Application of Ultrasound Biofeedback to the Learning of the Mendelsohn Maneuver in Non-dysphagic Adults: A Pilot Study.

This study aimed to investigate the application of ultrasound to the learning of swallowing maneuver. Forty non-dysphagic adults of both genders who were naïve to the Mendelsohn maneuver participated in the study. They were randomly assigned to receive ultrasound or surface electromyography (sEMG) as biofeedback when acquiring the Mendelsohn maneuver. Thirty-eight subjects (n = 19) completed the Learning phase. Accuracy of executing the Mendelsohn maneuver was measured immediately (Post-training percentage accuracy) and one week post-training (Retention percentage accuracy). Whereas comparable numbers of training blocks were completed by the two groups (t(31.51) = 3.68, p = 0.330), the Ultrasound group attained significantly higher percentage accuracies than the sEMG group at both Post-training (t(28.88) = 4.04, p < 0.001, d = 1.309) and Retention (t(30.78) = 2.13, p = 0.042, d = 0.690). Ultrasound is a more effective biofeedback than sEMG in the acquisition of the Mendelsohn maneuver and may be adopted to the rehabilitative treatment for dysphagic individuals. Non-specificity of sEMG as biofeedback should be emphasized when it is employed in the training and learning of swallowing maneuvers. Findings from the present study suggest that ultrasound is preferable to sEMG as biofeedback in the learning of the Mendelsohn maneuver.

Relations between verb factivity and first-order and second-order false belief understanding: Evidence from Mandarin-speaking typically developing children and children with autism spectrum disorders.

Previous studies have shown that factivity is closely related to first-order false belief (FB). However, whether the role of factivity in first-order FB extends to second-order FB remains unclear. Investigations of verb factivity and second-order FB would contribute to our knowledge of the role of language in theory of mind (ToM) development. This study examined relations between verb factivity and first-order and second-order FB reasoning in 156 four- to seven-year-old typically developing (TD) Mandarin-speaking children, and in 17 children with autism spectrum disorders (ASD) and 17 TD matched controls. Children's understanding of a factive zhidào 'know', a non-factive juédé 'think' and a counter-factive jiǎzhuang 'pretend' was assessed by a truth value judgement task. For TD children, zhidào 'know' (factive) significantly predicted their first-order and second-order FB performances, and jiǎzhuang 'pretend' (counter-factive) significantly predicted their first-order FB performance. For autistic children, they performed significantly poorer than their TD counterparts on complementation, verb factivity, first-order and second-order FB, and their first-order FB performance was significantly related to jiǎzhuang 'pretend' (counter-factive). The findings suggest that verb factivity relates to both first-order and second-order FB, and verbs differing in factuality and mental state status contribute differently to ToM development.

Comprehension of presupposition triggers in Cantonese-speaking children with and without autism spectrum disorders.

Built on a previous finding that children with autism spectrum disorders (ASD) had difficulty comprehending presuppositions, a domain of knowledge which is crucial for successful communication, the present study investigated the comprehension of seven types of presupposition trigger - namely definite descriptions, factive predicates, change-of-state verbs, implicative verbs, iteratives, temporal clauses, and counterfactual conditionals - in Cantonese-speaking children with and without ASD. Twenty-seven children with ASD (mean age 9.07) were compared with 23 typically developing (TD) children matched on chronological age and 21 TD children matched on language ability (LA). Knowledge of presupposition triggers was evaluated on the basis of children's ability to judge whether a given utterance was a correct presupposition of a preceding utterance. Children with ASD were found to perform significantly worse than TD children matched on chronological age in comprehending the seven types of presupposition trigger, but they performed similarly to TD children matched on language ability. After the effects of chronological age, language ability, and non-verbal intelligence were controlled for, children with ASD were still found to show a deficit in comprehending the presupposition triggered by a temporal clause, relative to the two groups of TD children. Future studies should investigate the factors contributing to this specific deficit in children with ASD, such as executive functioning and theory of mind.

