Auditory training for adults with cochlear implants: a systematic review.

OBJECTIVE: To systematically review the peer-reviewed literature on the efficacy of auditory training (AT) on auditory outcomes in post lingually deafened adults with cochlear implants (CIs). DESIGN: A systematic review. STUDY SAMPLE: Searches of five electronic databases yielded 10 studies published after 2010 that met the inclusion criteria. RESULTS: For post lingually deafened adults with CIs, the evidence is suggestive that some AT can improve some auditory outcomes compared to no training. More specifically, the evidence suggests that phonemic training can improve identification of trained phonemes, and nonsense word training can improve sentence recognition in noise in this population. CONCLUSIONS: While many AT interventions are currently being used with post lingually deafened adults with CIs, the evidence for AT improving auditory outcomes is suggestive with the best evidence being for nonsense word training improving sentence recognition in noise by an average of 10% with these improvements retained at 26 weeks post-training in this population. There remains a need for high quality studies that have the capacity to demonstrate, clearly and unequivocally, which AT is most effective for improving which auditory outcomes in this population.

Effects of emotional cues on novel word learning in typically developing children in relation to broader autism traits.

Emotion can influence various cognitive processes. Communication with children often involves exaggerated emotional expressions and emotive language. Children with autism spectrum disorder often show a reduced tendency to attend to emotional information. Typically developing children aged 7 to 9 years who varied in their level of autism-like traits learned the nonsense word names of nine novel toys, which were presented with either happy, fearful, or neutral emotional cues. Emotional cues had no influence on word recognition or recall performance. Eye-tracking data showed differences in visual attention depending on the type of emotional cues and level of autism-like traits. The findings suggest that the influence of emotion on attention during word learning differs according to whether the children have lower or higher levels of autism-like traits, but this influence does not affect word learning outcomes.

Cross-modal emotion recognition and autism-like traits in typically developing children.

The ability to explicitly recognize emotions develops gradually throughout childhood, and children usually have greater difficulty in recognizing emotions from the voice than from the face. However, little is known about how children integrate vocal and facial cues to recognize an emotion, particularly during mid to late childhood. Furthermore, children with an autism spectrum disorder often show a reduced ability to recognize emotions, especially when integrating emotion from multiple modalities. The current preliminary study explored the ability of typically developing children aged 7-9 years to match emotional tones of voice to facial expressions and whether this ability varies according to the level of autism-like traits. Overall, children were the least accurate when matching happy and fearful voices to faces, commonly pairing happy voices with angry faces and fearful voices with sad faces. However, the level of autism-like traits was not associated with matching accuracy. These results suggest that 7- to 9-year-old children have difficulty in integrating vocal and facial emotional expressions but that differences in cross-modal emotion matching in relation to the broader autism phenotype are not evident in this task for this age group with the current sample.

Outcomes for School-Aged Children with Aural Atresia.

This study compared the language, reading, classroom, and quality of life outcomes of primary school-aged children with aural atresia (AA) to matched controls. Participants included 10 children with AA (eight unilateral) and 10 children with typical hearing matched by chronological and mental age. All children with AA had been fitted with an amplification device. Outcome measures included standardized tests of language, reading, and functional communication questionnaires of children's classroom performance and hearing quality of life. The children with AA recorded significantly reduced hearing quality of life. The two groups did not differ on any other measures. The present preliminary findings suggest that children with AA who receive early amplification have similar language, communication, reading, and classroom outcomes as their typically hearing peers. Despite these promising outcomes, however, the children's quality of life is significantly reduced. Further research is needed to further elucidate these findings.

Spelling in Children With Cochlear Implants: Evidence of Underlying Processing Differences.

This study compared the spelling skills and sub-skills of young children with cochlear implants (CIs) who use spoken language only (n = 14) with those of a same-aged typically hearing (TH) control group (n = 30). Spelling accuracy was assessed using irregular and nonsense word stimuli. Error and regression analyses were conducted to provide insight into the phonological and orthographic spelling strategies used by each group. Results indicated that children with CIs were as accurate as the TH group. However, misspellings made by the CI group were less phonologically plausible, and while nonword spelling accuracy was related to letter-sound knowledge for the TH group, the same relationship was non-significant for the CI group. Hence, despite demonstrating a similar degree of overall spelling success to TH children, children with CIs appeared to apply phonics skills less effectively.

