Swedish speech and language pathologists reflect on how their clinical practises align to everyday language and communication skills of children with developmental language disorder.

This study aims to extend current knowledge about the possibilities and challenges encountered by Swedish speech and language pathologists (SLPs) in targeting everyday language and communication in children with developmental language disorder (DLD). To explore this matter, unstructured focus groups were conducted where 15 SLPs, working with children with DLD, shared their views on the alignment between their clinical practices and children's everyday lives. Thematic analysis was used to analyse the data, which resulted in five themes: It's everyday life that matters; As an SLP, you're not a part of the child's everyday life; How do we merge the different worlds?; Resources at home vary, and The employer sets the framework for clinical practices. The SLPs stressed the importance of targeting everyday skills and needs, but they experienced themselves as being detached from the children's daily context. Collaboration with caregivers and (pre)school staff was emphasised; however, the resources and capacity of the caregivers and staff varied, and this was experienced as a challenge for providing the most appropriate care. Some children and their families were situated in a multifaceted context and needed more extensive care, and this group was described as increasing. However, the services that the SLPs were able to offer varied and were largely regulated by organisational constraints. Individualised services are crucial for ensuring a positive development for children with DLD and for empowering caregivers to be effective collaborative partners in intervention. Therefore, it is essential for SLPs to have the time and resources to ensure high-quality care.

Clinical practices in Swedish speech-language pathology for children with (developmental) language disorder.

In Sweden, treatment for children with (developmental) language disorder ((D)LD) is traditionally carried out at a speech-language pathology (SLP) clinic, and based on formal language tests, which may not entirely represent the child's everyday language and communication skills. SLP services that include video recordings have shown positive outcomes in terms of providing information about children's linguistic and communicative abilities in everyday life, but little is known about the use of video in clinical practice. The aim of this study is therefore to investigate how Swedish SLPs link their clinical practices (assessment, treatment, and evaluation of treatment outcome) to the everyday language and communication abilities of children with (D)LD. A further aim is to explore SLPs' utilisation of video recordings as a part of their clinical practices with the target group. A web-based questionnaire was distributed to SLPs in Sweden, who work with children with (D)LD. Results demonstrate that Swedish SLPs perceive that their intervention is in alignment with children's everyday language and communication needs to a fairly high degree. However, an exception is assessment, which is considered to have a weaker alignment with children's everyday communication abilities. The use of video recordings for clinical purposes is very limited. It is suggested here that incorporating video recordings from children's everyday life would be an easy and time-efficient way to strengthen the ecological validity of SLP practices for children with (D)LD.

Supporting people living with dementia in novel joint activities: Managing tablet computers.

A bourgeoning number of studies have demonstrated that people living with dementia are capable of participating in a wide range of everyday activities when supported by care professionals or family carers. However, little remains known about the situated practices used by carers to support people living with dementia as active co-participants in novel joint activities. Taking the use of tablet computers as an example, this study focuses on the interactional organization of instructions in joint activities involving people living with dementia, who have no previous experiences of touchscreen technologies, and their carers. The study is based on forty-one video recordings of ten dyads, each comprising a person living with dementia and a carer, as they are using tablet computers with applications suited to individual interests. Drawing on multimodal interaction analysis, we show how the carers continually foster the accomplishment of their interlocutors, and rarely take over responsibility for closing an ongoing joint project themselves. Our findings suggest that the carers' instructions, realized as verbal and embodied directives, function as a form of scaffolding practice that facilitates the coordination of visual perception and embodied conduct for the participants living with dementia.

'It depends on who I'm with': How young people with developmental language disorder describe their experiences of language and communication in school.