Comprehension of literal statements and similes in Cantonese-speaking children with and without autism spectrum disorders.

While it has been proposed, following relevance theory, that similes can be understood at a purely literal level on a par with literal statements, it remains unclear whether children with high-functioning autism spectrum disorders (HFASD) perform similarly to typically developing (TD) children in comprehending literal statements and similes. The present study investigated comprehension of literal statements and similes in Cantonese-speaking children with HFASD and TD children matched on both chronological age and verbal mental age. An utterance-picture matching task was devised to assess their comprehension of literal statements and similes in Cantonese. Overall results showed that Cantonese-speaking children with HFASD performed worse than TD children in comprehending literal statements and similes, and both groups showed more difficulty in comprehending similes than literal statements. After the effects of chronological age and verbal mental age were controlled for, no group difference was found between children with HFASD and TD children in comprehending literal statements, whereas the group difference in simile comprehension still existed, suggesting that children with HFASD showed deficits in comprehending similes relative to TD children. These findings challenge the proposal that similes can be understood at a purely literal level on a par with literal statements. Future studies should investigate the role of different aspects of language ability and different levels of theory-of-mind skills in comprehension of similes and metaphors in children with HFASD.

Relations between awareness of morphosyntactic structures in Chinese compound words and reading abilities: A short report.

This is a short report of the investigation of the relationship between awareness of morphosyntactic structures in Chinese compound words and reading abilities on 268 fourth graders studying in three mainstream schools in Shenzhen. All children were assessed using reading and cognitive tasks including rapid automatized naming, phonological, orthographic and morphological awareness. A compound production task using pseudo compound words with different morphosyntactic structures in the first and second levels as stimuli was also conducted. Results of ANOVA indicated that main effect of first level morphosyntactic structures, main effect of second level morphosyntactic structures and interaction effects between the two were significant. Children's awareness of different morphosyntactic structures were affected by frequency of usage of individual morphosyntactic structures in the language. Results of hierarchical regression analyses revealed that the awareness of morphosyntactic structures in Chinese compound words is strongly associated with Chinese reading abilities. Theoretical and clinical implications were discussed.

Comprehension of presuppositions in school-age Cantonese-speaking children with and without autism spectrum disorders.

While an enormous amount of research has been done on the deficient conversation skills in individuals with autism spectrum disorders (ASD), little is known about their performance on presuppositions, a domain of knowledge that is crucial for successful communication. This study investigated the comprehension of four types of presupposition, namely existential, factive, lexical and structural presuppositions, in school-age Cantonese-speaking children with and without ASD. A group of children with ASD (n = 21), mean age 8.8, was compared with a group of typically developing children (n = 106). Knowledge of presuppositions was evaluated based on children's ability to judge whether a given utterance was a correct presupposition of a preceding utterance. Children with ASD were found to show a deficit in the comprehension of presuppositions, even after controlling for differences in general language ability and non-verbal intelligence. The relative difficulty of the four types of presupposition did not differ between the two groups of children. The present findings provide new empirical evidence that children with ASD have a deficit in the comprehension of presuppositions. Future research should explore whether the deficit in the comprehension of presuppositions is related to the development of theory of mind skills in children with ASD.

Hierarchical phrase-based grammatical analysis of language samples from Cantonese-speaking children with and without autism.

The present study made a reference to Zhu Dexi's phrase-based grammar approach to analyse Cantonese utterances hierarchically into 14 syntactic structures (SS). A total of 68 speech samples from Cantonese-speaking children with and without Autism Spectrum Disorder (ASD) were collected. The mean length of utterance in words (MLUw), the number of syntactic structures (NOSS), the number of different syntactic structures (NODSS) and the flexibility of syntactic structures (FSS) of the samples were calculated. Comparisons among four groups of typically developing (TD) children revealed that all the indexes show developmental changes across age stages. Comparisons between ASD subjects and their age-matched (AM) and MLUw-matched (MM) normal peers were done. MLUw, NOSS and NODSS and FSS could be used to distinguish autistic children from their AM normal peers, but only FSS could be used to distinguish ASD from MM groups qualitatively and quantitatively. The lack of production of SP, V1O/SV2 and Coord1Coord2 with low FSS may be one of the factors that will affect ASD children's further syntactic development.

