The Method of Surgical Lip Repair Affects Speech Outcomes in Children With Bilateral Cleft Lip and Palate.

OBJECTIVE: It was hypothesized that lip repair protocols in children with bilateral cleft lip and palate (BCLP) would affect development of bilabial consonants /m/ /b/ /p/. This study compared speech outcomes in 2 surgical groups. DESIGN: A retrospective case note investigation. SETTING: UK Cleft Centre (2000-2009). PATIENTS: Forty-nine children with complete BCLP, of whom 26 had a 1-stage and 23 a 2-stage bilateral cleft lip repair. INTERVENTIONS: One-stage cleft lip repair versus a 2-staged cleft lip repair. MAIN OUTCOME MEASURES: Bilabial consonant production at 18 months, 3 and 5 years of age. Cleft Speech Characteristics (CSCs) at age 5. RESULTS: At age 18 months, 81% of the 1-stage lip repair group and 4% of the 2-stage lip repair group produced bilabial consonants (P <·0001, Fisher test). At age 3 years, 81% of the 1-stage and 26% of the 2-stage lip repair groups produced bilabial consonants (P =·0133, Fisher test). At age 5 years, both groups had similar bilabial consonant production, but children in the 2-stage lip repair group had more frequent and severe CSCs (P = ·0037, χ2). CONCLUSION: A 1-stage lip repair for children with complete BCLP resulted in better bilabial consonant production at 18 months and 3 years of age than a 2-stage lip repair. At age 5 years both groups had bilabial consonants but children in the 2-stage lip repair group had worse CSCs. The surgical protocol for bilateral cleft lip repair affected speech outcome in children with BCLP.

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.

The influence of segmental and suprasegmental phonological awareness on word and pseudoword reading-A comparison between native English speakers and native Chinese speakers of English.

Segmental and suprasegmental phonological awareness (PA) are closely related to word reading skills in native speakers learning to read an alphabetic script as used in English. However, their roles in English word and pseudoword reading among native Chinese (NC) speakers, and how English proficiency might affect these relationships, remain less clear. This study examined the links between English segmental/suprasegmental PA and word/pseudoword reading in NC and native English (NE) speakers. Both child and adult participants were assessed on English segmental and suprasegmental PA, alongside vocabulary, at a single time point. The results showed that both segmental PA (elision and segmenting nonwords) and suprasegmental PA (aural suffix judgment and written suffix judgment) were significantly correlated with English real word and pseudoword reading of both NE and NC children, and NC adults, but not NE adults. Moreover, for NE and NC children, segmental PA correlated stronger with real word reading than suprasegmental PA after controlling for vocabulary. Among NC adults, both segmental and suprasegmental PA significantly contributed to real word reading. For pseudoword reading, after controlling for vocabulary, segmental PA had a stronger correlation among NC children and adults, while suprasegmental PA was more influential for NE children. This research gives insights into factors influencing NC speakers' English word reading ability, bearing essential implications for enhancing second language literacy in learners from a logographic background.

A meta-analysis of training effects on English phonological awareness and reading in native Chinese speakers.

Enhancing English phonological awareness is critical in promoting native English speakers' reading development. However, less attention has been paid to the role of phonological awareness development for English language learners in a logographic context. This meta-analysis aims to evaluate the effectiveness of training native Chinese speakers' English phonological awareness and reading across age groups. Thirty-three articles, including 37 independent samples, were identified as training studies that reported English phonological awareness as an outcome measure, and 16 articles, including 17 independent samples, featured training studies that reported reading as an outcome measure. Results based on a random-effect model revealed the effect sizes for overall English phonological awareness (including English syllable awareness, phoneme awareness, and rhyme awareness) and overall reading (including word reading and pseudoword reading) were g = 0.651 (n = 3137) and g = 0.498 (n = 1506), respectively. Specifically, instructional training exerted a small impact on word reading (g = 0.297), moderate effects on syllable awareness (g = 0.468) and pseudoword reading (g = 0.586), a medium to large effect on phoneme awareness (g = 0.736), and a large impact on rhyme awareness (g = 0.948). The moderator analyses yielded several significant findings. Regarding the English phonological awareness outcome, programs integrating lexical semantic knowledge exhibited the largest trend in enhancing native Chinese speakers' skills. Among all age groups, upper elementary students benefited most from instructional training. Furthermore, more intensive training had a greater impact than less intensive training. In terms of the reading outcome, similar to English phonological awareness findings, upper elementary students realized the greatest improvements. Additionally, unpublished articles indicated a larger training effect on reading than published ones. These findings provide practitioners with guidelines for delivering effective instruction to promote phonological awareness and reading ability for English language learners in a logographic language context.