BACKGROUND: The risks of developmental language disorder (DLD) for both educational progress and socio-emotional development are well documented, but little is known about how children and young people with DLD experience and describe their language and communication. The need to complement experimental and quantitative studies with qualitative perspectives of the lived experience of individuals with DLD for speech and language therapists (SLT) practice has recently been foregrounded. AIMS: To understand further the experiences of young people with DLD focusing on language and communication in a school context, and thereby contribute to the improvement of the communicative situation in school for this group. The study is guided by the following research question: How do young people diagnosed with DLD describe their experiences of language and communication in school? METHODS & PROCEDURES: The study is based on data generated from qualitative semi-structured interviews with 23 participants diagnosed with DLD (age 13-19 years old) living in Sweden. All participants attended mainstream schools. To enable data to be collected during COVID-19 restrictions, all interviews were conducted using Zoom. Reflexive thematic analysis was used to analyse the data. OUTCOMES & RESULTS: Four main themes related to experiences of language and communication in school were constructed from the interviews: (1) feelings of inadequacy and comparisons with others; (2) feelings of being misjudged and misunderstood; (3) the importance of feeling safe and comfortable; and (4) the significance of the social and communicative context. The results bear witness of difficult and challenging aspects related to language and communication in school, including educational, social and emotional dimensions. An important outcome of this study is how young people diagnosed with DLD describe their language and communication functioning to be dependent on both individual characteristics and abilities, as well as situational, contextual and social factors. CONCLUSIONS & IMPLICATIONS: The results from this study show that young people with DLD can have persisting problems related to language and communication in school, including educational, social and emotional dimensions. SLT services may therefore be needed throughout the school years to ensure that students with DLD receive adequate support. In addition, support that goes beyond language abilities and targets social, contextual and emotional aspects should be considered. WHAT THIS PAPER ADDS: What is already known on this subject Children and young people have unique knowledge about their language and communication which is instrumental for designing interventions and support strategies. Qualitative analyses of interview data have been able to identify both risk factors and protective strategies in relation to the well-being of individuals with DLD. Despite this, children and young people with DLD are rarely heard in research or clinical discussions. What this paper adds to existing knowledge In this study we listen to the voices of young people with DLD as they describe their experiences of language and communication in school. The participants describe a condition that makes them struggle to keep up with peers and puts them at risk of being misjudged by teachers, but also give examples of situations where negative consequences are hardly felt. What are the potential or actual clinical implications of this work? DLD is a complex and dynamic disorder where contextual and social factors interact with individual abilities in creating the end result. The results of the study indicate that DLD can cause persisting problems related to language and communication in school, with impact on educational, social and emotional dimensions. To counteract these effects, SLT services may be needed throughout the school years, and support that goes beyond language abilities must be considered.

Consonant articulation acoustics and intelligibility in Swedish speakers with Parkinson's disease: a pilot study.

Imprecise consonant articulation is common in speakers with Parkinson's disease and can affect intelligibility. The research on the relationship between acoustic speech measures and intelligibility in Parkinson's disease is limited, and most of the research has been conducted on English. This pilot study investigated aspects of consonant articulation acoustics in eleven Swedish speakers with Parkinson's disease and six neurologically healthy persons. The focus of the study was on consonant cluster production, articulatory motion rate and variation, and voice onset time, and how these acoustic features correlate with speech intelligibility. Among the measures in the present study, typicality ratings of heterorganic consonant clusters /spr/ and /skr/ had the strongest correlations with intelligibility. Measures based on syllable repetition, such as repetition rate and voice onset time, showed varying results with weak to moderate correlations with intelligibility. One conclusion is that some acoustic measures may be more sensitive than others to the impact of the underlying sensory-motor impairment and dysarthria on speech production and intelligibility in speakers with Parkinson's disease. Some aspects of articulation appear to be equally demanding in terms of acoustic realisation for elderly healthy speakers and for speakers with Parkinson's disease, such as sequential motion rate measures. Clinically, this would imply that for the purpose of detecting signs of disordered speech motor control, choosing measures with less variation among older speakers without articulation impairment would lead to more robust results.

Conversations in dementia with Lewy bodies: Resources and barriers in communication.

