Intraword Variability in Children With Auditory Brainstem Implants: A Longitudinal Comparison With Children With Cochlear Implants.

PURPOSE: Intraword variability designates the phenomenon that a particular target word is produced variably by a child at one point in the child's development. In this study, the amount of intraword variability is studied longitudinally in children with auditory brainstem implants (ABIs). Auditory brainstem implantation is a relative recent technique in pediatric hearing restoration. Therefore, little is known about the phonological development of these children's speech. METHOD: The intraword variability is investigated in three children with ABI, in comparison to children with cochlear implants, matched on lexical development. Intraword variability is measured using relative entropy in order to take into account the frequency distribution in children's productions. RESULT: Results showed considerable variation between the three children with ABI. Still, all children had higher levels of intraword variability in their spontaneous speech productions as compared to children with cochlear implants. CONCLUSION: It seems that children with ABI are lagging behind their phonological development in reference to children with cochlear implants.

Speech intelligibility of children with an auditory brainstem implant: a triple-case study.

Auditory brainstem implantation (ABI) is a relative recent development in paediatric hearing restoration. Consequently, young-implanted children's productive language has not received much attention. This study investigated speech intelligibility of children with ABI (N = 3) in comparison to children with cochlear implants (CI) and children with typical hearing (TH). Spontaneous speech samples were recorded from children representing the three groups matched on cumulative vocabulary level. Untrained listeners (N = 101) rated the intelligibility of one-word utterances on a continuous scale and transcribed each utterance. The rating task yielded a numerical score between 0 and 100, and similarities and differences between the listeners' transcriptions were captured by a relative entropy score. The speech intelligibility of children with CI and children with TH was similar. Speech intelligibility of children with ABI was well below that of the children with CI and TH. But whereas one child with ABI's intelligibility approached that of the control groups with increasing lexicon size, the intelligibility of the two other children with ABI did not develop in a similar direction. Overall, speech intelligibility was only moderate in the three groups of children, with quite low ratings and considerable differences in the listeners' transcriptions, resulting in high relative entropy scores.

Consonant and vowel production in the spontaneous speech productions of children with auditory brainstem implants.

Auditory brainstem implantation provides hearing sensations in children and adults with anomalies of the auditory nerves. In children, perceptual benefits have been established, and research already demonstrated (limited) effects on children's speech production. The current study extends the literature by scrutinizing the phonological development of three children with ABI. Spontaneous speech samples were used to establish their phonemic inventories of vowels, word-initial consonants and word-final consonants, both independently of the target phoneme and relative to the target phoneme. The three children produced all vowels with longer device use and larger vocabulary size. Word-initial and word-final consonants appeared in the three children's spontaneous productions. However, the segmental accuracy was only moderate in the children's productions.

Word characteristics and speech production accuracy in children with auditory brainstem implants: a longitudinal triple case report.

Auditory brainstem implants (ABI) in children in the first years of life is a recent innovation. Analyses of their speech and language development on the basis of spontaneous language samples are still largely lacking. The aim was to investigate the phonological complexity of the words children with ABI use in their spontaneous speech, and to compare their accuracy with that of children with cochlear implants (CI) and children with normal hearing (NH). Longitudinal recordings of spontaneous speech were collected of three children with ABI. Children with ABI target mainly words of low phonological complexity in their spontaneous speech, just as children with NH and children with CI do. The complexity of the words they attempt increases over time, but this development is less outspoken in comparison to children with CI and NH at the same hearing ages. The accuracy of the ABI children's word productions is situated in the lower ranges of the 95% confidence intervals of the NH and the CI groups, and - depending on the specific measure - even fall below the 95% border. The ABI intervention appears to be beneficial in the three cases studied, although their development is slow compared to children with CI and NH.

Expressive Vocabulary Growth After Pediatric Auditory Brainstem Implantation in Two Cases' Spontaneous Productions: A Comparison With Children With Cochlear Implants and Typical Hearing.

Auditory brainstem implants (ABI) are recently being used to restore hearing of children with a congenital hearing loss, due to for instance the absence of auditory nerves. Thus far, the literature has focused on perceptual outcomes. The present study is among the first ones to investigate the spoken language development after implantation. The lexical development of children with ABI is examined longitudinally in comparison to children with typical hearing and children with cochlear implants. Results show that children with ABI still have smaller spoken vocabularies as compared to (hearing) age-matched children with cochlear implants and children with typical hearing. Implications will be discussed.

Auditory brainstem implantation in children with hearing loss: Effect on speech production.

Auditory brainstem implantation (ABI) is a recent technique in children's hearing restoration. Up till now the focus in the literature has mainly been the perceptual outcomes after implantation, whereas the effect of ABI on spoken language is still an almost unexplored area of research. This study presents a one-year follow-up of the volubility of two children with ABI. The volubility of signed and oral productions is investigated and oral productions are examined in more detail. Results show clear developmental trends in both children, indicating a beneficial effect of ABI on spoken language development.

Intraword Variability in Children With Cochlear Implants: The Long-Term Development up to 5 Years of Age and a Comparison With Children With Normal Hearing.

