Deaf adolescents' quality of life: a questionnaire in Italian Sign Language.

For some deaf people, sign language is the preferred language, the one in which they feel most comfortable. However, there are very few assessment tools developed or adapted for sign languages. The aim of this study was to translate and adapt in Italian Sign Language (LIS) the Italian version of the Youth Quality of Life Instrument-Deaf and Hard of Hearing Module (YQOL-DHH). The YQOL-DHH is a questionnaire assessing health-related quality of life in young deaf people. The guidelines provided by the authors of the original version were followed. Further controls and changes were made to take into account variability in signers' linguistic skills. This work and availability of the YQOL-DHH questionnaire in LIS, in addition to the Italian version, will ensure accessibility for Italian deaf adolescents.

Gender differences in early stages of language development. Some evidence and possible explanations.

It is a common feeling that girls speak earlier than boys; however, whether or not there are gender differences in early language acquisition remains controversial. The present paper aims to review the research on gender effects in early language acquisition and development, to determine whether, and from which age, an advantage for girls does eventually emerge. The focus is on the production of actions and communicative gestures, and early lexical comprehension and production, by girls and boys. The data from various studies that were conducted with direct and indirect tools suggest that some gender differences in actions, gesture, and lexical development depend on the interactions of different factors. Studies differ in terms of age ranges, sample sizes, and tools used, and the girl advantage is often slight and/or not evident at all ages considered. Statistical significance for gender differences appears to depend on the greater individual variability among boys, with respect to girls, which results in a greater number of boys classified as children with poor verbal ability. Biological (e.g., different maturational rates), neuropsychological (e.g., different cognitive strategies in solving tasks), and cultural (e.g., differences in the way parents relate socially to boys and girls) factors appear to interact, to create feedback loops of mutual reinforcement.

The effect of face masks on sign language comprehension: performance and metacognitive dimensions.

In spoken languages, face masks represent an obstacle to speech understanding and influence metacognitive judgments, reducing confidence and increasing effort while listening. To date, all studies on face masks and communication involved spoken languages and hearing participants, leaving us with no insight on how masked communication impacts on non-spoken languages. Here, we examined the effects of face masks on sign language comprehension and metacognition. In an online experiment, deaf participants (N = 60) watched three parts of a story signed without mask, with a transparent mask or with an opaque mask, and answered questions about story content, as well as their perceived effort, feeling of understanding, and confidence in their answers. Results showed that feeling of understanding and perceived effort worsened as the visual condition changed from no mask to transparent or opaque masks, while comprehension of the story was not significantly different across visual conditions. We propose that metacognitive effects could be due to the reduction of pragmatic, linguistic and para-linguistic cues from the lower face, hidden by the mask. This reduction could impact on lower-face linguistic components perception, attitude attribution, classification of emotions and prosody of a conversation, driving the observed effects on metacognitive judgments but leaving sign language comprehension substantially unchanged, even if with a higher effort. These results represent a novel step towards better understanding what drives metacognitive effects of face masks while communicating face to face and highlight the importance of including the metacognitive dimension in human communication research.

Exploring Agreement between MB-CDI Short Forms for Evaluating the Language Skills of Italian Children Aged 18-24 Months.

INTRODUCTION: The short forms of MacArthur-Bates Communicative Development Inventories (MB-CDI) are widely used for assessing communicative and linguistic development in infants and toddlers. Italian norms for the Words and Gestures (WG) and Words and Sentences (WS) short forms overlap between 18 and 24 months. OBJECTIVE: To evaluate the agreement between these two forms. METHODS: Parents of 104 children aged 18-24 months filled in both questionnaires. RESULTS: The two questionnaires showed high agreement in measuring expressive vocabulary size and the percentile of lexical production and good agreement in identifying children at-risk for language delay (75% of the cases were accurately identified). Both short forms include a list of 100 words and a set of questions investigating potential risk factors for communication and language disorders. Ten children with an expressive vocabulary <10th percentile were compared to 10 with typical language development. Scores for children <10th percentile were significantly lower than their peers, in addition to scores of lexical comprehension, gesture-word, and 2-word combinations, and phonological accuracy, imitation of new words, and decontextualized use of language. CONCLUSIONS: Short forms of the Italian MB-CDI can be used interchangeably for evaluating lexical production, but each one offers different quantitative and qualitative information on the behaviours related to language acquisition.