BACKGROUND: In dementia with Lewy bodies (DLB), limitations in linguistic and cognitive abilities may lead to difficulties in participating in conversations. The conversational outcome is also dependent on how the conversation partner adjusts to potential communicative challenges. AIMS: This study explored resources and barriers in communication in DLB. METHODS & PROCEDURES: Linguistic and cognitive function was explored through standard clinical testing. The dyad's perception of function in daily life was explored through semi-structured interviews analysed with content analysis. Interactional patterns and participation in casual conversation was analysed with conversation analysis. OUTCOME & RESULTS: The results show how the husband diagnosed with DLB performed with high scores across most cognitive and linguistic test tasks. The interview data, however, revealed how both he and his wife experienced significant challenges regarding, for example, conversational tempo, as well as negative feelings relating to adjusting to these conversational changes. The interactional data from the casual conversation revealed, among other patterns, how the wife engaged in most of the storytelling in the conversation. The husband contributed details when his wife asked for help, or he acknowledged a faulty or missing detail in his wife's storyline. Thus, they both oriented to the husband's competence in monitoring and keeping track of the conversational content, despite challenges in taking the floor. CONCLUSIONS & IMPLICATIONS: A holistic picture of communication in DLB necessitates the use of different evaluation approaches. Both monological (e.g., test tasks revealing cognitive and linguistic resources) and dialogical information sources (e.g., observations of conversations revealing adjustments in conversations), as well as the perceptions of those engaging in everyday conversations (i.e., people with DLB and their conversation partner(s)), need to be evaluated when assessing resources and barriers in communication. WHAT THIS PAPER ADDS: What is already known on the subject It is well-known that dementia with Lewy bodies (DLB) affects language and cognition. In conversations, persons with DLB experience difficulties in turn-taking, topic initiation, entering conversations and keeping up with the conversational tempo. What this study adds This study sheds light on conversations in one dyad where the husband has been diagnosed with DLB. The results from three different information sources (testing of language and cognition, interviews and a video-recorded conversation) reveal patterns of resources and barriers that at first appear to contradict each other. However, the contradictions can be resolved when these discrepancies are examined in light of the differences in task structure, in terms of, for example, predetermined topics and how turn-taking is managed. What are the potential or actual clinical implications of this work? In order to gather a holistic picture of a person's conversational abilities, clinicians need to include information from both monological tasks (e.g., linguistic testing) as well as dialogical tasks (e.g., video recordings from conversation). The results also need to be evaluated in light of all conversation partners' perspectives on function in daily life. Furthermore, it is important to consider the nature of assessment tasks (particularly their interactional structure) when interpreting assessment results.

Conceptualizations of aging and cognitive competence: Evaluations and accounts after cognitive testing.

AIM: To investigate how conceptualizations of cognition and aging are displayed through evaluations and accounts after cognitive testing with elders who do not have dementia. METHOD: 14 persons >65 years of age without clinical memory loss were tested with the MMSE and interviewed about their experiences. The audio-recordings were transcribed according to Conversation Analytic conventions. Examples of evaluations and accounts related to cognitive competence were collected, categorized, and analyzed by topic. RESULTS: The results show how the interviewer and participant being tested evaluate and account for face threats related to the cognitive and communicative competence of the person being tested. Examples of evaluations include downplaying one's own competence, while accounts include attributing difficulties with test tasks to personal circumstances, such as participants' lived experiences or to expected (as opposed to pathological) cognitive change in aging. CONCLUSIONS: Inviting participants to share their experiences of cognitive testing can reveal valuable information on how they conceptualize cognition and aging, as well as the testing process itself. Reflections may also reveal potential dementia worry. Evaluations and accounts are closely related to face-saving acts.

Similarities and Differences between EU Platforms in the AHA and AAL Domains from a Software Viewpoint.

The EU PlatformUptake project's main goal is to investigate the usage of EU open and partly-open platforms in active and healthy aging (AHA) and ambient-assisted living (AAL) domains, from a software viewpoint. The aim of the project was to provide tools for a deeper interpretation and examination of the platforms, gather user feedback, and use it to improve the state-of-the-art approach in the AHA and AAL domains, and define instructions to enhance the platforms within the recommended order. The emphasis is on the software viewpoint for decision makers. In this paper, we present (i) the PlatformUptake methodology for AHA open platform assessments and its main objectives; (ii) clustering of the analyzed platforms; and (iii) the taxonomies generated from the text descriptions of the chosen platforms. With the use of the clustering tools, we present which platforms could be grouped together due to their similarities. Different numbers of clusters were obtained with two clustering approaches, resulting in the most informative two and four cluster groups. The platforms could be rather neatly presented in this way and, thus, potentially guide future platform structuring. Moreover, taxonomies, i.e., decision trees of platforms, were generated to easily determine each specific platform or to find platforms with the desired properties. Altogether, the computer comprehension of the platforms may be important additions to the human way of dealing with the AHA platforms, influencing future design, publications, related work, and research.

Picture Description in the Assessment of Connected Speech Intelligibility in Parkinson's Disease: A Pilot Study.

