Data mining of an acoustic biomarker in tongue cancers and its clinical validation.

The promise of speech disorders as biomarkers in clinical examination has been identified in a broad spectrum of neurodegenerative diseases. However, to the best of our knowledge, a validated acoustic marker with established discriminative and evaluative properties has not yet been developed for oral tongue cancers. Here we cross-sectionally collected a screening dataset that included acoustic parameters extracted from 3 sustained vowels /ɑ/, /i/, /u/ and binary perceptual outcomes from 12 consonant-vowel syllables. We used a support vector machine with linear kernel function within this dataset to identify the formant centralization ratio (FCR) as a dominant predictor of different perceptual outcomes across gender and syllable. The Acoustic analysis, Perceptual evaluation and Quality of Life assessment (APeQoL) was used to validate the FCR in 33 patients with primary resectable oral tongue cancers. Measurements were taken before (pre-op) and four to six weeks after (post-op) surgery. The speech handicap index (SHI), a speech-specific questionnaire, was also administrated at these time points. Pre-op correlation analysis within the APeQoL revealed overall consistency and a strong correlation between FCR and SHI scores. FCRs also increased significantly with increasing T classification pre-operatively, especially for women. Longitudinally, the main effects of T classification, the extent of resection, and their interaction effects with time (pre-op vs. post-op) on FCRs were all significant. For pre-operative FCR, after merging the two datasets, a cut-off value of 0.970 produced an AUC of 0.861 (95% confidence interval: 0.785-0.938) for T3-4 patients. In sum, this study determined that FCR is an acoustic marker with the potential to detect disease and related speech function in oral tongue cancers. These are preliminary findings that need to be replicated in longitudinal studies and/or larger cohorts.

Deficits in musical rhythm perception in children with specific learning disabilities.

BACKGROUND: A specific learning disability comes with a cluster of deficits in the neurocognitive domain. Phonological processing deficits have been the core of different types of specific learning disabilities. In addition to difficulties in phonological processing and cognitive deficits, children with specific learning disability (SLD) are known to have deficits in more innate non-language-based skills like musical rhythm processing. OBJECTIVES: This paper reviews studies in the area of musical rhythm perception in children with SLD. An attempt was made to throw light on beneficial effects of music and rhythm-based intervention and their underlying mechanism. METHODS: A hypothesis-driven review of research in the domain of rhythm deficits and rhythm-based intervention in children with SLD was carried out. RESULTS: A summary of the reviewed literature highlights that music and language processing have shared neural underpinnings. Children with SLD in addition to difficulties in language processing and other neurocognitive deficits are known to have deficits in music and rhythm perception. This is explained in the background of deficits in auditory skills, perceptuo-motor skills and timing skills. Attempt has been made in the field to understand the effect of music training on the children's auditory processing and language development. Music and rhythm-based intervention emerges as a powerful intervention method to target language processing and other neurocognitive functions. Future studies in this direction are highly underscored. CONCLUSIONS: Suggestions for future research on music-based interventions have been discussed.

The in-out effect: examining the role of perceptual fluency in the preference for words with inward-wandering consonantal articulation.

Words whose consonantal articulation spots wander inward, simulating ingestion movements, are preferred to words featuring the opposite consonantal articulation direction, that is, resembling expectoration movements. The underlying mechanism of this so-called in-out effect is far from settled. Contrary to the original explanation proposing an oral approach-avoidance mechanism, recent evidence has been used to support an oral motor-fluency mechanism, suggesting that inward words are preferred because they may be more common and/or easier to pronounce. Across six experiments (n = 1123), we examined the impact of different fluency sources in the emergence of the in-out effect. The preference for inward-wandering words persisted both with classical font type and figure-ground contrast fluency manipulations, and no systematic additive effects were observed. The in-out effect was also replicated for the first time with a between-participant design. These results suggest that the in-out effect may be permeable to fluency manipulations, but it is not dependent upon a plain fluency mechanism.