Predicting the naming of regular-, irregular- and non-phonetic compounds in Chinese.

This study investigated the contributions of different cognitive measures in predicting the three types of Chinese characters: regular phonetic compounds, irregular phonetic compounds and non-phonetic compounds. A total of 246 Grade 3 children (mean age = 8.63 yrs) were tested using a bunch of tasks including phonological processing, orthographic processing, morphological processing, rapid automatised naming and Chinese character naming. Results showed that advanced phonological processing skills contributed largely to regular phonetic compounds naming while other cognitive measures predict the naming of the other two types of characters. The results imply that the skills underlying the learning of regular phonetic compounds are different from that of irregular phonetic compounds and non-phonetic compounds, which are similar. Data from three poor readers whose performances pattern on naming different types of Chinese characters agreed with the pattern predicted by their performances in different cognitive tasks provide further support to the claim. Theoretical and pedagogical implications were discussed.

The roles of language and executive function in Mandarin-speaking children's theory of mind development.

Introduction: Research has indicated that language and executive function relate closely to first-order false belief reasoning, yet their roles in second-order false belief reasoning are under-explored, and their interplay in theory of mind development remains obscure. Methods: This study assessed 160 Mandarin-speaking preschoolers' and early primary schoolers' language, executive function, and theory of mind abilities to examine the unique roles and interplay of language and executive function in first-order and second-order false belief reasoning. Results: Results showed that language significantly uniquely predicted the children's first-order as well as second-order false belief reasoning when controlling for the effects of age and executive function. Although executive function significantly predicted first-order FB reasoning when controlling for age, it was no longer a significant predictor of first-order FB reasoning when language was included in the model. However, executive function played a significant unique role in second-order FB reasoning when controlling for the effects of age and language. Discussion: The current findings suggest that language plays a greater role than executive function in Mandarin-speaking children's theory of mind development and the contributors to theory of mind development vary in different levels of false belief reasoning.

Corrigendum: Corpus of Mandarin Child Language: a preliminary study on the acquisition of semantic content categories in Mandarin-speaking preschoolers.

[This corrects the article DOI: 10.3389/fpsyg.2023.1234525.].

Reading strategies of Chinese students with severe to profound hearing loss.

The present study investigated the significance of auditory discrimination and the use of phonological and orthographic codes during the course of reading development in Chinese students who are deaf or hard of hearing (D/HH). In this study, the reading behaviors of D/HH students in 2 tasks-a task on auditory perception of onset rime and a synonym decision task-were compared with those of their chronological age-matched and reading level (RL)-matched controls. Cross-group comparison of the performances of participants in the task on auditory perception suggests that poor auditory discrimination ability may be a possible cause of reading problems for D/HH students. In addition, results of the synonym decision task reveal that D/HH students with poor reading ability demonstrate a significantly greater preference for orthographic rather than phonological information, when compared with the D/HH students with good reading ability and their RL-matched controls. Implications for future studies and educational planning are discussed.

Corpus of Mandarin Child Language: a preliminary study on the acquisition of semantic content categories in Mandarin-speaking preschoolers.