Parent-implemented home therapy programmes for speech and language: a systematic review.

BACKGROUND: Parent-delivered home programmes are frequently used to remediate speech and language difficulties in young children. However, the evidence base for this service delivery model is limited. AIMS: The aim of this systematic review is to investigate the effectiveness of parent-implemented home programmes in facilitating the development of children's speech and language skills, and to evaluate the cost-effectiveness and feasibility of this service delivery method. METHODS & PROCEDURES: A systematic search of the PsycINFO, CINAHL and ERIC databases was conducted. Quality appraisal of individual studies was conducted. Findings from each of the studies were then integrated to report on outcomes for the child, the parent and the service. OUTCOMES & RESULTS: There is preliminary evidence that home programmes can lead to growth in a child's speech and language skills and are more effective than no intervention, provided the home programmes are used with high dosage rates and direct parent training. CONCLUSIONS & IMPLICATIONS: Home programmes are a potentially useful service delivery model, but caution should be exercised when considering their use to address broader service delivery challenges. Further high-level evidence is needed across all facets of this service delivery model.

Change in receptive vocabulary from childhood to adulthood: associated mental health, education and employment outcomes.

BACKGROUND: Population-based studies have found that early language delays are associated with poorer long-term outcomes in adolescence and adulthood. Few studies have explored the influence of change in language ability over time on adult outcomes. AIM: To examine the educational, vocational and mental health outcomes for adults accounting for different vocabulary developmental profiles over a 16-year period. METHODS & PROCEDURES: A total of 1914 participants of the Mater-University of Queensland Study of Pregnancy (MUSP) were categorized into four groups based on their vocabulary skills at 5 and 21 years: (1) persistently good (n = 1679), (2) persistently poor (n = 33), (3) improved (n = 160), and (4) deteriorated (n = 42). The associations between vocabulary group and educational, vocational, and mental health outcomes at 21 years were investigated. OUTCOMES & RESULTS: Adults with deteriorated and persistently poor vocabulary skills were less likely to have completed secondary school; with the improved, deteriorated and persistently poor groups being less likely to be engaged in education, employment or training at the 21-year follow-up, compared with the persistently good group. Adults with deteriorated performance were at an increased risk of affective disorders, as well as substance and alcohol abuse/misuse. CONCLUSIONS & IMPLICATIONS: These findings provide evidence that impaired vocabulary skills in adulthood, regardless of whether the deficit was acquired early or later, are associated with adverse outcomes. Clinicians and educators need to be aware of these adversities and ensure they are supporting children and adolescents in whom language difficulties exist or emerge so as to prevent poor long-term outcomes from occurring.

Fidaxomicin versus Vancomycin in the Treatment of Clostridium difficile Infection: Canadian Outcomes.

Background. This analysis examined the efficacy of fidaxomicin versus vancomycin in 406 Canadian patients with Clostridium difficile infection (CDI), based on data from 2 randomized, clinical trials. Methods. Patients received fidaxomicin or vancomycin 1. Patients were assessed for clinical response recurrence of infection and sustained clinical response for 28 days after treatment completion. Patients at increased risk of recurrence were subjected to subgroup analyses. Results. Clinical response rates for fidaxomicin (90.0%) were noninferior to those with vancomycin (92.2%; 95% confidence interval for difference: -7.7, 3.5). However, fidaxomicin-treated patients had lower recurrence (14.4% versus 28.0%, p = 0.001) and higher sustained clinical response (77.1% versus 66.3%, p = 0.016). Compared with vancomycin, fidaxomicin was associated with lower recurrence rates in all subgroups, reaching statistical significance in patients with age ≥ 65 years (16.0% versus 30.9%, p = 0.026), concomitant antibiotic use (16.2% versus 38.7%, p = 0.036), and non-BI strains (11.8% versus 28.3%, p = 0.004). Higher sustained clinical response rates were observed for fidaxomicin compared with vancomycin in all subgroups; this was statistically significant in the non-BI subgroup (82.8% versus 69.1%, p = 0.021). Conclusions. In Canadian patients, fidaxomicin was superior to vancomycin in sustaining clinical response and reducing CDI recurrence.

A systematic review of electrophysiological outcomes following auditory training in school-age children with auditory processing deficits.

