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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

White noise enhances new-word learning in healthy adults.

Research suggests that listening to white noise may improve some aspects of cognitive performance in individuals with lower attention. This study investigated the impact of white noise on new word learning in healthy young adults, and whether this effect was mediated by executive attention skills. Eighty participants completed a single training session to learn the names of twenty novel objects. The session comprised 5 learning phases, each followed by a recall test. A final recognition test was also administered. Half the participants listened to white noise during the learning phases, and half completed the learning in silence. The noise group demonstrated superior recall accuracy over time, which was not impacted by participant attentional capacity. Recognition accuracy was near ceiling for both groups. These findings suggest that white noise has the capacity to enhance lexical acquisition.

Late talkers and later language outcomes: Predicting the different language trajectories.

PURPOSE: The aim of the current study was to investigate the risk factors present at 2 years for children who showed language difficulties that persisted from 2 to 10 years and difficulties that emerged later, at 10 years. METHOD: Participants (n = 783) were drawn from the Raine Study in Western Australia. Patterns of change from 2 to 10 years were identified based on child performance on the Language Development Survey and the Clinical Evaluation of Language Fundamentals, respectively. Logistic regression analyses were conducted to test whether parental, family and child characteristics present at 2 years predicted poorer language outcomes at age 10. RESULT: Across the 8 year period, 5.6% of the children displayed consistently low language skills, 5.9% improved skills and 23.2% deteriorated skills. Compared to children with consistently typical skills, the deteriorated group was more likely to have mothers who smoked during pregnancy, fathers with incomplete secondary education, low family income, poor early literacy environment and be male. Children showing consistently low language skills were more likely to have mothers who smoked during pregnancy than late talkers whose early delays improved. CONCLUSION: Results provide evidence of some modifiable risk factors at 2 years which are associated with language outcome.

A Relationship Between Early Language Skills and Adult Autistic-Like Traits: Evidence from a Longitudinal Population-Based Study.

The current study examined the relationship between early language ability and autistic-like traits in adulthood, utilising data from 644 participants from a longitudinal study of the general population. Language performance at 2 years was measured with the Language Development Survey (LDS), and at 20 years the participants completed the Autism-Spectrum Quotient (AQ). Vocabulary size at 2 years was negatively associated with Total AQ score, as well as scores on the Communication, and Social Skills subscales. Adults who had been late talkers were also more likely to have 'high' scores on the Communication subscale. This is the first study to show an association between early language ability and autistic-like traits in adulthood.

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.

Predicting receptive vocabulary change from childhood to adulthood: A birth cohort study.

This study examined the parental and early childhood risk factors of different receptive vocabulary developmental profiles from childhood to adulthood. The sample (n=1914), comprised of monolingual English speaking participants, from the Mater University of Queensland Study of Pregnancy (MUSP). Receptive vocabulary was measured using the Peabody Picture Vocabulary Test-Revised (PPVT-R) at the 5 and 21-year follow ups. Four vocabulary profiles were evident: persistently typical, persistently impaired, later onset of difficulties, and resolved delays. The presence of internalising behaviours at 5 years, lower paternal educational attainment, and maternal smoking during pregnancy were associated with later onset vocabulary impairment. These findings have clinical and educational implications for identifying children 'at risk' of later deterioration in language skills.

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.

Long-term Communication Outcomes for Children Receiving Cochlear Implants Younger Than 12 Months: A Multicenter Study.

OBJECTIVE: Examine the influence of age at implant on speech perception, language, and speech production outcomes in a large unselected paediatric cohort. STUDY DESIGN: This study pools available assessment data (collected prospectively and entered into respective databases from 1990 to 2014) from three Australian centers. PATIENTS: Children (n = 403) with congenital bilateral severe to profound hearing loss who received cochlear implants under 6 years of age (excluding those with acquired onset of profound hearing loss after 12 mo, those with progressive hearing loss and those with mild/moderate/severe additional cognitive delay/disability). MAIN OUTCOME MEASURE(S): Speech perception; open-set words (scored for words and phonemes correct) and sentence understanding at school entry and late primary school time points. Language; PLS and PPVT standard score equivalents at school entry, CELF standard scores. Speech Production; DEAP percentage accuracy of vowels, consonants, phonemes-total and clusters, and percentage word-intelligibility at school entry. RESULTS: Regression analysis indicated a significant effect for age-at-implant for all outcome measures. Cognitive skills also accounted for significant variance in all outcome measures except open-set phoneme scores. ANOVA with Tukey pairwise comparisons examined group differences for children implanted younger than 12 months (Group 1), between 13 and 18 months (Group 2), between 19 and 24 months (Group 3), between 25 and 42 months (Group 4), and between 43 and 72 months (Group 5). Open-set speech perception scores for Groups 1, 2, and 3 were significantly higher than Groups 4 and 5. Language standard scores for Group 1 were significantly higher than Groups 2, 3, 4, and 5. Speech production outcomes for Group 1 were significantly higher than scores obtained for Groups 2, 3, and 4 combined. Cross tabulation and χ2 tests supported the hypothesis that a greater percentage of Group 1 children (than Groups 2, 3, 4, or 5) demonstrated language performance within the normative range by school entry. CONCLUSIONS: Results support provision of cochlear implants younger than 12 months of age for children with severe to profound hearing loss to optimize speech perception and subsequent language acquisition and speech production accuracy.