INTRODUCTION: Assessment of intelligibility in dysarthria tends to rely on oral reading of sentences or words. However, self-generated utterances are closer to a client's natural speech. This study investigated how transcription of utterances elicited by picture description can be used in the assessment of intelligibility in speakers with Parkinson's disease. METHODS: Speech samples from eleven speakers with Parkinson's disease and six neurologically healthy persons were audio-recorded. Forty-two naive listeners completed transcriptions of self-generated sentences from a picture description task and orally read sentences from the Swedish Test of Intelligibility, as well as scaled ratings of narrative speech samples. RESULTS: Intelligibility was higher in orally read than self-generated sentences and higher for content words than for the whole sentence in self-generated sentences for most of the speakers, although these within-group differences were not statistically significant at the group level. Adding contextual leads for the listeners increased intelligibility in self-generated utterances significantly but with individual variation. Although correlations between the intelligibility measures were at least moderate or strong, there was a considerable inter- and intra-speaker variability in intelligibility scores between tasks for the speakers with Parkinson's disease, indicating individual variation of factors that impact intelligibility. Intelligibility scores from neurologically healthy speakers were generally high across tasks with no significant differences between the conditions. CONCLUSION: Within-speaker variability supports literature recommendations to use multiple methods and tasks when assessing intelligibility. The inclusion of transcription of self-generated utterances elicited by picture description to the intelligibility assessment has the potential to provide additional information to assessment methods based on oral reading of pre-scripted sentences and to inform the planning of interventions.

A person living with dementia learning to navigate an iPad: a case study.

PURPOSE: This study challenges the notion that people living with dementia are unable to achieve novel learning without focussed intervention techniques. The purpose of this study is to explore how a woman living with dementia (Alzheimer's disease) learns to use a tablet computer with support from communicative partners. METHOD: The study is based on video recordings and the theoretical framework of learning as changing participation in joint activities. Quantitative and qualitative focus is on changes in the interactional organization over the course of six weeks in the activity of using an augmentative and alternative communication application. RESULTS: Over time, the participant living with dementia, relies less on the expertise and explicit instructions of her communicative partners when navigating the application, and more on the immediate feedback provided by the tablet computer. CONCLUSIONS: The findings suggest that novel learning still is possible for people living with dementia, even without the implementation of focussed interventions. This study further emphasizes the procedural nature of learning for people living with dementia as the woman's embodied actions were carried out in an increasingly more direct fashion.Implications for rehabilitationFor people living with dementia, learning in everyday activities is facilitated by repeated exposure to the activity and the scaffolding practices of a more experienced communicative partner.In instances of novel learning, one should not underestimate the importance of embodied engagement from people living dementia.Care professionals need not to worry about exposing people living with dementia to unfamiliar activities.

Swedish Clinical Professionals' Perspectives on Evaluating Cognitive and Communicative Function in Dementia.

Objectives: This study investigated Swedish clinical professionals' experiences of diagnostic pathways in dementia, focusing on the assessment of cognitive and communicative abilities.Methods: Interdisciplinary teams in Memory Clinics, General Practitioners in Primary Health Care, and Speech Language Pathologists were interviewed. The transcripts were analyzed using qualitative Content Analysis.Results: The study sheds light upon the perceived barriers and facilitators of good practice, e.g. time and clinical collaborations. Perspectives among professionals vary as to how informal and formal information and procedures are to be integrated and weighted. External factors (e.g. physical proximity of professions) have considerable influence on information availability, transmission, and diagnostic processes. Communication impairment does not emerge as a clinical priority.Conclusions: Published clinical guidelines notwithstanding, there is in practice no "gold standard" regarding diagnostic processes. Reorganization of services that impact feasibility of cross-disciplinary contact may negatively impact diagnostics.Clinical implications: Interprofessional collaboration is impacted by many factors, e.g. physical proximity and availability of specific professions. In order to optimize collaboration in dementia diagnosis, communication channels between professions need to be optimized. Additionally, making clinical impressions and "gut-feelings" explicit could contribute valuable information to the diagnostic process.

"It's Our Gang" - Promoting Social Inclusion for People with Dementia by Using Digital Communication Support in a Group Activity.

OBJECTIVES: In the present paper we aim to contribute to the understanding of how people with dementia experience using a web-based communication support application on a tablet computer in a group activity. The specific focus of the present paper is on perception of social inclusion among people with dementia in a group activity using digital communication support. METHODS: The study is based on interviews with participants in a communication group for people with dementia where the application CIRCA, specifically designed to support interaction involving people with dementia, was used. Five individuals with dementia were recruited from a residential care home where they lived in different wards. Seven group interviews with the participating persons with dementia following directly after each session were carried out. RESULTS: The views of the participants were generally very positive, regarding many aspects of the activity. In the present study, the group activity seemed more important and beneficial for the participants, than the specific use of the application in itself. CONCLUSIONS: Taking part in a group activity targeting communication made participants with dementia feel that they were part of a social group, that they had learnt things, and that they had been able to contribute with their expertise to others. CLINICAL IMPLICATIONS: Group activities targeting communication give people with dementia the opportunity to exercise their social inclusion practices. Group activities may render a feeling of social community and a sense of belonging to the participants. The use of digital communication support may enhance such activities.