OBJECTIVE: To systematically review the peer-reviewed literature on electrophysiological outcomes following auditory training (AT) in school-age children with (central) auditory processing disorder ([C]APD). DESIGN: A systematic review. STUDY SAMPLE: Searches of 16 electronic databases yielded four studies involving school-aged children whose auditory processing deficits had been confirmed in a manner consistent with ASHA (2005) and AAA (2010) and compared to a treated and/or an untreated control group before and after AT. A further three studies were identified with one lacking a control group and two measuring auditory processing in a manner not consistent with ASHA (2005) and AAA (2010). RESULTS: There is limited evidence that AT leads to measurable electrophysiological changes in children with auditory processing deficits. CONCLUSION: The evidence base is too small and weak to provide clear guidance on the use of electrophysiological outcomes as a measure of AT outcomes in children with auditory processing problems. The currently limited data can only be used to suggest that click-evoked AMLR and tone-burst evoked auditory P300 might be more likely to detect such outcomes in children diagnosed with (C)APD, and that speech-evoked ALLR might be more likely to detect phonological processing changes in children without a specific diagnosis of (C)APD.

Modulations of right hemisphere connectivity in young children relates to the perception of spoken words.

The early school years shape a young brain's capability to comprehend and contextualize words within milliseconds of exposure. Parsing word sounds (phonological interpretation) and word recognition (enabling semantic interpretation) are integral to this process. Yet little is known about the causal mechanisms of cortical activity during these early developmental stages. In this study, we aimed to explore these causal mechanisms via dynamic causal modelling of event-related potentials (ERPs) acquired from 30 typically developing children (ages 6-8 years) as they completed a spoken word-picture matching task. Source reconstruction of high-density electroencephalography (128 channels) was used to ascertain differences in whole-brain cortical activity during semantically "congruent" and "incongruent" conditions. Source activations analyzed during the N400 ERP window identified significant regions-of-interest (pFWE<.05) localized primarily in the right hemisphere when contrasting congruent and incongruent word-picture stimuli. Dynamic causal models (DCMs) were tested on source activations in the fusiform gyrus (rFusi), inferior parietal lobule (rIPL), inferior temporal gyrus (rITG) and superior frontal gyrus (rSFG). DCM results indicated that a fully connected bidirectional model with self-(inhibiting) connections over rFusi, rIPL and rSFG provided the highest model evidence, based on exceedance probabilities derived from Bayesian statistical inferences. Connectivity parameters of rITG and rSFG regions from the winning DCM were negatively correlated with behavioural measures of receptive vocabulary and phonological memory (pFDR<.05), such that lower scores on these assessments corresponded with increased connectivity between temporal pole and anterior frontal regions. The findings suggest that children with lower language processing skills required increased recruitment of right hemisphere frontal/temporal areas during task performance.

Impaired reading comprehension in schizophrenia: evidence for underlying phonological processing deficits.

The present study examined reading ability in high functioning people with schizophrenia. To this end, 16 people with schizophrenia who were living in the community and 12 matched controls completed tests of passage reading (comprehension, accuracy, and rate), word recognition, and phonological processing (phonological awareness, phonological memory and rapid naming) and ratings of reading self-concept and practices. Performance of the participants with schizophrenia was impaired relative to control participants on reading comprehension and rapid naming and relative to the population norms on phonological awareness, and rapid naming. In addition, self-rating data revealed that participants with schizophrenia had poorer perceptions of their reading ability and engaged in reading activities less frequently than their control counterparts. Consistent with earlier research, significant correlations were found between phonological awareness and reading comprehension. These findings expand on previous research in the area to suggest that community-based individuals with schizophrenia experience problems with reading comprehension that may have a phonological basis.

Semantic activation in Parkinson's disease patients on and off levodopa.

Research suggests that dopamine may exert a neuromodulatory influence on automatic spreading activation within semantic networks. In order to investigate the influence of dopamine depletion on semantic activation in Parkinson's disease (PD), nine patients with PD performed a lexical decision task when on and off levodopa medication. Eleven healthy controls matched to the PD patients in terms of sex, age and education also participated in the study. Both directly related word pairs (e.g., tiger - stripe) and indirectly related word pairs (word pairs related via a mediating word, e.g., chalk - black) were used to measure semantic activation across stimulus onset asynchronies (SOAs) of 270msec, 520msec and 1020msec. Analysis of variance statistics revealed that the activation of directly related and indirectly related targets was slower for the PD group relative to the control group. Within group comparisons revealed further changes to semantic activation in PD patients off medication, with no activation of directly or indirectly related target words evident in PD patients off medication. These results further clarify the nature of dopamine's neuromodulatory influence on semantic activation, and suggest that the nature of altered semantic activation in PD may depend on the magnitude of dopamine depletion.

