Shear wave elastography detects novel imaging biomarkers of aromatase inhibitor-induced joint pain: a pilot study.

AIM: To determine whether differences in joint and tendon stiffness as measured by ultrasound shear wave elastography are present in breast cancer patients with aromatase inhibitor-associated arthralgias compared to age-comparable healthy control women. METHODS: Postmenopausal women with stage I-III breast cancer who were taking adjuvant aromatase inhibitors and complained of joint pain were enrolled (n = 6). Postmenopausal women with no history of breast cancer, hormone treatment, or joint pain served as controls (n = 7). All subjects had bilateral hands and wrists evaluated by gray-scale and power Doppler ultrasound, and shear wave elastography ultrasound. RESULTS: Patients with AI-associated arthralgias had significantly stiffer tendons than controls in the 1st extensor compartment (long axis; p = 0.001), 4th extensor compartment (long axis; p = 0.014), 3rd metacarpophalangeal joint (p = 0.002), the pooled values of the extensor compartments, both long (p = 0.044) and short axes (p = 0.035), and the pooled values for the metacarpophalangeal joints (p = 0.002). On ultrasound, the patients (but not controls) presented with hyperemia and increased tenosynovial fluid in the flexor and extensor tendon sheaths, and the median nerves were symptomatic and bifid; however, these differences were not statistically significant. CONCLUSIONS: This is the first study to identify increased tendon stiffness as a putative physiological characteristic of aromatase inhibitor-associated arthralgias. Future studies should determine whether increased tendon stiffness is a risk factor for the development of aromatase inhibitor-associated arthralgias, or a result of aromatase inhibitor treatment.

Cross-linguistic generalization in the treatment of two sequential Spanish-English bilingual children with speech sound disorders.

PURPOSE: The effect of bilingual service delivery on treatment of speech sound disorders (SSDs) in bilingual children is largely unknown. Bilingual children with SSDs are typically provided intervention in only one language, although research suggests dual-language instruction for language disorders is best practice for bilinguals. This study examined cross-linguistic generalization of bilingual intervention in treatment of two 5-year-old sequential bilingual boys with SSDs (one with Childhood Apraxia of Speech), hypothesizing that selecting and treating targets in both languages would result in significant overall change in their English and Spanish speech systems. METHOD: A multiple baseline across behaviours design was used to measure treatment effectiveness for two targets per child. Children received treatment 2-3 times per week for 8 weeks and in Spanish for at least 2 of every 3 days. Ongoing treatment performance was measured in probes in both languages; overall speech skills were compared pre- and post-treatment. RESULT: Both children's speech improved in both languages with similar magnitude; there was improvement in some non-treated errors. CONCLUSION: Treating both languages had an overall positive effect on these bilingual children's speech. Future bilingual intervention research should explore alternating treatments designs, efficiency of monolingual vs bilingual treatment, different language and bilingual backgrounds, and between-group comparisons.

Dialect Density in Bilingual Puerto Rican Spanish-English Speaking Children.

It is still largely unknown how the two phonological systems of bilingual children interact. In this exploratory study, we examine children's use of dialect features to determine how their speech sound systems interact. Six monolingual Puerto Rican Spanish-speaking children and 6 bilingual Puerto Rican Spanish-English speaking children, ages 5-7 years, were included in the current study. Children's single word productions were analyzed for (1) dialect density and (2) frequency of occurrence of dialect features (after Oetting & McDonald, 2002). Nonparametric statistical analyses were used to examine differences within and across language groups. Results indicated that monolinguals and bilinguals exhibited similar dialect density, but differed on the types of dialect features used. Findings are discussed within the theoretical framework of the Dual Systems Model (Paradis, 2001) of language acquisition in bilingual children.

Phonological skills in English language learners.