In studying language acquisition in children, sizable research studies have been focusing on the investigation of form and lexical semantics. This study aims to establish a child language database annotated both syntactically with part of speech and semantically with semantic content category to supplement the study of child language acquisition in the semantic domain beyond lexical level. The Corpus of Mandarin Child Language (CMCL) that documented the production of different semantic content categories by Mandarin-speaking children was established. Naturalistic language samples of 82 native Mandarin-speaking children aged 25-60 months, divided into three age groups, were obtained. The corresponding semantic content categories coded in each utterance were tagged according to previous studies, in addition to the annotations of part of speech. MLU and lexical diversity were examined and the usage and acquisition of different semantic content categories were also analyzed. The results regarding syntactic complexity and lexical diversity replicated the typical language acquisition pattern from previous studies, which supported the validity of the data obtained in the CMCL. To investigate the trajectory of acquisition of various semantic content categories by age, a 90% acquisition criterion was used. Our findings regarding the acquisition order of semantic content category were basically in line with previous studies in general, with some minor differences. This acquisition order observed is largely explained by the cognitive and syntactic complexity associated with the semantic content category, with additional influence from language specific properties and cultural specific factors of Mandarin. In addition, with the tags in both part-of-speech and semantic content category, the CMCL potentially provides a platform for examining the form-content interface in early child language acquisition, which also implies significantly on the theoretical and clinical ground.

Temporal measures of oropharyngeal swallowing events identified using ultrasound imaging in healthy young adults.

Swallowing is a complex process that involves precise coordination among oral and pharyngeal structures, which is essential to smooth transition of bolus and adequate airway protection. Tongue base retraction and hyolaryngeal excursion are two significant swallowing movements, and their related events can be examined using ultrasound imaging, which is physically and radioactively non-invasive. The present study aimed to 1) establish the temporal sequences and timing of swallowing events identified using ultrasound imaging, and 2) investigate the variability of the above temporal sequences and 3) investigate the effect of bolus type on the variability of temporal sequences in non-dysphagic individuals. Forty-one non-dysphagic young adults of both genders (19 males and 22 females) participated in the study. Ultrasound images were acquired mid-saggitally at their submental region during swallowing of boluses with different volume (i.e. 5mL or 10mL) and consistencies (i.e. IDDSI Levels 0 and 4). Timing and sequence of six events 1) displacement onset (TBOn), 2) maximum displacement (TBMax) and 3) displacement offset of tongue base retraction (TBOff); and, 4) displacement onset (HBOn), 5) maximum displacement (HBMax) and 6) displacement offset of the hyoid bone excursion (HBOff) were extracted from the ultrasound images. Out of the 161 swallows, 85.7% follow a general sequence of HBOn < TBOn < HBMax < TBMax < HBOff < TBOff. Percentage adherence to six anticipated paired-event sequences was studied. Results suggested the presence of individual variability as adherence ranged from 75.8% to 98.1% in four of the anticipated sequences, leaving only two sequences (HBOn < TBMax and TBMax < HBOff) obligatory (i.e. 100% adherence). For non-obligatory sequences, it was found that bolus type may have an effect on the level of adherence. Findings of the present study lay the groundwork for future studies on swallowing using ultrasound imaging and also the clinical application of ultrasonography.

Early difficulties of Chinese preschoolers at familial risk for dyslexia: deficits in oral language, phonological processing skills, and print-related skills.

The present study examined some early performance difficulties of Chinese preschoolers at familial risk for dyslexia. Seventy-six high-risk (40 good and 36 poor readers) and 25 low-risk Chinese children were tested on oral language, reading-related cognitive skills (e.g. phonological processing skills, rapid naming, and morphological awareness), and Chinese word reading and spelling over a 3-year period. The parents were also given a behaviour checklist for identifying child at-risk behaviours. Results showed that the High Risk (Poor Reading) group performed significantly worse than the Low Risk and the High Risk (Good Reading) group on most of the measures and domains. More children in the High Risk (Poor Reading) group displayed at-risk behaviours than in the other two groups. These results suggest that Chinese at-risk children with early difficulties in reading and spelling do show a wide range of language-, phonology-, and print-related deficits, similar to their alphabetic counterparts. An understanding of these early difficulties may help prevent dyslexia from developing in at-risk children.