Purpose: This study evaluates intraword or token-to-token variability in the spontaneous speech of Dutch-speaking children with cochlear implants (CIs) longitudinally up to 5 years of age in comparison with intraword variability in age-matched peers with normal hearing (NH). Method: Spontaneous speech samples of 9 children with CI were collected longitudinally up to age 5. The data of the NH control group consisted of cross-sectional recordings. Children's word productions were categorized into 4 response types of the variability score (consistent correct, consistent incorrect, variable with hits, variable with no hits), and the proportion of whole-word variation (PWV) was calculated. Results: PWV was high in both groups of children but decreased with age. All response types of the variability score appeared in both groups. Children with CI were significantly more variable than their peers with NH up to age 4, but this difference has disappeared by age 5. Longer words had a higher PWV and were more often consistent incorrect and variable. Conclusions: Intraword variability was characteristic of children with CI's spontaneous speech productions as it was in children with NH, and a similar factor (word length) affected variability in production. Group comparisons showed higher rates of intraword variability in children with CI, but they seemed to catch up with their peers with NH by age 5.

The Effect of Word Frequency on Phonemic Accuracy in Children With Cochlear Implants and Peers With Typical Levels of Hearing.

The frequency of occurrence of words and sounds has a pervasive influence on typically developing children's language acquisition. For instance, highly frequent words appear earliest in a child's lexicon, and highly frequent phonemes are produced more accurately. This study evaluates (a) whether word frequency influences word accuracy and (b) whether this is also the case for children with a history of auditory deprivation. More specifically, the influence of word frequency on phonemic accuracy is examined in deaf children with a cochlear implant (CI), and compared to age-matched children with typical hearing, between word onset and age 7. Results show that highly frequent words are produced more accurately, except for words in the highest frequency regions (i.e., predominantly closed-class words). This effect is more pronounced in children with typical hearing when compared with children with CI. Thus, children with CI are sensitive to word frequency, but to a lesser extent than peers with typical hearing.

Word initial fricative production in children with cochlear implants and their normally hearing peers matched on lexicon size.

Fricative production is affected in children with cochlear implants (CI) as compared to age-matched normally hearing (NH) children. However, the phonological development of children with CI is rarely compared to that of NH peers matched on lexicon size. We compare the early word initial fricative development of 10 children with CI and 30 NH children matched on lexicon size and on chronological age. Children with CI are expected to differ from their NH peers when they are matched on chronological age. But, are lexical development and phonological development commensurate in children with CI as they have been shown to be in NH children? Results show that fricative production in children with CI deviates from that of age-matched NH peers. The differences between both groups disappear when they were matched on lexicon size. Thus, phonological development in children with CI is similar to that of their NH peers with comparable lexicon sizes.

Phonemic accuracy development in children with cochlear implants up to five years of age by using Levenshtein distance.

UNLABELLED: Phonemic accuracy of children with cochlear implants (CI) is often reported to be lower in comparison with normally hearing (NH) age-matched children. In this study, we compare phonemic accuracy development in the spontaneous speech of Dutch-speaking children with CI and NH age-matched peers. A dynamic cost model of Levenshtein distance is used to compute the accuracy of each word token. We set up a longitudinal design with monthly data for comparisons up to age two and a cross-sectional design with yearly data between three and five years of age. The main finding is that phonemic accuracy steadily increases throughout the period studied. Children with CI's accuracy is lower than that of their NH age mates, but this difference is not statistically significant in the earliest stages of lexical development. But accuracy of children with CI initially improves significantly less steeply than that of NH peers. Furthermore, the number of syllables in the target word and target word's complexity influence children's accuracy, as longer and more complex target words are less accurately produced. Up to age four, children with CI are significantly less accurate than NH children with increasing word length and word complexity. This difference has disappeared at age five. Finally, hearing age is shown to influence accuracy development of children with CI, while age of implant activation is not. LEARNING OUTCOMES: This article informs the reader about phonemic accuracy development in children. The reader will be able to (a) discuss different metrics to measure phonemic accuracy development, (b) discuss phonemic accuracy of children with CI up to five years of age and compare them with NH children, (c) discuss the influence of target word's complexity and target word's syllable length on phonemic accuracy, (d) discuss the influence of hearing experience and age of implantation on phonemic accuracy of children with CI.

Syntagmatic and paradigmatic development of cochlear implanted children in comparison with normally hearing peers up to age 7.

OBJECTIVE: Grammatical development is shown to be delayed in CI children. However, the literature has focussed mainly on one aspect of grammatical development, either morphology or syntax, and on standard tests instead of spontaneous speech. The aim of the present study was to compare grammatical development in the spontaneous speech of Dutch-speaking children with cochlear implants and normally hearing peers. Both syntagmatic and paradigmatic development will be assessed and compared with each other. METHOD: Nine children with cochlear implants were followed yearly between ages 2 and 7. There was a cross-sectional control group of 10 normally hearing peers at each age. Syntactic development is measured by means of Mean Length of Utterance (MLU), morphological development by means of Mean Size of Paradigm (MSP). This last measure is relatively new in child language research. RESULTS: MLU and MSP of children with cochlear implants lag behind that of their normally hearing peers up to age 4 and up to age 6 respectively. By age 5, CI children catch up on MSP and by age 7 they caught up on MLU. CONCLUSION: Children with cochlear implants catch up with their normally hearing peers for both measures of syntax and morphology. However, it is shown that inflection is earlier age-appropriate than sentence length in CI children. Possible explanations for this difference in developmental pace are discussed.