"They sure aren't from around here": Children's perception of accent distance in L1 and L2 varieties of English.

Children exhibit preferences for familiar accents early in life. However, they frequently have more difficulty distinguishing between first language (L1) accents than second language (L2) accents in categorization tasks. Few studies have addressed children's perception of accent strength, or the relation between accent strength and objective measures of pronunciation distance. To address these gaps, 6- and 12-year-olds and adults ranked talkers' perceived distance from the local accent (i.e., Midland American English). Rankings were compared with objective distance measures. Acoustic and phonetic distance measures were significant predictors of ladder rankings, but there was no evidence that children and adults significantly differed in their sensitivity to accent strength. Levenshtein Distance, a phonetic distance metric, was the strongest predictor of perceptual rankings for both children and adults. As a percept, accent strength has critical implications for social judgments, which determine real world social outcomes for talkers with non-local accents.

The Influence of Caregiver Language on the Association Between Child Temperament and Spoken Language in Children Who Are Deaf or Hard of Hearing.

OBJECTIVES: To examine the interaction between child temperament and caregiver linguistic input (i.e., syntactic complexity and lexical diversity) on receptive language in children who are deaf or hard of hearing (DHH). DESIGN: Families of 59 DHH children ( Mage = 5.66 years) using spoken language for communication participated in this cross-sectional study. Caregivers completed the Child Behavior Questionnaire-Short Form, which measured child temperament across three established factors (i.e., effortful control, negative affectivity, surgency-extraversion) and participated with their child in a semi-structured, dyadic play interaction that occurred during a home visit. Caregivers' language during the play interaction was quantified based on lexical diversity and syntactic complexity. Children also completed norm-referenced receptive language measures (i.e., Comprehensive Assessment of Spoken Language-2, age-appropriate Clinical Evaluation of Language Fundamentals) during the home visit that were combined into a composite measure of child receptive language. RESULTS: When caregivers used lower to moderate levels of lexical diversity, child effortful control was positively related to child receptive language. However, when caregivers used higher levels of lexical diversity, child effortful control and child receptive language were not related to each other. CONCLUSIONS: Family environments rich in caregiver lexical input to children might provide a protective influence on DHH child language outcomes by helping to ensure DHH children with varying self-regulatory abilities achieve better spoken language comprehension. These findings highlight the importance of encouraging caregivers to provide rich and stimulating language-learning environments for DHH children.

Barriers to and Facilitators of Early Hearing Detection and Intervention in the United States: A Systematic Review.

OBJECTIVES: Early hearing detection and intervention (EHDI) is guided by the 1-3-6 approach: screening by one month, diagnosis by 3 mo, and early intervention (EI) enrollment by 6 mo. Although screening rates remain high, successful diagnosis and EI-enrollment lag in comparison. The aim of this systematic review is to critically examine and synthesize the barriers to and facilitators of EHDI that exist for families, as they navigate the journey of congenital hearing loss diagnosis and management in the United States. Understanding barriers across each and all stages is necessary for EHDI stakeholders to develop and test novel approaches which will effectively reduce barriers to early hearing healthcare. DESIGN: A systematic literature search was completed in May and August 2021 for empirical articles focusing on screening, diagnosis, and EI of children with hearing loss. Two independent reviewers completed title and abstract screening, full-text review, data extraction, and quality assessments with a third independent reviewer establishing consensus at each stage. Data synthesis was completed using the Framework Analysis approach to categorize articles into EHDI journey timepoints and individual/family-level factors versus system-level factors. RESULTS: Sixty-two studies were included in the narrative synthesis. Results revealed that both individual/family-level (e.g., economic stability, medical status of the infant including middle ear involvement) and system-level barriers (e.g., system-service capacity, provider knowledge, and program quality) hinder timely diagnosis and EI for congenital hearing loss. Specific social determinants of health were noted as barriers to effective EHDI; however, system-level facilitators such as care coordination, colocation of services, and family support programs have been shown to mitigate the negative impact of those sociodemographic factors. CONCLUSIONS: Many barriers exist for families to obtain appropriate and timely EHDI for their children, but system-level changes could facilitate the process and contribute to long-term outcomes improvement. Limitations of this study include limited generalizability due to the heterogeneity of EHDI programs and an inability to ascertain factor interactions.

Time after time: Factors influencing children's comprehension of Before and After.

