds, though some specific functional contrasts are not mastered until C.A. 8;7. Aspects of intonation comprehension continue to develop up to C.A. 10;10, correlating with measures of expressive and receptive language development.

Intonation abilities of children with speech and language impairments.

Intonation has been little studied in children with speech and language impairments, although deficits in related aspects of prosody have been hypothesized to underlie specific language impairment. In this study a new intonation battery, the Profiling Elements of Prosodic Systems-Child version (PEPS-C), was administered to 18 children with speech and/or language impairments (LI). PEPS-C comprises 16 tasks (8 x 8, Input x Output) tapping phonetic and functional aspects of intonation in four areas: grammar, affect, interaction, and pragmatics. Scores were compared to a chronological age (CA) matched group of 28 children and a group of 18 children matched for language comprehension (LC). Measures of language comprehension, expressive language, nonverbal intelligence, and segmental phonology were also taken. The LI group did not score significantly below the LC group on any PEPS-C task. On 5 of 16 tasks, the LI group scored significantly lower than the CA group. In the LI group, there were just 2 significant correlations between a PEPS-C task and 1 of the nonprosodic measures. The results support the view that intonation is relatively discrete from other levels of speech and language while suggesting some specific areas of possible vulnerability: auditory memory for longer prosodic strings and the of prosody for pragmatic/interactional purposes.

Between-word junctures in early multi-word speech.

Most children aged 1;6 to 2;0 begin to use utterances of two words or more. It is therefore important for child phonologists to consider the development of phonetic and phonological phenomena that characterize connected speech. The longitudinal case study reported here investigated three juncture types--assimilation, elision and liaison--in the speech of a typically-developing child between the ages of 2;4 and 3;4. Attempts at production of these adult juncture types occurred from the onset of two-word utterances. However, for some juncture types, the child still had to perfect the intergestural relationships and gestural articulations that the adult between-word junctures demand. This process of phonetic development was largely accomplished by the age of 3;4. With one exception, between-word junctures appear not to be the result of learned phonological rules or processes. The exception is liaison involving /r/, which did not occur until the child was three years old.

From phonological therapy to phonological awareness.

Children with speech difficulties often have delayed phonological awareness development and associated literacy problems. Speech-language pathologists (S-LPs) typically use phonological and articulatory approaches in their treatment of such children. However, it is unclear to what extent phonological awareness training, originally designed to promote literacy skills, might also improve children's speech output. This article adopts a psycholinguistic approach to examine the nature and development of phonological awareness and to explore the relationship between phonological awareness training and phonological therapy. The role of phonological awareness in predicting literacy development in children is discussed, and principles for analyzing the psycholinguistic properties of therapy tasks are presented. Phonological awareness cannot be dealt with independently as it is an integral part of articulation and phonological intervention. Further, phonological awareness is a necessary "on-line" skill in the dynamic communication process between therapist and child. Failure to take this into account will result in inappropriately targeted therapy and pragmatic breakdown between the child and S-LP.