How does exercise benefit performance on cognitive tests in primary-school pupils?

AIM: We have previously demonstrated improved cognitive performance after a classroom-based exercise regime. In this study, we examined the reproducibility of this effect in a more socio-economically diverse sample and also investigated whether cognitive benefits of exercise were moderated by body mass index (BMI) or symptoms of attention-deficit-hyperactivity disorder (ADHD). METHOD: A crossover design trial (2 wks in duration) randomized 552 children (mean age 9 y 8 mo, SD 1 y 2 mo; range 8-12 y) by their school into two counterbalanced groups. Children were eligible to participate provided that they did not receive any additional support. One group received a classroom-based programme of physical exercise on week 1 and then no programme on week 2, and this order was reversed for the other group. Each week, all participants completed a cognitive test battery that was delivered in one part per day at the end of each school day. RESULTS: On the cognitive tests, a significant interaction between counterbalance group and exercise was observed (p<0.001). Benefits occurred only for participants who exercised during the second week (mean improvement mean 3.85, standard error 1.39). Although test scores were affected by age, sex, and level of ADHD symptoms, the effect of exercise was not moderated by either these factors or BMI. INTERPRETATION: Exercise interventions have a positive effect (with variable magnitude) on cognitive performance, possibly by facilitating practice effects. These effects are not moderated by sex, ADHD symptom level, or BMI.

The relationship between developmental language disorder and dyslexia in European Portuguese school-aged children.

Developmental Language Disorder (DLD) [Also referred to as Specific Language Impairment (SLI)] and dyslexia are neurodevelopmental disorders which show similar behavioral manifestations. In this study, between-group comparisons and frequency analysis were combined to investigate the relationship between DLD and dyslexia. European Portuguese children aged 7-10 years, with DLD (N = 7) or dyslexia (N = 11) were recruited and compared to age-matched typically developing (TD) children (N = 21) on phonological processing, language andf literacy measures. The between-group comparison revealed that for phonological processing, the clinical groups scored significantly below TD children on most tasks, yet the DLD group performed similarly to TD children for RAN speed and digit span. The clinical groups did not statistically differ in their phonological processing abilities. For language abilities, children with dyslexia did not differ from TD children, whilst children with DLD performed significantly below TD children on all measures and significantly below children with dyslexia for vocabulary. Finally, for literacy measures, there were no statistical differences between clinical groups which underperformed on all measures when compared to TD children. The frequency analysis showed that children with DLD exhibited a lower prevalence of RAN difficulties when compared to children with dyslexia, whilst children with DLD tended to show more frequent nonword repetition and phoneme deletion deficits. Additionally, whilst children with DLD consistently showed more prevalent language impairments, both clinical groups demonstrated similar prevalence rates of literacy deficits compared to TD children.These findings lend support to the additional deficit model as children with DLD show more severe and prevalent language impairments than those with dyslexia, despite similar phonological and literacy difficulties.

Exercising attention within the classroom.

AIM: to investigate whether increased physical exercise during the school day influenced subsequent cognitive performance in the classroom. METHOD: a randomized, crossover-design trial (two weeks in duration) was conducted in six mainstream primary schools (1224 children aged 8-11y). No data on sex was available. Children received a teacher-directed, classroom-based programme of physical exercise, delivered approximately 30 minutes after lunch for 15 minutes during one week and no exercise programme during the other (order counterbalanced across participants). At the end of each school day, they completed one of five psychometric tests (paced serial addition, size ordering, listening span, digit-span backwards, and digit-symbol encoding), so that each test was delivered once after exercise and once after no exercise. RESULTS: general linear modelling analysis demonstrated a significant interaction between intervention and counterbalance group (p<0.001), showing that exercise benefitted cognitive performance. Post-hoc analysis revealed that benefits occurred in participants who received the exercise intervention in the second but not the first week of the experiment and were also moderated by type of test and age group. INTERPRETATION: physical exercise benefits cognitive performance within the classroom. The degree of benefit depends on the context of testing and participants' characteristics. This has implications for the role that is attributed to physical exercise within the school curriculum.