We investigated older children's (7-12 years) ability to comprehend before and after sentences. Results found that three factors that influence pre-school aged children's learning of these words continues to influence older children's comprehension. Specifically, children's accuracy is improved when the events can be naturally (vs. arbitrarily) ordered; when the clauses in the sentence iconically match (vs. mismatch) the order of the events in the world; and when sentences use before (vs. after). The first two factors are argued to directly facilitate the building of mental models while the last one does so indirectly because of patterns of input usage.

Computational Estimation of the Acidities of Pyrimidines and Related Compounds.

Pyrimidines are key components in the genetic code of living organisms and the pyrimidine scaffold is also found in many bioactive and medicinal compounds. The acidities of these compounds, as represented by their pKas, are of special interest since they determine the species that will prevail under different pH conditions. Here, a quantum chemical quantitative structure-activity relationship (QSAR) approach was employed to estimate these acidities. Density-functional theory calculations at the B3LYP/6-31+G(d,p) level and the SM8 aqueous solvent model were employed, and the energy difference ∆EH2O between the parent compound and its dissociation product was used as a variation parameter. Excellent estimates for both the cation → neutral (pKa1, R2 = 0.965) and neutral → anion (pKa2, R2 = 0.962) dissociations were obtained. A commercial package from Advanced Chemical Design also yielded excellent results for these acidities.

Naturalistic Use of Aspect Morphology in Deaf and Hard-of-Hearing Children.

Grammatical morphology often links small acoustic forms to abstract semantic domains. Deaf and hard-of-hearing (DHH) children have reduced access to the acoustic signal and frequently have delayed acquisition of grammatical morphology (e.g., Tomblin, Harrison, Ambrose, Walker, Oleson & Moeller, 2015). This study investigated the naturalistic use of aspectual morphology in DHH children to determine if they organize this semantic domain as normal hearing (NH) children have been found to do. Thirty DHH children (M = 6;8) and 29 NH children (M = 5;11) acquiring English participated in a free-play session and their tokens of perfective (simple past) and imperfective (-ing) morphology were coded for the lexical aspect of the predicate they marked. Both groups showed established prototype effects, favoring perfective + telic and imperfective + atelic pairings over perfective + atelic and perfective + atelic ones. Thus, despite reduced access to the acoustic signal, this DHH group was unimpaired for aspectual organization.

How pronunciation distance impacts word recognition in children and adults.

Although unfamiliar accents can pose word identification challenges for children and adults, few studies have directly compared perception of multiple nonnative and regional accents or quantified how the extent of deviation from the ambient accent impacts word identification accuracy across development. To address these gaps, 5- to 7-year-old children's and adults' word identification accuracy with native (Midland American, British, Scottish), nonnative (German-, Mandarin-, Japanese-accented English) and bilingual (Hindi-English) varieties (one talker per accent) was tested in quiet and noise. Talkers' pronunciation distance from the ambient dialect was quantified at the phoneme level using a Levenshtein algorithm adaptation. Whereas performance was worse on all non-ambient dialects than the ambient one, there were only interactions between talker and age (child vs adult or across age for the children) for a subset of talkers, which did not fall along the native/nonnative divide. Levenshtein distances significantly predicted word recognition accuracy for adults and children in both listening environments with similar impacts in quiet. In noise, children had more difficulty overcoming pronunciations that substantially deviated from ambient dialect norms than adults. Future work should continue investigating how pronunciation distance impacts word recognition accuracy by incorporating distance metrics at other levels of analysis (e.g., phonetic, suprasegmental).

Family Environment in Children With Hearing Aids and Cochlear Implants: Associations With Spoken Language, Psychosocial Functioning, and Cognitive Development.

OBJECTIVES: To examine differences in family environment and associations between family environment and key speech, language, and cognitive outcomes in samples of children with normal hearing and deaf and hard-of-hearing (DHH) children who use hearing aids and cochlear implants. DESIGN: Thirty families of children with normal hearing (n = 10), hearing aids (n = 10), or cochlear implants (n = 10) completed questionnaires evaluating executive function, social skills, and problem behaviors. Children's language and receptive vocabulary were evaluated using standardized measures in the children's homes. In addition, families were administered a standardized in-home questionnaire and observational assessment regarding the home environment. RESULTS: Family environment overall was similar across hearing level and sensory aid, although some differences were found on parental responsivity and physical environment. The level of supportiveness and enrichment within family relationships accounted for much of the relations between family environment and the psychosocial and neurocognitive development of DHH children. In contrast, the availability of objects and experiences to stimulate learning in the home was related to the development of spoken language. CONCLUSIONS: Whereas broad characteristics of the family environments of DHH children may not differ from those of hearing children, variability in family functioning is related to DHH children's at-risk speech, language, and cognitive outcomes. Results support the importance of further research to clarify and explain these relations, which might suggest novel methods and targets of family-based interventions to improve developmental outcomes.