The effects of tongue loading and auditory feedback on vowel production.

This study investigated the role of sensory feedback during the production of front vowels. A temporary aftereffect induced by tongue loading was employed to modify the somatosensory-based perception of tongue height. Following the removal of tongue loading, tongue height during vowel production was estimated by measuring the frequency of the first formant (F1) from the acoustic signal. In experiment 1, the production of front vowels following tongue loading was investigated either in the presence or absence of auditory feedback. With auditory feedback available, the tongue height of front vowels was not modified by the aftereffect of tongue loading. By contrast, speakers did not compensate for the aftereffect of tongue loading when they produced vowels in the absence of auditory feedback. In experiment 2, the characteristics of the masking noise were manipulated such that it masked energy either in the F1 region or in the region of the second and higher formants. The results showed that the adjustment of tongue height during the production of front vowels depended on information about F1 in the auditory feedback. These findings support the idea that speech goals include both auditory and somatosensory targets and that speakers are able to make use of information from both sensory modalities to maximize the accuracy of speech production.

Reading Picture Books With Elements of Positive Psychology for Enhancing the Learning of English as a Second Language in Young Children.

This study aimed to investigate the learning effectiveness of reading picture books with EMPATHICS elements using dialogic reading techniques in enhancing young children's English language learning and creativity. EMPATHICS is an acronym of Emotion and Empathy, Meaning and Motivation, Perseverance, Agency and Autonomy, Time, Habits of Mind, Intelligences, Character Strengths, and Self Factors (Oxford, 2016). It adopted a quasi-experimental design, and 78 kindergarten children aged from 4 to 5 years old in a cluster group were randomly assigned to the experimental and control groups. Both groups read the same four picture books with their homeroom teachers, including two readers suggested in the curriculum and two picture books with enriched elements for 12 sessions over 8 weeks. A doubly multivariate analysis was used to measure the main time and group effects and the interaction effect on the performance of English receptive vocabulary, syntactic complexity, and verbal creativity of the two groups across three different times. There were significant differences only in the interactive effect on syntactic complexity. Children in the experimental condition gave responses with more complex syntactic structures. Significant time effects for receptive vocabulary, syntactic complexity, and verbal creativity were observed in all children. Reading enriched English texts better prepares children to creatively and effectively express themselves. This study extends previous research in two ways. First, this study is one of the few studies on the effectiveness of dialogic reading using EMPATHICS-enriched picture books among young language learners. Second, this study investigates the effects of dialogic teaching on English as a second language development in young children. The educational implications will be discussed.

Psychometric Properties of the Chinese (Putonghua) Version of the Oxford Cognitive Screen (OCS-P) in Subacute Poststroke Patients without Neglect.

BACKGROUND: Oxford Cognitive Screen is designed for assessing cognitive functions of poststroke patients. This study was aimed to assess the psychometric properties of the Chinese (Putonghua) version of the Oxford Cognitive Screen-Putonghua (OCS-P) for use among poststroke patients without neglect. METHODS: Expert review panel evaluated content validity of the Chinese-translated items. After pilot tested the translated items, the patients and healthy participants completed the OCS-P as well as the Montreal Cognitive Assessment (MoCA-ChiB) and Goldenberg's test. A group of patients completed OCS-P for the second time within seven days. Data analyses included confirmatory factor analysis, item difficulty and item-total correlation, inter- and intrarater reliability, internal consistency, and between-group discrimination. RESULTS: One hundred patients and 120 younger (n = 60) or older (n = 60) healthy participants completed all the tests. Modifications were required for items in the "Picture Naming", "Orientation", and "Sentence Reading" subscales. Confirmatory factor analysis revealed a three-factor structure for the OCS-P subscales. The internal consistency coefficients for the three identified test dimensions were 0.30 to 0.52 (Cronbach's alpha). Construct validity coefficients between the OCS-P and MoCA-ChiB subscales were 0.45 < r < 0.79 (p < 0.001) and the "Praxis" subscale of OCS-P and Goldenberg's test was r = 0.72 (p < 0.001). The interrater reliability coefficients for the subscales were in general higher than the intrarater reliability coefficients. The "Picture Naming" and "Numerical Cognition" subscales were the most significant (p = 0.003) for differentiating patient participants from their older healthy counterpart. CONCLUSION: This study generated satisfactory evidence on the content validity, substantive validity, construct validity, inter- and intrarater reliability, and known-group discrimination of the OCS-P. They support its application among poststroke patients who speak Putonghua. Future studies could review the existing five-dimension domains for improving its structural validity and internal consistency as well as generate evidence of the OCS-P for use among the poststroke patients with neglect.