PURPOSE: The purpose of this study was to examine the English phonological skills of English language learners (ELLs) over 5 time points. METHOD: Sound class accuracy, whole-word accuracy, percentage of occurrence of phonological patterns, and sociolinguistic correlational analyses were investigated in 19 ELLs ranging in age from 5;0 (years;months) to 7;6. RESULTS: Accuracy across all samples was over 90% for all sound classes except fricatives and increased for all sound classes across time. Whole-word accuracy was high and increased across time. With the exception of cluster reduction, stopping, and final consonant deletion, the frequency of occurrence for phonological patterns was less than or equal to 5% at every time point. Sociolinguistic variables such as age of arrival, age of exposure, and age were significantly related to phonological skills. CONCLUSIONS: The results were consistent with the hypotheses outlined in Flege's (1995) speech learning model in that the phonological skills of ELLs increased over time and as a function of age of arrival and time. Thus, speech-language pathologists (SLPs) also should expect phonological skills in ELLs to increase over time, as is the case in monolingual children. SLPs can use the longitudinal and connected-speech results of this study to interpret their assessments of the phonological skills of ELLs.

The effects of measures of language experience and language ability on segmental accuracy in bilingual children.

PURPOSE: The present study investigated the effects of selected measures of language experience (parent-reported estimates of frequency of output and language use) and language ability (parent-reported language proficiency and mean length of utterance in words) on the segmental accuracy of Spanish- and English-speaking bilingual children. METHOD: The phonological skills of 50 typically developing bilingual Spanish-English children (mean age = 5;9 [years;months]) were examined. Independent variables included parent estimates of language use, language proficiency, and frequency of language output (5 groups), as well as a direct language measure (mean length of utterance in words) to predict the dependent segmental accuracy measures (percentage of consonants and vowels correct). RESULTS: Frequency of language output did not have an effect on any of the English or Spanish segmental accuracy measures. However, parent-reported language use and language proficiency as well as the direct measure of language ability (mean length of utterance in words) had various effects on segmental accuracy. Those effects differed, however, in language-specific patterns. CONCLUSIONS: Parental estimates of language use and language proficiency are useful for predicting the phonological skills of bilingual Spanish- and English-speaking children, and augmenting them with a direct measure of language ability as a predictor of segmental accuracy is desirable.

Whole word measures in bilingual children with speech sound disorders.

Phonological acquisition traditionally has been measured using constructs that focus on segments rather than the whole words. Findings from recent research have suggested whole-word productions be evaluated using measures such as phonological mean length of utterance (pMLU) and the proportion of whole-word proximity (PWP). These measures have been investigated mainly in typically-developing children, but their use with children with speech sound disorders has been limited. This study compares PMLU, PWP, and consonant accuracy in Spanish-English bilinguals with speech sound disorders (SSD) to age-matched monolingual peers. This study relates directly to the type of research that Adele Miccio favoured. First, it is focusing on bilingual children. For the past 5 years, she has been the principal investigator of a grant developing a comprehensive phonological assessment tool for bilingual speakers. Second, during her career, Miccio advocated using multiple analyses to gauge the phonological skills of children, especially those with speech sound disorders. Her work in stimulability is evidence of that perspective. This study examines one 'raditional' measure (consonant accuracy) and two newer ones (pMLU and PWP), thereby broadening the analyses of phonological skills in bilingual children with SSD and thus carrying out multiple analyses, just as Miccio recommended throughout her illustrious career.

Phonological acquisition in bilingual Spanish-English speaking children.

PURPOSE: In this study, the authors aimed to determine how between-language interaction contributes to phonological acquisition in bilingual Spanish-English speaking children. METHOD: A total of 24 typically developing children, ages 3;0 (years;months) to 4;0, were included in this study: 8 bilingual Spanish-English speaking children, 8 monolingual Spanish speakers, and 8 monolingual English speakers. Single word and connected speech samples were obtained for each child. This study examined interaction between the two languages of bilingual children during phonological acquisition through the measurement of (a) transfer (the frequency and types of phonological transfer present in the speech of bilingual children); (b) deceleration (a slower rate of acquisition for bilinguals as compared with monolinguals); and (c) acceleration (a faster rate of acquisition for bilinguals as compared with monolinguals. RESULTS: Findings demonstrated that (a) transfer was evident in the productions of bilingual children, (b) differences were found in accuracy between monolingual and bilingual children, and (c) sound frequency did not predict differential accuracy of either phonetically similar sounds between languages or phonetically dissimilar sounds specific to Spanish or English. IMPLICATIONS: The results from this study indicate that transfer, deceleration, and a possible variation of the acceleration hypothesis occur in bilingual phonological acquisition. Evidence was found for separation and interaction between the bilingual children's 2 languages (J. Paradis & F. Genesee, 1996).