INFLUENCE OF FAMILY ENVIRONMENT ON DEVELOPMENTAL OUTCOMES IN CHILDREN WITH COCHLEAR IMPLANTS: A MATCHED CASE STUDY.

This case study analyzes and describes the language, executive function, and psychosocial outcomes of two 6-year-old children with cochlear implants in the context of their respective family environments. Despite having nearly identical audiological histories, their language abilities and social skills are markedly different from one another, exemplifying the variability in outcomes of children with cochlear implants. Families play a critical role in child development. Including analyses of the family environment serves to draw attention to the importance of expanding the variables of potential influence beyond child characteristics to more fully encompass the factors that influence children's performance in future studies.

Introducing a Conversational Model Therapy Approach as a Team Model of Care: The Clinician Experience in a Sexual Assault Service.

This article examines clinician experience in adopting a contemporary psychodynamic model of care by exploring the experiences and perspectives of staff at an Australian hospital-based sexual assault service (SAS), reflecting then on implications for how to best engage clinicians in a model of care change and training. The Conversational Model of Therapy (CMT) is a contemporary psychodynamic approach integrating evidence from developmental psychology, neuroscience and trauma. Training was provided in the CMT approach to Short-Term Intensive Psychodynamic Psychotherapy seeking to enable the service to better provide for the needs of adult clients with less recent sexual assault experiences and/or those able to receive a short-term psychotherapy. Five semi-structured individual interviews and one focus group (with four participants) were undertaken to identify SAS staff perceptions of their experiences after initial training of up to 13 sessions with CMT. Thematic analysis was performed to identify, analyse and report patterns in the responses with the following themes emerging: the challenges staff face in providing a service to clients; coping mechanisms staff utilise in their work; the current service structure and how this compares with their experiences of CMT, and; feelings and thoughts on SAS staff being evaluated. Findings provide evidence that the majority of staff understood the need for change and were able to undertake training towards this due to effective coping mechanisms within their work and good support from within their team. The research also highlights the need to ensure effective training to evaluate participants' understanding of the model being taught. In the context of training experience elsewhere, learning and synthesis of all of the knowledge relevant to a psychodynamic model of care may require experiential learning through supervision of audio-recorded sessions, although this has challenges in the SAS context.

Type-D Personality and Elevated Psychological Symptoms In Early Adjustment of Severe Burn Injury Patients.

Severe burn injuries are highly traumatic requiring lengthy recovery. High levels of distress in the early stages of treatment have been associated with poor physical and psychosocial recovery outcomes. Identifying traits relating to distress and personal coping styles may aid screening. Type-D, or 'distressed', personality may be such a trait. Type-D personality refers to an ongoing personality organization defined by a tendency to experience greater negative emotions and thoughts while simultaneously socially inhibiting their expression (Denollet et al., 1996 . Type-D has been linked to poor health outcomes in those with cardiovascular disease as well as other populations and has been found to be associated with elevated psychological symptoms. Currently, there are no investigations in the literature looking at Type-D in the severe burns injury population. This study aimed to investigate Type-D in severe burn injury patients, specifically regarding the presence of psychological symptoms in early treatment, using data gathered during a pilot study conducted at a severe burn injury unit. The DS-16, Davidson Trauma scale and Depression Anxiety and Stress Scale scores were analysed along with demographic and clinical data in 54 participants (40 males, 14 females). Participants who were found to have Type-D displayed significantly higher levels of psychopathology. Additionally, Type-D was found to be a significant predictor of psychological symptoms.

Audiovisual speech perception development at varying levels of perceptual processing.