Developing a Visual Attention Assessment for Children at School Entry.

Whereas young children's visual attention has been explored in a number of previous studies, so far it has not been investigated by an assessment based on Bundesen's Theory of Visual Attention (TVA). TVA is a prominent visual attention model that has been widely used as foundation in studies targeting older children, adolescents or adults. In this paper we explore the utility of adopting TVA to explore the visual attention of 4- to 5- year olds and present the development of a simplified adapted version of a TVA-based assessment designed for this age group. Key assessment alterations included the substitution of letter stimuli with black and white symbols and the reduction of assessment duration. The suitability of the assessment for the target age group was subsequently tested in two consecutive studies (Study I: N = 43; Study II: N = 24). Study results show that measuring visual attention based on a simplified TVA-based assessment appears feasible in such a young age group, provided that the study design takes into account the capabilities of these young children. The authors argue that by adopting this kind of visual attention assessment the relationship between visual attention development and early learning could be better understood.

Rhythm production at school entry as a predictor of poor reading and spelling at the end of first grade.

Rhythm plays an organisational role in the prosody and phonology of language, and children with literacy difficulties have been found to demonstrate poor rhythmic perception. This study explored whether students' performance on a simple rhythm task at school entry could serve as a predictor of whether they would face difficulties in word reading and spelling at the end of grade 1. The participants were 479 Norwegian 6-year-old first graders randomized as controls in the longitudinal RCT on track (n = 1171). Rhythmic timing and pre-reading skills were tested individually at school entry on a digital tablet. On the rhythm task, the students were told to tap a drum appearing on the screen to two different rhythms (2 Hz paced and 1.5 Hz paced). Children's responses were recorded as they tapped on the screen with their index finger. Significant group differences were found in rhythm tapping ability measured at school entry, when groups were defined upon whether children went on to score above or below the 20th percentile reading and spelling thresholds in national assessment tests at the end of grade one. Inclusion of the school-entry rhythmic tapping measure into a model of classification accuracy for above or below threshold reading and spelling improved accuracy of classification by 6.2 and 9.2% respectively.

E-readers are more effective than paper for some with dyslexia.

E-readers are fast rivaling print as a dominant method for reading. Because they offer accessibility options that are impossible in print, they are potentially beneficial for those with impairments, such as dyslexia. Yet, little is known about how the use of these devices influences reading in those who struggle. Here, we observe reading comprehension and speed in 103 high school students with dyslexia. Reading on paper was compared with reading on a small handheld e-reader device, formatted to display few words per line. We found that use of the device significantly improved speed and comprehension, when compared with traditional presentations on paper for specific subsets of these individuals: Those who struggled most with phoneme decoding or efficient sight word reading read more rapidly using the device, and those with limited VA Spans gained in comprehension. Prior eye tracking studies demonstrated that short lines facilitate reading in dyslexia, suggesting that it is the use of short lines (and not the device per se) that leads to the observed benefits. We propose that these findings may be understood as a consequence of visual attention deficits, in some with dyslexia, that make it difficult to allocate attention to uncrowded text near fixation, as the gaze advances during reading. Short lines ameliorate this by guiding attention to the uncrowded span.

Shorter lines facilitate reading in those who struggle.

People with dyslexia, who ordinarily struggle to read, sometimes remark that reading is easier when e-readers are used. Here, we used eye tracking to observe high school students with dyslexia as they read using these devices. Among the factors investigated, we found that reading using a small device resulted in substantial benefits, improving reading speeds by 27%, reducing the number of fixations by 11%, and importantly, reducing the number of regressive saccades by more than a factor of 2, with no cost to comprehension. Given that an expected trade-off between horizontal and vertical regression was not observed when line lengths were altered, we speculate that these effects occur because sluggish attention spreads perception to the left as the gaze shifts during reading. Short lines eliminate crowded text to the left, reducing regression. The effects of attention modulation by the hand, and of increased letter spacing to reduce crowding, were also found to modulate the oculomotor dynamics in reading, but whether these factors resulted in benefits or costs depended on characteristics, such as visual attention span, that varied within our sample.