Verbal learning and memory in prelingually deaf children with cochlear implants.

OBJECTIVE: Deaf children with cochlear implants (CIs) show poorer verbal working memory compared to normal-hearing (NH) peers, but little is known about their verbal learning and memory (VLM) processes involving multi-trial free recall. DESIGN: Children with CIs were compared to NH peers using the California Verbal Learning Test for Children (CVLT-C). STUDY SAMPLE: Participants were 21 deaf (before age 6 months) children (6-16 years old) implanted prior to age 3 years, and 21 age-IQ matched NH peers. RESULTS: Results revealed no differences between groups in number of words recalled. However, CI users showed a pattern of increasing use of serial clustering strategies across learning trials, whereas NH peers decreased their use of serial clustering strategies. In the CI sample (but not in the NH sample), verbal working memory test scores were related to resistance to the build-up of proactive interference, and sentence recognition was associated with performance on the first exposure to the word list and to the use of recency recall strategies. CONCLUSIONS: Children with CIs showed robust evidence of VLM comparable to NH peers. However, their VLM processing (especially recency and proactive interference) was related to speech perception outcomes and verbal WM in different ways from NH peers.

Some Neurocognitive Correlates of Noise-Vocoded Speech Perception in Children With Normal Hearing: A Replication and Extension of ).

OBJECTIVES: Noise-vocoded speech is a valuable research tool for testing experimental hypotheses about the effects of spectral degradation on speech recognition in adults with normal hearing (NH). However, very little research has utilized noise-vocoded speech with children with NH. Earlier studies with children with NH focused primarily on the amount of spectral information needed for speech recognition without assessing the contribution of neurocognitive processes to speech perception and spoken word recognition. In this study, we first replicated the seminal findings reported by ) who investigated effects of lexical density and word frequency on noise-vocoded speech perception in a small group of children with NH. We then extended the research to investigate relations between noise-vocoded speech recognition abilities and five neurocognitive measures: auditory attention (AA) and response set, talker discrimination, and verbal and nonverbal short-term working memory. DESIGN: Thirty-one children with NH between 5 and 13 years of age were assessed on their ability to perceive lexically controlled words in isolation and in sentences that were noise-vocoded to four spectral channels. Children were also administered vocabulary assessments (Peabody Picture Vocabulary test-4th Edition and Expressive Vocabulary test-2nd Edition) and measures of AA (NEPSY AA and response set and a talker discrimination task) and short-term memory (visual digit and symbol spans). RESULTS: Consistent with the findings reported in the original ) study, we found that children perceived noise-vocoded lexically easy words better than lexically hard words. Words in sentences were also recognized better than the same words presented in isolation. No significant correlations were observed between noise-vocoded speech recognition scores and the Peabody Picture Vocabulary test-4th Edition using language quotients to control for age effects. However, children who scored higher on the Expressive Vocabulary test-2nd Edition recognized lexically easy words better than lexically hard words in sentences. Older children perceived noise-vocoded speech better than younger children. Finally, we found that measures of AA and short-term memory capacity were significantly correlated with a child's ability to perceive noise-vocoded isolated words and sentences. CONCLUSIONS: First, we successfully replicated the major findings from the ) study. Because familiarity, phonological distinctiveness and lexical competition affect word recognition, these findings provide additional support for the proposal that several foundational elementary neurocognitive processes underlie the perception of spectrally degraded speech. Second, we found strong and significant correlations between performance on neurocognitive measures and children's ability to recognize words and sentences noise-vocoded to four spectral channels. These findings extend earlier research suggesting that perception of spectrally degraded speech reflects early peripheral auditory processes, as well as additional contributions of executive function, specifically, selective attention and short-term memory processes in spoken word recognition. The present findings suggest that AA and short-term memory support robust spoken word recognition in children with NH even under compromised and challenging listening conditions. These results are relevant to research carried out with listeners who have hearing loss, because they are routinely required to encode, process, and understand spectrally degraded acoustic signals.