Phonological awareness and language intervention in preschoolers from low socio-economic backgrounds: a longitudinal investigation.

This study examines the literacy outcomes for children from socially disadvantaged backgrounds who had received specific whole-class phonological awareness (PA) and language intervention in preschool. The participants were 57 children who had been involved in the original intervention study. Their PA skills, letter-sound knowledge, real word and non-word spelling and reading comprehension were assessed in Grade 2. The results indicated that children who had received intervention in preschool performed similarly to the children who had not received intervention. The gains made in PA and language skills post intervention had failed to augment further literacy development. A post hoc examination of individual student profiles, however, revealed that a subgroup of children who had received intervention had maintained their enhanced performance and that the intervention cohort had similar scores on tests of PA ability to their age-matched peers in the population. It was concluded that whole-class, teacher-delivered, PA and language intervention, while effective in the short term, does not lead to a generalized improvement in literacy skills in Grade 2. Possible reasons for the failure of the program to produce medium term gains are discussed.

Reading Development in Children With Cochlear Implants Who Communicate via Spoken Language: A Psycholinguistic Investigation.

Purpose This study sought to comprehensively examine the reading skills and subskills of children with cochlear implants (CIs) and gain insight into the processes underlying their early reading development. Method Fourteen 6- to 9-year-old children with CIs were assessed on a range of reading and spoken language measures. Their performances were compared to a control group of 31 children with normal hearing (NH) of the same chronological and mental age. Group differences were examined using t tests and regression modeling. Results Children with CIs performed significantly worse than children with NH on reading accuracy, phonological processing, and spoken language tasks. The predominant predictor of reading comprehension was word reading accuracy for the CI group and listening comprehension for the NH group. Word reading profiles were similar across groups, with orthographic and phonological processing skills both contributing significant variance. Conclusions Children with CIs demonstrated more early reading difficulties than their peers with NH. As predicted by the Simple View of Reading model, successful reading comprehension for all children related to skills in listening comprehension and word recognition. The CI group's increased reliance on word reading accuracy when comprehending written text may stem from reduced word recognition automaticity. Despite showing reduced reading accuracy, children with CIs appeared to draw on orthographic and phonological skills to a similar degree as children with NH when reading words in isolation.

Semantic processing in children with cochlear implants: Evidence from event-related potentials.

Introduction: Existing research has shown that children with significant hearing loss who use cochlear implants (CIs) perform worse than their hearing peers on behavioral measures of spoken language. The present study sought to examine how children with CIs process lexical-semantic incongruence, as indexed by electrophysiological evidence of the N400 effect. Method: Twelve children with CIs, aged between 6 and 9 years, participated in a spoken word-picture matching task while event-related potentials (ERPs) were recorded. To determine whether the N400 effect elicited in this group deviated from normal, independent samples t tests and analysis of variance (ANOVA) analyses were used to compare the results of children with CIs against those of a similarly aged typically hearing (TH) group (n = 30). Correlational analyses were also conducted within each group to gauge the degree to which the N400 effect related to behavioral measures of spoken language. Results: An N400 effect was elicited in both groups of CI and TH children. The amplitude and latency of the N400 effect did not differ significantly between groups. Despite the similarity in ERP responses, children with CIs scored significantly lower on behavioral measures of spoken word- and sentence-level comprehension. No significant correlations between ERP and behavioral measures were found, although there was a trending relationship between sentence-level spoken language comprehension and the TH group's N400 effect mean amplitude (p = .060). Conclusions: The results suggest that, at a neural level, children with CIs can process lexical-semantic incongruence, and that other underlying processes not measured by the N400 effect contribute to this population's spoken language difficulties.

White noise facilitates new-word learning from context.