Comparison of simple frenotomy with 4-flap Z-frenuloplasty in treatment for ankyloglossia with articulation difficulty: A prospective randomized study.

OBJECTIVE: To compare the surgical outcomes of simple frenotomy and the 4-flap Z-frenuloplasty according to the articulation test values and tongue-tie classification in patients with ankyloglossia with articulation difficulty. STUDY DESIGN: prospective randomized study. SETTING: Tertiary academic center. SUBJECTS: and methods: Children with ankyloglossia with articulation difficulty were randomly divided into 2 groups for surgical treatment. Patients were evaluated for the tongue-tie classification and articulation test before surgery. Three months after the operation, the frenulum classification and articulation test were re-evaluated to compare the differences in surgical outcome between the two surgical methods. RESULTS: Out of 37 patients, 19 underwent the 4-flap Z-frenuloplasty and 18, the simple frenotomy. No differences were observed in the baseline characteristics of the patients assigned to both groups. Changes in the tongue-tie classification and improvement in the articulation test results were observed with both the surgical methods. Both surgical groups had significant improvement in the speech articulation test (consonants) but there was no difference in the speech outcomes between the surgical groups. CONCLUSION: Although there was no significant difference in the surgical outcome between the two surgical methods, ankyloglossia patients showed improvement in a Korean speech articulation test 3 months after undergoing surgery to release the lingual frenulum.

Overusing the pacifier during infancy sets a footprint on abstract words processing.

Perturbations to the speech articulators induced by frequently using an interfering object during infancy (i.e., pacifier) might shape children's language experience and the building of conceptual representations. Seventy-one typically developing third graders performed a semantic categorization task with abstract, concrete and emotional words. Children who used the pacifier for a more extended period were slower than the others. Moreover, overusing the pacifier increased response time of abstract words, whereas emotional and (above all) concrete words were less affected. Results support the view that abstract words are grounded both in perception-action and in linguistic experience.

Automated Assessment of Oral Diadochokinesis in Multiple Sclerosis Using a Neural Network Approach: Effect of Different Syllable Repetition Paradigms.

Slow and irregular oral diadochokinesis represents an important manifestation of spastic and ataxic dysarthria in multiple sclerosis (MS). We aimed to develop a robust algorithm based on convolutional neural networks for the accurate detection of syllables from different types of alternating motion rate (AMR) and sequential motion rate (SMR) paradigms. Subsequently, we explored the sensitivity of AMR and SMR paradigms based on voiceless and voiced consonants in the detection of speech impairment. The four types of syllable repetition paradigms including /ta/, /da/, /pa/-/ta/-/ka/, and /ba/-/da/-/ga/ were collected from 120 MS patients and 60 matched healthy control speakers. Our neural network algorithm was able to correctly identify the position of individual syllables with a very high average accuracy of 97.8%, with the correct temporal detection of syllable position of 87.8% for 10 ms and 95.5% for 20 ms tolerance value. We found significantly altered diadochokinetic rate and regularity in MS compared to controls across all types of investigated tasks ( ). MS patients showed slower speech for SMR compared to AMR tasks, whereas voiced paradigms were more irregular. Objective evaluation of oral diadochokinesis using different AMR and SMR paradigms may provide important information regarding speech severity and pathophysiology of the underlying disease.

Prevalence of Phonological Articulation Disorders in Preschool Children in the City of Skopje.