This study used the auditory evaluation framework [Erber (1982). Auditory Training (Alexander Graham Bell Association, Washington, DC)] to characterize the influence of visual speech on audiovisual (AV) speech perception in adults and children at multiple levels of perceptual processing. Six- to eight-year-old children and adults completed auditory and AV speech perception tasks at three levels of perceptual processing (detection, discrimination, and recognition). The tasks differed in the level of perceptual processing required to complete them. Adults and children demonstrated visual speech influence at all levels of perceptual processing. Whereas children demonstrated the same visual speech influence at each level of perceptual processing, adults demonstrated greater visual speech influence on tasks requiring higher levels of perceptual processing. These results support previous research demonstrating multiple mechanisms of AV speech processing (general perceptual and speech-specific mechanisms) with independent maturational time courses. The results suggest that adults rely on both general perceptual mechanisms that apply to all levels of perceptual processing and speech-specific mechanisms that apply when making phonetic decisions and/or accessing the lexicon. Six- to eight-year-old children seem to rely only on general perceptual mechanisms across levels. As expected, developmental differences in AV benefit on this and other recognition tasks likely reflect immature speech-specific mechanisms and phonetic processing in children.

The influence of talker and foreign-accent variability on spoken word identification.

In spoken word identification and memory tasks, stimulus variability from numerous sources impairs performance. In the current study, the influence of foreign-accent variability on spoken word identification was evaluated in two experiments. Experiment 1 used a between-subjects design to test word identification in noise in single-talker and two multiple-talker conditions: multiple talkers with the same accent and multiple talkers with different accents. Identification performance was highest in the single-talker condition, but there was no difference between the single-accent and multiple-accent conditions. Experiment 2 further explored word recognition for multiple talkers in single-accent versus multiple-accent conditions using a mixed design. A detriment to word recognition was observed in the multiple-accent condition compared to the single-accent condition, but the effect differed across the language backgrounds tested. These results demonstrate that the processing of foreign-accent variation may influence word recognition in ways similar to other sources of variability (e.g., speaking rate or style) in that the inclusion of multiple foreign accents can result in a small but significant performance decrement beyond the multiple-talker effect.

Auditory skills, language development, and adaptive behavior of children with cochlear implants and additional disabilities.

OBJECTIVE: The objective of this study was to evaluate the development of functional auditory skills, language, and adaptive behavior in deaf children with cochlear implants (CI) who also have additional disabilities (AD). DESIGN: A two-group, pre-test versus post-test design was used. STUDY SAMPLE: Comparisons were made between 23 children with CIs and ADs, and an age-matched comparison group of 23 children with CIs without ADs (No-AD). Assessments were obtained pre-CI and within 12 months post-CI. RESULTS: All but two deaf children with ADs improved in auditory skills using the IT-MAIS. Most deaf children in the AD group made progress in receptive but not expressive language using the preschool language scale, but their language quotients were lower than the No-AD group. Five of eight children with ADs made progress in daily living skills and socialization skills; two made progress in motor skills. Children with ADs who did not make progress in language, did show progress in adaptive behavior. CONCLUSIONS: Children with deafness and ADs made progress in functional auditory skills, receptive language, and adaptive behavior. Expanded assessment that includes adaptive functioning and multi-center collaboration is recommended to best determine benefits of implantation in areas of expected growth in this clinical population.

Associations Between Paternal Play and Executive Function in Deaf and Hard of Hearing Children.

PURPOSE: Responsive and dynamic aspects of father-child play are associated with behavioral and neurocognitive development in children and could represent an important contributor to executive function (EF) skills for children who are deaf and hard of hearing (DHH). This study examined associations between paternal behaviors during play and EF skills of DHH children and children with typical hearing (TH). METHOD: Father-child dyads in families with DHH children (n = 30) and TH children (n = 29) participated in a 15-min video-recorded free-play session that was coded for parental behaviors using Parent-Child Interaction Rating Scales and Rough and Tumble Play Quality. Families also completed an age-appropriate version of the Behavior Rating Index of Executive Function as a measure of child EF. RESULTS: DHH children were rated as having significantly more everyday difficulties with working memory than TH children. Fathers of DHH children were rated as more intrusive during play than fathers of TH children; however, there were no other differences between paternal groups on coded dimensions of father child play. Paternal respect for child autonomy was associated with fewer child difficulties with planning and organization skills and paternal play engagement was associated with fewer child EF difficulties. Moderation analyses revealed that paternal sensitivity was associated with more working memory difficulties and paternal respect for child autonomy was associated with fewer working memory difficulties for DHH children only. CONCLUSIONS: Paternal play could be an important environmental context for DHH outcomes. Fathers supporting independent play might generally support EF. Paternal engagement in play might also benefit EF. Results highlight paternal behavioral attributes that could lead to potential father-embedded intervention models.