Early-, middle-, and late-developing sounds in monolingual and bilingual children: an exploratory investigation.

PURPOSE: To examine the accuracy of early-, middle-, and late-developing (EML) sounds in Spanish-English bilingual children and their monolingual peers. METHOD: Twenty-four typically developing children, age 3-4 years, were included in this study: 8 bilingual Spanish-English-speaking children, 8 monolingual Spanish speakers, and 8 monolingual English speakers. Single-word speech samples were obtained to examine (a) differences on the accuracy of EML sounds between Spanish-English bilingual children and monolingual Spanish and monolingual English children and (b) the developmental trend on the accuracy of EML sounds within languages for Spanish-English bilingual children and monolingual Spanish and monolingual English children. RESULTS: Findings support those of Shriberg (1993) for English-speaking children and suggest possible EML categories for monolingual Spanish-speaking children and bilingual Spanish-English-speaking children. CONCLUSIONS: These exploratory findings indicate the need for longitudinal examination of EML categories with a larger cohort of children to observe similarities and differences between monolingual and bilingual development.

Phonological skills in Puerto Rican and Mexican Spanish-speaking children with phonological disorders.

The effects of dialectal differences upon the speech production skills of children with phonological disorders are poorly understood. One might predict that the phonological profile of children using a radical dialect (e.g., Puerto Rican Spanish, which alters consonants in the syllable rhyme) will differ from that of children who use a conservative dialect (e.g., Mexican Spanish, which preserves such consonants). This study evaluated the impact of such dialectal differences by comparing the phonological skills of two groups of Spanish-speaking children with phonological disorders. Six participants used the Mexican dialect; the other six used the Puerto Rican dialect of North American Spanish. All children were matched on number of segmental errors and age, which ranged from 4;4 to 5;6 (M=4;10). A single-word assessment instrument was used to elicit data, and independent and relational analyses were completed for each child. Measures included phonetic inventory complexity, vowel accuracy, consonant accuracy, sound class accuracy, percentage-of-occurrence of phonological patterns, and frequency and types of substitutions. Significant between-group differences were not found for any measures. These findings do not support the hypothesis of significant phonological differences between phonologically disordered speakers of radical and conservative Spanish dialects.

Phonological skills in predominantly English-speaking, predominantly Spanish-speaking, and Spanish-English bilingual children.

PURPOSE: There is a paucity of information detailing the phonological skills of Spanish-English bilingual children and comparing that information to information concerning the phonological skills of predominantly English-speaking (PE) and predominantly Spanish-speaking (PS) children. The purpose of this study was to examine the relationship between amount of output (i.e., percentage of time each language was spoken) in each language and phonological skills in Spanish-English bilingual children and PE and PS children. METHOD: Fifteen typically developing children, ranging in age from 5;0 (years;months) to 5;5 (mean = 5;2), participated in the study. The participants consisted of 5 PE speakers, 5 PS speakers, and 5 bilingual (Spanish-English) speakers. A single-word assessment was used to gather information on phonological skills (consonant accuracy, type and frequency of substitutions, frequency of occurrence of phonological patterns [e.g., cluster reduction], accuracy of syllable types [e.g., CV, CVC, CCV, etc.]), and type and rate of cross-linguistic effects. RESULTS: The results indicated that there was no significant correlation between amount of output in each language and phonological skills either in the Spanish skills of PS children and Spanish-English bilingual speakers or in the English skills of PE children and Spanish-English bilingual speakers. In addition, there was no significant difference in segmental accuracy, syllabic accuracy, or percentage of occurrence of phonological patterns between either the Spanish skills of PS children and Spanish-English bilingual speakers or the English skills of PE children and Spanish-English bilingual speakers. Finally, the children showed a limited number of cross-linguistic effects. CLINICAL IMPLICATIONS: Results from this study indicate no link between parent estimates of language output and phonological skill and demonstrate that Spanish-English bilingual children will have commensurate, although not identical, phonological skills as compared to age-matched PS and PE children.