A database for investigating the logographeme as a basic unit of writing Chinese.

Chinese script is non-alphabetic and a Chinese graph is basically syllabic which may consist of phonetic and semantic radicals with no representation of phonemes. The logographeme, a unit smaller than a radical, has been suggested to be the basic unit of Chinese writing based on data collected on people with aphasia. To better understand the role of logographemes in Chinese writing development, a data corpus of logographemes based on characters appearing in primary school textbooks is established. Logographemes are analysed in terms of features that are believed to influence writing development. A total of 249 logographemes were identified: 151 logographemes with no meaning and sound (NMS), 84 logographemes with both sound and meaning which could also stand alone to serve as a character (SA) and 14 logographemes with meaning only (MO). At each grade, the frequencies of NMS logographemes were relatively lower than those of SA and MO logographemes, and the frequencies of SA and MO logographemes were similar; 94% of logographemes were present in the characters taught to grade one students. Students learnt all the pronounceable logographemes by grade three, while they finished all the logographemes without sound until grade six. Characters with left-right, top-bottom and enclosing configurations constituted about 94% of all single-unit characters acquired in primary school years. Statistics derived from the data corpus regarding these features across grades enable us to make specific predictions about stages of literacy development and suggestions for investigation into processes involved in character production.

Data analysis of Chinese characters in primary school corpora of Hong Kong and mainland China: preliminary theoretical interpretations.

Metalinguistic awareness (an awareness about the structure of orthography) had been considered vital for reading acquisition. The awareness of phonological regularity and consistency had been found in advanced readers in recent research. Evidence based on simplified Chinese suggested the effect of semantic transparency on reading in school readers. Studies based on traditional Chinese also reported that reading acquisition, including the development of metalinguistic awareness, is affected by script, properties of characters in school curricula, approaches and strategies of reading training. This paper reports the comparison between corpora of simplified Chinese characters based on primary school textbooks and the updated Hong Kong Corpus of Primary School Chinese (HKCPSC). The proportion of characters in the total curriculum, the ratio of phonetic-semantic compounds, visual complexity (defined by the number of strokes) and the levels of phonetic regularity and semantic transparency of Chinese characters across grades in the two corpora are compared. Two marked differences found are the frequency-weighted proportion of regular characters and the proportion of semantically transparent characters across grades. The relationships between the data and recent findings of reading development in Chinese are discussed.

The effect of vertical tongue loading on the position perception of the tongue.

We investigated the effects of vertical tongue loading on the position perception of the tongue. Five male and 5 female university students served as subjects. Vertical upward and downward loading forces were applied to the tongue of the subjects. Their task was to judge the perceived horizontal position of the tongue after tongue-loading directions. The means of the judgments for the control conditions (no tongue loading) were compared with the judgments for perceived horizontal position after tongue loading. The results showed that vertical tongue loading produced a shift in the perceived horizontal direction opposite to the applied force. These results fully replicated the analogous aftereffect found by Grover and Craske (1991) for horizontal tongue loading. However, the judgments of perceived horizontal position in the present study had lower variability than did those in Grover and Craske's study, suggesting that mapping of the tongue along the vertical axis is more precise than mapping along the horizontal axis.