Assessment of Working Memory Capacity in Preschool Children Using the Missing Scan Task.

The purpose of this study was to investigate the feasibility and validity of a modified version of Buschke's missing scan methodology, the Missing Scan Task (MST), to assess working memory capacity (WMC) and cognitive control processes in preschool children 3-6 years in age. Forty typically developing monolingual English-speaking children between 36 and 84 months in age participated in the study. The children were tested on measures of WMC (MST), verbal and nonverbal memory (NEPSY Narrative Memory and Memory for Designs subtests), and language skills (Peabody Picture Vocabulary Test, fourth edition). Children showed increased working memory capacity scores with age, as measured by the MST, with significant differences between 3- and 5-year-olds and 3- and 6-year-olds. Significant correlations were also found between the MST and language and verbal and nonverbal memory scores. MSTscores still remained significantly correlated with the other measures of memory even after age and global language were accounted for in a regression analysis, demonstrating that the MST captures unique variance related specifically to WMC and cognitive control processes used to retrieve and scan information in short-term memory (STM). The results of this study demonstrate that the MST is a feasible and valid methodology for assessing WMC in preschool children as young 3 years of age.

Measures of digit span and verbal rehearsal speed in deaf children after more than 10 years of cochlear implantation.

OBJECTIVES: Conventional assessments of outcomes in deaf children with cochlear implants (CIs) have focused primarily on endpoint or product measures of speech and language. Little attention has been devoted to understanding the basic underlying core neurocognitive factors involved in the development and processing of speech and language. In this study, we examined the development of factors related to the quality of phonological information in immediate verbal memory, including immediate memory capacity and verbal rehearsal speed, in a sample of deaf children after >10 yrs of CI use and assessed the correlations between these two process measures and a set of speech and language outcomes. DESIGN: Of an initial sample of 180 prelingually deaf children with CIs assessed at ages 8 to 9 yrs after 3 to 7 yrs of CI use, 112 returned for testing again in adolescence after 10 more years of CI experience. In addition to completing a battery of conventional speech and language outcome measures, subjects were administered the Wechsler Intelligence Scale for Children-III Digit Span subtest to measure immediate verbal memory capacity. Sentence durations obtained from the McGarr speech intelligibility test were used as a measure of verbal rehearsal speed. RESULTS: Relative to norms for normal-hearing children, Digit Span scores were well below average for children with CIs at both elementary and high school ages. Improvement was observed over the 8-yr period in the mean longest digit span forward score but not in the mean longest digit span backward score. Longest digit span forward scores at ages 8 to 9 yrs were significantly correlated with all speech and language outcomes in adolescence, but backward digit spans correlated significantly only with measures of higher-order language functioning over that time period. While verbal rehearsal speed increased for almost all subjects between elementary grades and high school, it was still slower than the rehearsal speed obtained from a control group of normal-hearing adolescents. Verbal rehearsal speed at ages 8 to 9 yrs was also found to be strongly correlated with speech and language outcomes and Digit Span scores in adolescence. CONCLUSIONS: Despite improvement after 8 additional years of CI use, measures of immediate verbal memory capacity and verbal rehearsal speed, which reflect core fundamental information processing skills associated with representational efficiency and information processing capacity, continue to be delayed in children with CIs relative to NH peers. Furthermore, immediate verbal memory capacity and verbal rehearsal speed at 8 to 9 yrs of age were both found to predict speech and language outcomes in adolescence, demonstrating the important contribution of these processing measures for speech-language development in children with CIs. Understanding the relations between these core underlying processes and speech-language outcomes in children with CIs may help researchers to develop new approaches to intervention and treatment of deaf children who perform poorly with their CIs. Moreover, this knowledge could be used for early identification of deaf children who may be at high risk for poor speech and language outcomes after cochlear implantation as well as for the development of novel targeted interventions that focus selectively on these core elementary information processing variables.