Family Environmental Dynamics Differentially Influence Spoken Language Development in Children With and Without Hearing Loss.

PURPOSE: The aim of this study was to evaluate whether families of children with sensorineural hearing loss (SNHL) are organized similarly to those of typically developing, typically hearing (TH) children and whether the dimensions of family dynamics and environment are related to spoken language development similarly in children with and without SNHL. METHOD: Primary caregivers of children with SNHL (n = 63) or TH (n = 65) completed the Family Environment Scale-Fourth Edition (FES-4) to assess multiple dimensions of family environment. Children's receptive vocabulary was assessed with the Peabody Picture Vocabulary Test-Fourth Edition, and their receptive language was assessed by an age-appropriate version of the Concepts and Following Directions subtest of the Clinical Evaluation of Language Fundamentals and the Sentence Comprehension subscale of the Comprehensive Assessment of Spoken Language-Second Edition. Principal component analysis was used to examine the dimensional structure of the family environment. RESULTS: Three higher order components were derived from FES-4 subscales for both families of children with SNHL and with TH: Supportive, Controlling, and Conflicted. However, the composition of the factors themselves differed between the two groups. For the TH group, most family environment measures on the FES-4 were not associated with language outcomes. In contrast, for children with SNHL, families who were more supportive, less controlling, and less conflicted had children with better language skills. CONCLUSIONS: Three well-accepted dimensions of family dynamics and functioning apply to families of children with SNHL, but their composition differs from those of families with TH children. Family environmental dynamics were much more strongly associated with language outcomes in children with SNHL than in their TH peers. The spoken language development of children with SNHL, in particular, is better in families that provide high levels of support for each other and, in particular, low levels of control, disorganization, and conflict, reflecting the fragile nature of their spoken language development.

Interactive Effects of Temperament and Family-Related Environmental Confusion on Spoken Language in Children Who Are Deaf and Hard of Hearing.

PURPOSE: The aim of this study was to examine the influence of caregivers' reports of family-related environmental confusion-which refers to the level of overstimulation in the family home environment due to auditory and nonauditory (i.e., visual and cognitive) noise-on the relation between child temperament and spoken language outcomes in children who are deaf and hard of hearing (DHH) in comparison to age-matched children with typical hearing (TH). METHOD: Two groups of families with children between 3 and 7 years of age (TH = 59, DHH = 58) were sequentially recruited from a larger longitudinal study on developmental outcomes in children who are DHH. Caregivers (all TH) completed questionnaires measuring three dimensions of child temperament (i.e., effortful control, negative affectivity, and surgency-extraversion) and family-related environmental confusion. A norm-referenced language measure was administered to children. Testing took place within the families' homes. RESULTS: For children who are DHH, effortful control was positively related to spoken language outcomes, but only when levels of family-related environmental confusion were low to moderate. Family-related environmental confusion did not interact with temperament to influence spoken language in children with TH. CONCLUSIONS: Homes with low-to-moderate levels of environmental confusion provide an environment that supports DHH children with better effortful control to harness their self-regulatory skills to achieve better spoken language comprehension than those with lower levels of effortful control. These findings suggest that efforts to minimize chaos and auditory noise in the home create an environment in which DHH children can utilize their self-regulatory skills to achieve optimal spoken language outcomes.

Associations Between Parent Mental State Language and Child Inhibitory Control in Children Who Are Deaf or Hard of Hearing.