Experiencing dementia: How does assessment of cognition and language relate to daily life?

This Swedish study investigates how persons living with dementia report their experiences of cognitive and linguistic testing, as well as their perspectives on the communicative resources and barriers they experience in daily interactions. Eight dyads were included in this qualitative exploratory study; eight persons with dementia and eight family members with whom they interact with daily. Semi-structured interviews, with questions focusing on experiences of diagnostic pathways as well as communicative and cognitive function in daily life, were carried out together with standard clinical testing. The data were analysed using qualitative content analysis. The results shed light on the experiences of uncertainty during the dementia assessment process related to the assessment tasks, the consequences of the assessment and receiving a diagnosis. We interpret this as a result of the unfamiliar clinical focus on function as measured in decontextualised tasks, compared to the participants' view based on their abilities in everyday life. The study also reveals that adjustments in daily life that are necessitated by the consequences of neurological change are often developed in collaboration between the person with dementia and their conversation partners. There are, however, reports of conflicting feelings by the persons diagnosed with dementia, and by their families, as well as their views on how to best handle change, while maintaining a sense of being a competent person through the progression of disease.

Patients' and communication partners' experiences of communicative changes in Parkinson's disease.

Purpose: The aim of the present study was to investigate the experiences of people with Parkinson's disease and their close communication partners regarding disease-related communicative changes and participation in everyday conversations.Materials and methods: Semi-structured qualitative interviews were conducted with six dyads consisting of a person with Parkinson's disease and a close communication partner. The interview material was analysed through thematic analysis.Results: The main theme was the experiences of barriers and facilitators for participation in conversations. Subthemes were experiences related to changes in voice and articulation, language and cognition, body language and facial expressions, fatigue, self-image, communicative initiative, and familiarity with conversation partner. The results show individual variation. A change observed in almost all dyads was the person with Parkinson's disease participating less in conversations.Conclusions: Assessment and interventions should be based on a broad perspective on communication, and individuals' priorities should be foregrounded in intervention planning. Both the person with Parkinson's disease and communication partners need to make adjustments for communication to work. Therefore, close communication partners should be included in assessment and intervention of communication in Parkinson's disease from an early stage.Implications for rehabilitationInterventions targeting communication in Parkinson's disease should be individually tailored and be based on a holistic perspective on communication.Communicative functions and participation should be assessed already at an early stage of the disease in order to minimize and slow down adverse effects, and to enable the development of effective, personalized strategies.Since changes in communicative abilities might affect self-perception and self-confidence, these aspects need to be taken into account when assessing and planning interventions targeting communication.Close communication partners should be included early in both assessment and intervention.

The mini-mental state examination (MMSE) from a language perspective: an analysis of test interaction.

Assessment of language and cognitive abilities are associated with clinical challenges. The aim of the present study was to learn more about the MMSE test process from a language perspective by looking in detail at the interaction between patient and tester. In addition, we aimed to further explore the relationship between linguistic and cognitive difficulties. The study was based on an analysis of 20 MMSE test dyads, 10 persons with aphasia and 10 persons with dementia, in interaction with speech and language pathologists. All conversations were audio and video recorded and transcribed verbatim according to Conversation Analytical principles. The thorough analysis of the interactions highlighted some main findings that affected the communicative project of the test interactions. Finally, the test results were summarized and analyzed. Through the analysis, some particularly challenging aspects emerged; the understanding of the verbal instructions, the handling of the instructions and the evaluation of the answers. The test results demonstrated that there were no significant differences between the two groups of participants' MMSE results. The results in the 'language' category did not seem to capture the language disorders among many of the participants more than the remaining test items. By qualitative analyses of the interactional aspects of test situations, information about both cognitive and linguistic abilities that otherwise would have been overlooked may be revealed.

An interactional perspective on sound prolongation in multilingual encounters in residential care.