INTRODUCTION: Speech communication is a complex process based on the function of the central nervous system, and also on the speech mechanisms conditioned and controlled by auditory perception, verbal memory, intellectual activity and peripheral speech apparatus.The aim of this study was to determine the prevalence of the most common phonological articulation disorders in preschool children, from 4-6 years old. MATERIALS AND METHODS: A cross-sectional study was conducted during 2018, on a representative sample of 550 preschool children aged 4 - 6 years, who attend preschool institutions-kindergartens in the city of Skopje. The study used standardized articulation tests: The Global Articulation Test (GAT) and the Triple Test (vocals, plasia, affricative, fricative, nasal, and lateral), and a questionnaire filled out by a social worker at the kindergarten about the socioeconomic status and the child's health condition. RESULTS: Using GAT, we found that 260 (47.3%) children didn't manifest any phonological articulation disorders, but 290 (52.7%) had disorders. The analysis of gender-based data showed a higher percentage of speech disorders in 57% of boys and 46.9% of girls. The highest percentage of speech disorder is sigmatism with 24.5% in boys and 20.4% in girls, rhotacismus was found in 17.8% in boys and 16.5% in girls. Lambdacism with 8.3% was found in boys and 4.2% in girls. A mixed form (sigmatism, rotacism, and lambdacism) was also found in 2.4% of boys and 3.5% of girls. CONCLUSIONS: The calculated prevalence of phonological articulation disorders in preschool children aged 4-6 years is 52.7%, (57.9% in boys and 46.9% in girls), or every second child in kindergarten has some form of speech disorder. These findings indicate that the treatment of speech disorders should begin in the appropriate services as soon as possible, because the early detection and treatment of speech disorders enable child's normal intellectual development. The treatment should be started in the preschool period, to allow the start of the educational process without any speech problems.

A Comparative Study of Auditory-Perceptual Speech Measures for the Early Detection of Mild Speech Impairments.

BACKGROUND AND PURPOSE: The aim of the study was to compare transcription-based speech intelligibility and scaled speech severity for the detection of mild speech impairments, by studying these metrics across talkers with Parkinson's disease (PD), age- and sex-matched older adults, and younger adults. An additional aim was to determine the impact of listener experience on these clinical measures. METHODS: Fifteen speakers from each experimental group were asked to read aloud 11 randomly generated sentences from the Speech Intelligibility Test at their typical speaking rate and loudness. Two groups of four listeners each, stratified as experienced or inexperienced listeners based on their clinical experience, judged the sentence samples. To estimate intelligibility, both listener groups were asked to orthographically transcribe exactly what they heard for each sentence. For severity estimates, the listener groups were asked to rate the sentences for overall quality based on voice, resonance, articulation, and prosody, using a visual analog scale. RESULTS: Transcription-based intelligibility and scaled severity scores of the PD group differed significantly from those of the older and younger adults. Between-age group differences in intelligibility and scaled severity were not observed. Listener experience had an impact on scaled speech severity, but not speech intelligibility. Between-group differences in speech severity were driven by the inexperienced group and not the experienced listener group. IMPLICATIONS: Both transcription-based intelligibility and scaled severity estimates appear to be sensitive to relatively mild speech impairments in PD. Obtaining scaled severity is less labor intensive than transcription; therefore, visual analog scaling may be the preferred paradigm for clinical use. However, listener experience and training are important considerations for scaling techniques to be implemented clinically.

Lenguaje en la Enfermedad de Parkinson. Retos para la Logopedia / Language in Parkinson's disease. Challenges for speech therapy

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How Well Does Diadochokinetic Task Performance Predict Articulatory Imprecision? Differentiating Individuals with Parkinson's Disease from Control Subjects.

OBJECTIVE: To investigate whether syllables produced in an oral diadochokinetic (DDK) task may be quantified so that persons with Parkinson's disease (PD) perceived to have reduced articulatory precision when reading may be correctly identified using that quantification. PATIENTS AND METHODS: Syllable sequences from 38 speakers with PD and 38 gender- and age-matched control speakers (normal controls [NC]) were quantified acoustically and evaluated in terms of (1) the speakers' ability to accurately predict speaker group membership (PD or NC) and (2) their ability to predict reduced/non-reduced articulatory precision. RESULTS: A balanced accuracy of 80-93% in predicting speaker group membership was achieved. The best measures were related to the proportion of a syllable made up of a vowel, amplitude slope and syllable-to-syllable variation in duration and amplitude. The best material was that based on /ka/. Reduced articulatory precision was accurately predicted from DDK measures in 89% of the samples. Release-transient prominence and voicing during the onset of plosives were particularly strong predictors. CONCLUSIONS: DDK sequences can predict articulatory imprecision as observed in another speech task. The linking of performance across speech tasks probably requires measures of stability in syllable durations and amplitudes, as well as measures of subsyllabic acoustic features.