PURPOSE: Children who are deaf or hard of hearing (D/HH) are at increased risk for neurocognitive delays, which can have cascading effects on development. Associations between neurocognition and the content of parental language-specifically the use of mental state vocabulary-have been observed in typically hearing (TH) children. This study investigated the role of parental use of mental state language (e.g., vocabulary related to thought processes, desires, and emotions) in explaining variability in neurocognition in children who are D/HH. METHOD: Dyads of 62 TH and 69 D/HH children who wear hearing aids or cochlear implants (ages 3-8 years) and their primary parent were videorecorded during a 20-min play session. Specific mental state words used by parents were extracted. Child neurocognition (specifically, inhibitory control) was assessed using norm-referenced measures. RESULTS: Parent use of mental state language predicted child inhibitory control differentially based on hearing status, with a significant relation in the D/HH but not the TH group. Mental state vocabulary related to cognition (e.g., "think," "know"), but not to desire (e.g., "want," "like") or emotion (e.g., "feel," "frustrated"), predicted child inhibitory control in the D/HH group. Finally, there was a significant relation between the use of first person, but not second or third person, mental state verbs (e.g., "I think") and child inhibitory control. CONCLUSIONS: Parental use of cognitive mental state vocabulary models language around thought processes, and parents' use of first-person referents models "self-talk." Modeling of these linguistic forms is likely foundational for developing self-regulation. Children who are D/HH often experience reduced auditory access and/or language delays and thus rely on high-quality parental language input for longer periods of development than their TH peers. Continued support from interventionists is indicated to coach parents to be high-quality models of more abstract, decontextualized language, supporting complex language development and inhibitory control in children who are D/HH.

Executive functioning and spoken language skills in young children with hearing aids and cochlear implants: Longitudinal findings.

Deaf or hard-of-hearing (DHH) children who use auditory-oral communication display considerable variability in spoken language and executive functioning outcomes. Furthermore, language and executive functioning skills are strongly associated with each other in DHH children, which may be relevant for explaining this variability in outcomes. However, longitudinal investigations of language and executive functioning during the important preschool period of development in DHH children are rare. This study examined the predictive, reciprocal associations between executive functioning and spoken language over a 1-year period in samples of 53 DHH and 59 typically hearing (TH) children between ages 3-8 years at baseline. Participants were assessed on measures of receptive spoken language (vocabulary, sentence comprehension, and following spoken directions) and caregiver-completed executive functioning child behavior checklists during two in-person home visits separated by 1 year. In the sample of DHH children, better executive functioning at baseline (Time 1) was associated with better performance on the higher-order language measures (sentence comprehension and following spoken directions) 1 year later (Time 2). In contrast, none of the Time 1 language measures were associated with better executive functioning in Time 2 in the DHH sample. TH children showed no significant language-executive functioning correlations over the 1-year study period. In regression analyses controlling for Time 1 language scores, Time 1 executive functioning predicted Time 2 language outcomes in the combined DHH and TH samples, and for vocabulary, that association was stronger in the DHH than in the TH sample. In contrast, after controlling for Time 1 executive functioning, none of the regression analyses predicting Time 2 executive functioning from Time 1 language were statistically significant. These results are the first findings to demonstrate that everyday parent-rated executive functioning behaviors predict basic (vocabulary) and higher-order (comprehension, following directions) spoken language development 1 year later in young (3-8 year old) DHH children, even after accounting for initial baseline language skills.

Family-Level Executive Functioning and At-Risk Pediatric Hearing Loss Outcomes.

Purpose Using a new measure of family-level executive functioning (EF; the Family Characteristics Scale [FCS]), we investigated associations between family-level EF, spoken language, and neurocognitive skills in children with hearing loss (HL), compared to children with normal hearing. Method Parents of children with HL (n = 61) or children with normal hearing (n = 65) completed the FCS-Parent, and clinicians evaluated families using the FCS-Examiner. Children completed an age-appropriate version of the Concepts and Following Directions subtest of the Clinical Evaluation of Language Fundamentals and the Peabody Picture Vocabulary Test-Fourth Edition. Child EF was assessed via the parent report Behavior Rating Inventory of Executive Function. Results Two higher order components were derived from FCS subscales: Family Inhibition and Family Organization. For both samples, Family Inhibition was positively associated with child inhibition, child shifting, and child language comprehension skills. Family Organization was differentially associated with child inhibition, working memory, and planning/organization skills across the samples. Additionally, Family Inhibition was associated with child planning and organization skills for children with HL. Conclusions Results support the FCS as a measure of family-level EF. Family-level inhibition related to better child inhibition, flexibility/shifting, and language comprehension across both samples and to better planning and organization skills in children with HL. As children with HL experienced greater difficulties in EF, families demonstrated greater organization, possibly as a compensatory measure. Results suggest that inhibition and organization at a family level may be important targets for the development of novel interventions to promote EF and language outcomes for children with HL.