Elderspeak refers to adapting one's language to a  perceived language decline of an older interlocutor. Earlier studies have explored different features of elderspeak; some of these studies attribute positive outcomes to using elderspeak that facilitates communication, but other studies consider elderspeak a negative way of communicating that should be avoided. The aim of this study is to investigate a largely unexplored feature of elderspeak, namely sound prolongation in a multilingual context. There are five participants in this study: three carers and two care recipients in a residential care unit. The carers and care recipients have limited access to a shared spoken language. The data consist of video- and audio recordings of interaction between the participants. The recordings have been transcribed and analysed in accordance with Conversation Analytical methodology. The analysis shows that the carers use sound prolongation as part of their interactional repertoire in order to manage situations of distress. We conclude that in some distressful situations carers' use of sound prolongation may help mitigating the care recipient's emotional concerns since the source of agitations has been addressed properly. In other situations, the use of sound prolongation may lead to an escalation in distress, if the source of agitation is not addressed adequately. Our results bring to the fore that an interactional practice, such as the use of sound prolongation in the context of expressed distress must be interpreted in relation to the complexity of each and every situation participants find themselves in, their level of understanding, and the task/activity at hand.

Digital communication support in interaction involving people with dementia.

BACKGROUND: People with dementia frequently suffer from communication disabilities, which usually influence their quality of life. The communication disabilities may affect a person's possibility to participate in interaction as a result of reduced ability to initiate new topics and difficulties in contributing new information to maintain the conversational topic. Technical aids have been proved useful to facilitate communicative activities by supporting memory and stimulating communicative initiatives. PURPOSE: The aim of the present study is to further understandings of how digital communication support may be used in interaction involving people with dementia. A further aim is to investigate how participants experience communication with and without the use of communication aids. METHODS: The study is carried out in a Swedish context, and three dyads of older women with dementia and professional carers participated in the study. The dyads interact in the home environments of the persons with dementia using tablet computers and two web-based applications with generic pictures, videos, and music files (Computer Interactive Reminiscence and Communication Aid, CIRCA) and personalised pictures and films (Computer Interactive Reminiscence and Communication University of Sheffield, CIRCUS). The data include twenty-one video recorded activities. RESULTS AND CONCLUSION: The applications appear to provide support for the dyads in finding things to talk about. The participants talk both about the material and memories associated with the material. The participants experience the use of communication aids as positive.

Prosodic aspects of repetition in Swedish-speaking children with developmental language disorder.

Purpose: To examine repetition of stress and tonal word accents in real words and non-words in Swedish-speaking children with developmental language disorder (DLD), and to investigate the relation of prosodic repetition to measures of language ability.Method: A cross-sectional study was undertaken with 30 monolingual Swedish-speaking children with DLD, mean age 4;11 (years;months) and 29 age-matched controls, mean age 5;1, who repeated words and non-words with systematically varying prosody. Group differences for the repetition of prosodic features, and correlations between repetition and phonology, grammar, and vocabulary, were explored.Result: Children with DLD performed below controls on repetition of prosodic features of words and non-words. Repetition of stress and tonal word accent was not correlated with phonological production or receptive vocabulary, but a significant correlation was found between stress repetition in words and expressive grammar.Conclusion: Repetition of stress and tonal word accents is challenging for children with DLD acquiring Swedish as their first language, but may not be a good indicator of general language ability. Prosody should be taken into account when interpreting results from clinically used word repetition (WR) and non-word repetition (NWR) tasks.

Prosodic and segmental aspects of nonword repetition in 4- to 6-year-old children who are deaf and hard of hearing compared to controls with normal hearing.

Children who are deaf or hard of hearing (DHH) are at an increased risk of speech and language deficits. Nonword repetition (NWR) is a potential predictor of problems with phonology, grammar and lexicon in DHH children. The aim of the present study was to examine repetition of prosodic features and segments in nonwords by DHH children compared to children with normal hearing (NH) and to relate NWR performance to measures of language ability and background variables. In this cross-sectional study, 14 Swedish-speaking children with mild-profound sensorineural hearing loss, aged 4-6 years, and 29 age-matched controls with NH and typical language development participated. The DHH children used cochlear implants (CI), hearing aids or a combination of both. The assessment materials included a prosodically controlled NWR task, as well as tests of phonological production, expressive grammar and receptive vocabulary. The DHH children performed below the children with NH on the repetition of tonal word accents, stress patterns, vowels and consonants, with consonants being hardest, and tonal word accents easiest, to repeat. NWR performance was also correlated with language ability, and to hearing level, in the DHH children. Both prosodic and segmental features of nonwords are problematic for Swedish-speaking DHH children compared to children with NH, but performance on tonal word accent repetition is comparably high. NWR may have potential as a clinically useful tool for identification of children who are in need of speech and language intervention.