An Investigation of the Clinical Use of a Single-Word Procedure to Assess Intelligibility (Swedish Test of Intelligibility for Children) and an Evaluation of the Validity and Reliability of the Intelligibility in Context Scale.

Purpose Intelligibility is a core concept of speech-language pathology, central both to the assessment of speech disorders and to intervention in such disorders. One purpose of this study was to investigate the reliability and usability of a single-word assessment procedure, the Swedish Test of Intelligibility for Children (STI-CH), in a clinical setting. Another purpose was to investigate the validity and reliability of an assessment method designed to assess functional intelligibility: the Intelligibility in Context Scale (ICS). Method Thirty children aged 4;1-10;1 years;months were recruited from speech-language pathology clinics in Western Sweden. Each child's treating speech-language pathologist served as listener in the STI-CH assessment while the ICS was completed by each child's parents. External listeners (2 last-year speech-language pathology students) were used to assess the validity of the speech-language pathology. Results The mean duration of the test procedure for the STI-CH was about 19 min, and 57% of the test sessions were reported as difficult. There was a weak but statistically significant correlation between the results from the STI-CH and the ICS ( r = .40, p < .05), and both methods showed high reliability in terms of interlistener reliability (intraclass correlation exceeding .97) and internal consistency, respectively. Conclusions The STI-CH had high reliability and was time efficient but had some procedural problems. The ICS had moderate validity but high reliability. The STI-CH is promising for clinical use but needs to be developed further. The validity of the ICS can be discussed and needs to be further investigated.

Development and validation of a new scale for assessment of speech stimulability in Persian speaking children.

OBJECTIVES: Speech and language pathologists need to assess speech stimulability as a crucial component of assessment in clients with speech sound disorders. The purpose of the current survey was to develop and validate an instrument to assess speech stimulability in Persian speaking children. METHODS: The present study was accomplished in two steps. In step I, the test material was developed based on extensive literature review, and five experts were requested to make judgment on the content validity of the test. We evaluated other psychometric properties in step II. A pilot study was performed by the administration of the test on 25 children, and then the correct answer percentages of 100 participants for each item of the Persian test of speech stimulability were calculated. The participants were divided into four groups by six-month intervals. Inter-rater reliability, test-retest, and internal consistency were computed for the reliability measures. Statistical Package for the Social Sciences, version 24.0 (SPSS, Inc., Chicago, IL) was used for the statistical analysis of the data. The significance level was (P < 0.05). RESULTS: The final version of the test includes 132 items (consonant and vowel singleton words and sentences). There was no significant difference among experts' judgment in the content validity of the items (P > 0.05). All of the children could easily repeat the items in the pilot study. The participants were stimulable more than 80% for all of the consonants except/ʒ/and 100% for the vowels in the items of the final version of the Persian test of speech stimulability. All of the reliability values (inter-rater reliability, test-retest, and internal consistency) were higher than 0.8. CONCLUSION: Investigation of psychometric properties of the Persian test of speech stimulability showed that this test is a valid and reliable scale to assess the speech stimulability in Persian speaking children.

Phonological Treatment Options for Children with Expressive Language Impairment.

The vast majority of treatment efficacy research in the area of phonology focuses on issues relevant to children who have significant limitations in productive phonology but are "typically developing" in most other ways. The base of evidence to guide clinicians on planning intervention for children with phonological and cooccurring expressive language difficulties (PD + LI) is less well developed. Thus, the goal of this paper is to summarize the evidence on two treatment procedures designed to facilitate growth in phonological inventory for children who also require direct intervention to target other aspects of expressive language. We first review what is known about the delicate interaction between phonology and grammatical morphology. We focus the remainder of the summary on what is known about how to best address the more complex needs of children with PD + LI in intervention.