Listening to white noise may facilitate cognitive performance, including new word learning, for some individuals. This study investigated whether auditory white noise facilitates the learning of novel written words from context in healthy young adults. Sixty-nine participants were required to determine the meaning of novel words placed within sentence contexts during a silent reading task. Learning was performed either with or without white noise, and recognition of novel word meanings was tested immediately after learning and after a short delay. Immediate recognition accuracy for learned novel word meanings was higher in the noise group relative to the no noise group, however this effect was no longer evident at the delayed recognition test. These findings suggest that white noise has the capacity to facilitate meaning acquisition from context, however further research is needed to clarify its capacity to improve longer-term retention of meaning.

An investigation of working memory influences on lexical ambiguity resolution.

The present study employed a combined semantic judgment and lexical decision priming paradigm to examine the impact of working memory on the inhibitory processes of lexical ambiguity resolution. The results indicated that overall, participants activated one meaning of a presented homograph while not priming the alternative meaning. As hypothesized, participants with high working-memory spans exhibited a pattern of priming for congruent conditions and a lack of positive priming for incongruent conditions. In contrast, participants with low working-memory capacity showed priming for both congruent and incongruent conditions, but only for conditions in which the context was related to the dominant meaning of the homograph. The results suggest that people with low working-memory capacity have difficulty inhibiting inappropriate homograph meanings and further demonstrate that these difficulties may vary as a function of context-meaning dominance.

Effects of Prosodic and Semantic Cues on Facial Emotion Recognition in Relation to Autism-Like Traits.

The current study investigated whether those with higher levels of autism-like traits process emotional information from speech differently to those with lower levels of autism-like traits. Neurotypical adults completed the autism-spectrum quotient and an emotional priming task. Vocal primes with varied emotional prosody, semantics, or a combination, preceded emotional target faces. Prime-target pairs were congruent or incongruent in their emotional content. Overall, congruency effects were found for combined prosody-semantic primes, however no congruency effects were found for semantic or prosodic primes alone. Further, those with higher levels of autism-like traits were not influenced by the prime stimuli. These results suggest that failure to integrate emotional information across modalities may be characteristic of the broader autism phenotype.

The impact of auditory white noise on semantic priming.

It has been proposed that white noise can improve cognitive performance for some individuals, particularly those with lower attention, and that this effect may be mediated by dopaminergic circuitry. Given existing evidence that semantic priming is modulated by dopamine, this study investigated whether white noise can facilitate semantic priming. Seventy-eight adults completed an auditory semantic priming task with and without white noise, at either a short or long inter-stimulus interval (ISI). Measures of both direct and indirect semantic priming were examined. Analysis of the results revealed significant direct and indirect priming effects at each ISI in noise and silence, however noise significantly reduced the magnitude of indirect priming. Analyses of subgroups with higher versus lower attention revealed a reduction to indirect priming in noise relative to silence for participants with lower executive and orienting attention. These findings suggest that white noise focuses automatic spreading activation, which may be driven by modulation of dopaminergic circuitry.

Predicting Language Difficulties in Middle Childhood From Early Developmental Milestones: A Comparison of Traditional Regression and Machine Learning Techniques.

Purpose: The current study aimed to compare traditional logistic regression models with machine learning algorithms to investigate the predictive ability of (a) communication performance at 3 years old on language outcomes at 10 years old and (b) broader developmental skills (motor, social, and adaptive) at 3 years old on language outcomes at 10 years old. Method: Participants (N = 1,322) were drawn from the Western Australian Pregnancy Cohort (Raine) Study (Straker et al., 2017). A general developmental screener, the Infant Monitoring Questionnaire (Squires, Bricker, & Potter, 1990), was completed by caregivers at the 3-year follow-up. Language ability at 10 years old was assessed using the Clinical Evaluation of Language Fundamentals-Third Edition (Semel, Wiig, & Secord, 1995). Logistic regression models and interpretable machine learning algorithms were used to assess predictive abilities of early developmental milestones for later language outcomes. Results: Overall, the findings showed that prediction accuracies were comparable between logistic regression and machine learning models using communication-only performance as well as performance on communication and broader developmental domains to predict language performance at 10 years old. Decision trees are incorporated to visually present these findings but must be interpreted with caution because of the poor accuracy of the models overall. Conclusions: The current study provides preliminary evidence that machine learning algorithms provide equivalent predictive accuracy to traditional methods. Furthermore, the inclusion of broader developmental skills did not improve predictive capability. Assessment of language at more than 1 time point is necessary to ensure children whose language delays emerge later are identified and supported. Supplemental Material: https://doi.org/10.23641/asha.6879719.