Speech outcome in young children born with unilateral cleft lip and palate treated with one- or two-stage palatal repair and the impact of early intervention.

OBJECTIVES: The aim of this study was to describe speech at 1, 1;6 and 3 years of age in children born with unilateral cleft lip and palate (UCLP) and relate the findings to operation method and amount of early intervention received. METHODS: A prospective trial of children born with UCLP operated with a one-stage (OS) palatal repair at 12 months or a two-stage repair (TS) with soft palate closure at 3-4 months and hard palate closure at 12 months was undertaken (Scandcleft). At 1 and 1;6 years the place and manner of articulation and number of different consonants produced in babbling were reported in 33 children. At three years of age percentage consonants correct adjusted for age (PCC-A) and cleft speech errors were assessed in 26 of the 33 children. Early intervention was not provided as part of the trial but according to the clinical routine and was extracted from patient records. RESULTS: At age 3, the mean PCC-A was 68% and 46% of the children produced articulation errors with no significant difference between the two groups. At one year there was a significantly higher occurrence of oral stops and anterior place consonants in the TS group. There were significant correlations between the consonant production between one and three years of age, but not with amount of early intervention received. CONCLUSIONS: The TS method was beneficial for consonant production at age 1, but not shown at 1;6 or 3 years. Behaviourally based early intervention still needs to be evaluated.

School-Aged Children's Phonological Accuracy in Multisyllabic Words on a Whole-Word Metric.

Purpose: The purpose of this study is to examine differences in phonological accuracy in multisyllabic words (MSWs) on a whole-word metric, longitudinally and cross-sectionally, for elementary school-aged children with typical development (TD) and with history of protracted phonological development (PPD). Method: Three mismatch subtotals, Lexical influence, Word Structure, and segmental Features (forming a Whole Word total), were evaluated in 3 multivariate analyses: (a) a longitudinal comparison (n = 22), at age 5 and 8 years; (b) a cross-sectional comparison of 8- to 10-year-olds (n = 12 per group) with TD and with history of PPD; and (c) a comparison of the group with history of PPD (n = 12) with a larger 5-year-old group (n = 62). Results: Significant effect sizes (ηp2) found for mismatch totals were as follows: (a) moderate (Lexical, Structure) and large (Features) between ages 5 and 8 to 10 years, mismatch frequency decreasing developmentally, and (b) large between 8- to 10-year-olds with TD and with history of PPD (Structure, Features; minimal lexical influences), in favor of participants with TD. Mismatch frequencies were equivalent for 8- to 10-year-olds with history of PPD and 5-year-olds with TD. Classification accuracy in original subgroupings was 100% and 91% for 8- to 10-year-olds with TD and with history of PPD, respectively, and 86% for 5-year-olds with TD. Conclusion: Phonological accuracy in MSW production was differentiated for elementary school-aged children with TD and PPD, using a whole-word metric. To assist with the identification of children with ongoing PPD, the metric has the ability to detect weaknesses and track progress in global MSW phonological production.

Marcadores del trastorno específico del lenguaje en español: comparación entre la repetición de oraciones y la repetición de pseudopalabras / Specific Language Impairment markers in Spanish: Comparison between sentence and pseudoword repetition

Objetivo: El objetivo de este trabajo es comparar 2 marcadores del trastorno específico del lenguaje en niños españoles de 5 a 7 años. Estos marcadores son la repetición de oraciones y la repetición de pseudopalabras, que son los utilizados para esta función en la investigación sobre este trastorno. Los 2 remiten a déficits de memoria como origen de este trastorno. Se revisan las formas en que estas tareas han sido utilizadas en el marcaje del trastorno específico del lenguaje. Participantes: Se han aplicado estas tareas a 3 grupos de niños de 5 a 7 años; uno constituido por niños con trastorno específico del lenguaje, otro por niños con trastorno de habla y articulación y otro con niños con desarrollo típico. Resultados: Los análisis discriminantes y la curva ROC ponen de manifiesto que es la repetición de oraciones la que tiene una mayor sensibilidad y especificidad para distinguir a los niños con trastorno específico del lenguaje de los niños con desarrollo típico, pero muestra una sensibilidad discreta en la diferenciación de los niños con desarrollo típico de los que tienen trastorno de habla y articulación. Ninguna de las tareas logra diferenciar con una precisión aceptable a los niños con trastorno específico del lenguaje de los que tienen trastorno de habla y articulación. Discusión y conclusiones: Se explican las razones de la distinta potencia marcadora de ambas tareas para identificar a los niños con trastorno específico del lenguaje, trastorno de habla y articulación y desarrollo típico

Objective: This study compares two markers of Specific Language Impairment in Spanish children aged 5 to 7. The markers examined are sentence repetition and pseudoword repetition, which are the two main tasks outlined in the research to identify this disorder. Both contemplate memory deficits as the source of this disorder. We review the ways in which these tasks have been used in marking Specific Language Impairment. Participants: These tasks have been applied to three groups of children, aged 5 to 7 years; one consisting of children with Specific Language Impairment, another of children with Speech Sound Disorder and another of children who are typically developing. Results: The results of the discriminant analysis and ROC curve show that sentence repetition exhibits higher sensitivity and specificity in distinguishing children with Specific Language Impairment from children who are typically developing, but only show modest sensibility in differentiating children who are typically developing from children with Speech Sound Disorder. Neither of the two tasks can distinguish with acceptable accuracy children with Specific Language Impairment from children with Speech Sound Disorder. Discussion and conclusions: We explain the reasons of different marking power to identify children with Specific Language Impairment, Speech Sound Disorder and typical development

Evidence of validity and reliability of a phonological assessment tool. / Evidências de validade e fidedignidade de um instrumento de avaliação fonológica.

PURPOSE: To present evidence of the validity and reliability of a phonological assessment tool developed to assess the phonological inventory of Brazilian Portuguese. METHODS: The study included 866 children aged between 3 and 8:11 years, divided into three groups: typical, control and clinical. Participants were evaluated using a phonological assessment software, which prompted the spontaneous naming of a series of images. The children's responses were audio recorded and transcribed at the time of the assessment, by the software itself. The Cronbach's alpha coefficient was used to evaluate the internal consistency of the instrument for reliability and validity purposes. Criterion validity was examined by comparing the performance of different groups using Student's t-test for independent samples. Intra- and inter-rater agreement were investigated using Kendall's tau. Results were considered significant at p ≤ 0.05. RESULTS: The present study provided evidence of validity and reliability (internal consistency) for this phonological assessment tool, confirming the reliability of its items and demonstrating excellent agreement rates between examiners regarding its scoring (intra- and inter-rater reliability). The criterion validity assessment demonstrated that the control group outperformed the clinical group across all phonemes, showing that test scores were successful in identifying children with speech sound disorders (phonological disorders). CONCLUSION: The present findings provide strong evidence of the validity and reliability of this phonological assessment tool.

OBJETIVO: Apresentar evidências de validade e fidedignidade de um instrumento de avaliação fonológica (INFONO) desenvolvido para avaliar os fonemas do Português Brasileiro. MÉTODO: Participaram do estudo 866 crianças com idades entre 3 e 8:11 anos, divididas em grupos: típico, controle e clínico. Os participantes foram avaliados pelo INFONO por nomeação espontânea. A produção da criança foi gravada e transcrita no momento da avaliação, no próprio software. Para análise de validade e fidedignidade, foram analisadas a consistência interna a partir da técnica Alpha de Cronbach. Para a validade de critério, comparou-se o desempenho entre os grupos através do teste t de Student para amostras independentes. A fidedignidade foi analisada pela concordância intra e interavaliadores por meio do Teste de Kendall. Considerou-se significância quando p ≤0,05. RESULTADOS: O INFONO apresentou evidências de validade e fidedignidade (consistência interna), indicando uma confiabilidade satisfatória dos itens, bem como excelente concordância entre os avaliadores em relação aos escores do teste (confiabilidade intra e interavaliador). Em relação à validade de critério, o desempenho do grupo clínico para todos os fonemas foi inferior ao grupo controle, mostrando que os escores são sensíveis para identificar crianças com desvio fonológico. CONCLUSÃO: O INFONO apresentou fortes evidências de validade e fidedignidade.

The Relationship Between Speech, Language, and Phonological Awareness in Preschool-Age Children With Developmental Disabilities.

Purpose: A number of intrinsic factors, including expressive speech skills, have been suggested to place children with developmental disabilities at risk for limited development of reading skills. This study examines the relationship between these factors, speech ability, and children's phonological awareness skills. Method: A nonexperimental study design was used to examine the relationship between intrinsic skills of speech, language, print, and letter-sound knowledge to phonological awareness in 42 children with developmental disabilities between the ages of 48 and 69 months. Hierarchical multiple regression was done to determine if speech ability accounted for a unique amount of variance in phonological awareness skill beyond what would be expected by developmental skills inclusive of receptive language and print and letter-sound knowledge. Results: A range of skill in all areas of direct assessment was found. Children with limited speech were found to have emerging skills in print knowledge, letter-sound knowledge, and phonological awareness. Speech ability did not predict a significant amount of variance in phonological awareness beyond what would be expected by developmental skills of receptive language and print and letter-sound knowledge. Conclusion: Children with limited speech ability were found to have receptive language and letter-sound knowledge that supported the development of phonological awareness skills. This study provides implications for practitioners and researchers concerning the factors related to early reading development in children with limited speech ability and developmental disabilities.

Are RAN deficits in university students with dyslexia due to defective lexical access, impaired anchoring, or slow articulation?

The purpose of this study was to examine different hypotheses in relation to RAN deficits in dyslexia. Thirty university students with dyslexia and 32 chronological-age controls were assessed on RAN Digits and Colors as well as on two versions of RAN Letters and Objects (one with five items repeated 16 times and one with 20 items repeated four times). In addition, participants were tested on discrete letter and object naming, phonological awareness, orthographic knowledge, and speed of processing, and the RAN Letters and Objects total times were partitioned into pause times and articulation times. Results showed first that the dyslexia group was slower than the control group on all RAN tasks and the differences remained significant after controlling for discrete naming time. Second, both groups were slower in the large item set condition (20 × 4) than in the small set condition (5 × 16). Third, the dyslexia group was slower than the control group in both the pause and the articulation times. Although none of the processing skills was sufficient on its own to eliminate group differences in RAN Letters components, phonological awareness, and orthographic processing were sufficient on their own to eliminate group differences in the RAN Objects pause time. Taken together, our findings suggest that the deficits in RAN are not due to impaired anchoring, but rather due to subtle impairments in lexical access (specific to alphanumeric RAN), serial processing, and articulation.

Not all phonological awareness deficits are created equal: evidence from a comparison between children with Otitis Media and poor readers.

Children with reading difficulties and children with a history of repeated ear infections (Otitis Media, OM) are both thought to have phonological impairments, but for quite different reasons. This paper examines the profile of phonological and morphological awareness in poor readers and children with OM. Thirty-three poor readers were compared to individually matched chronological age and reading age controls. Their phonological awareness and morphological awareness skills were consistently at the level of reading age matched controls. Unexpectedly, a significant minority (25%) of the poor readers had some degree of undiagnosed mild or very mild hearing loss. Twenty-nine children with a history of OM and their matched controls completed the same battery of tasks. They showed relatively small delays in their literacy and showed no impairment in morphological awareness but had phonological awareness scores below the level of reading age matched controls. Further analysis suggested that this weakness in phonological awareness was carried by a specific weakness in segmenting and blending phonemes, with relatively good performance on phoneme manipulation tasks. Results suggest that children with OM show a circumscribed deficit in phoneme segmentation and blending, while poor readers show a broader metalinguistic impairment which is more closely associated with reading difficulties.