The Italian Words and Sentences MB-CDI: normative data and concordance between complete and short forms.

One of the most popular and widely used parent report instruments for assessing early language acquisition is the MacArthur-Bates Communicative Development Inventories (MB-CDI). This study compares normative data of the Italian Words and Sentences complete form (WS-CF) and short form (WS-SF). The samples included 752 children for the WS-CF and 816 children for the WS-SF designed for children aged 18-36 months. The concordance between WS-SF and WS-CF is analyzed in a subgroup of 65 children. The results revealed strong correlations between WS-CF and WS-SF in both lexical and grammar skills as well as strong relationship between lexical and grammar skills. There was a high percentage agreement (97%) between the two forms for scores below the 10th percentile, suggesting that the two forms may be used interchangeably in order to describe vocabulary and grammatical development.

Sign Language Skills Assessed Through a Sentence Reproduction Task.

The aim of this study is to analyze Italian Sign Language (LIS) linguistic skills in two groups of deaf signing children at different ages, and to compare their skills with those of a group of deaf signing adults. For this purpose, we developed a new Sentence Reproduction Task (SRT) for Italian Sign Language (LIS-SRT), which we administered to 33 participants. Participants' scores and type of errors were analyzed to investigate similarities and differences related to both chronological age and age of LIS acquisition. Results showed that signs tended to be omitted more frequently by the younger children than both the older children and adults and that non-manual components produced simultaneously with manual components appear to be the most difficult linguistic elements to be acquired and mastered. Our results are compared to those of previous studies using SRTs for other signed languages.

Validity of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS) in the Italian population.

Cognitive dysfunction involves 40-65 % of multiple sclerosis (MS) patients. It can be detected in all MS phenotypes from the early stages of the disease, and it tends to progress over time. Minimal Assessment of Cognitive Function in MS (MACFIMS) has been proved to be the most sensitive and comprehensive battery available for MS cognitive assessment in the English population. In Italy, MACFIMS applicability is limited in everyday clinical practice since the overall validity of this battery in the Italian MS population has never been demonstrated. The aim of this study was to translate/cross-culturally adapt and validate an Italian version of the MACFIMS. A total of 130 MS patients and 60 healthy controls (HCs) were enrolled and evaluated with an Italian version of the MACFIMS. All tests discriminated MS patients from HCs; according to the literature, approximately more than half of MS patients (70.8 %) exhibit cognitive impairment. Principal component analysis showed four distinct components: visual-spatial memory/processing speed, working memory, executive functions and verbal memory. Our study is the first to validate an Italian version of the MACFIMS. Several aspects of validity have been demonstrated: criterion and, partially, construct. Future work will investigate the longitudinal course of neuropsychological dysfunction in Italian MS patients using these measures.

Finding the balance between capture and control: Oculomotor selection in early deaf adults.

Previous work investigating the consequence of bilateral deafness on attentional selection suggests that experience-dependent changes in this population may result in increased automatic processing of stimulus-driven visual information (e.g., saliency). However, adaptive behavior also requires observers to prioritize goal-driven information relevant to the task at hand. In order to investigate whether auditory deprivation alters the balance between these two components of attentional selection, we assessed the time-course of overt visual selection in deaf adults. Twenty early-deaf adults and twenty hearing controls performed an oculomotor additional singleton paradigm. Participants made a speeded eye-movement to a unique orientation target, embedded among homogenous non-targets and one additional unique orientation distractor that was more, equally or less salient than the target. Saliency was manipulated through color. For deaf participants proficiency in sign language was assessed. Overall, results showed that fast initiated saccades were saliency-driven, whereas later initiated saccades were goal-driven. However, deaf participants were overall slower than hearing controls at initiating saccades and also less captured by task-irrelevant salient distractors. The delayed oculomotor behavior of deaf adults was not explained by any of the linguistic measures acquired. Importantly, a multinomial model applied to the data revealed a comparable evolution over time of the underlying saliency- and goal-driven processes between the two groups, confirming the crucial role of saccadic latencies in determining the outcome of visual selection performance. The present findings indicate that prioritization of saliency-driven information is not an unavoidable phenomenon in deafness. Possible neural correlates of the documented behavioral effect are also discussed.

Sign vocabulary in deaf toddlers exposed to sign language since birth.

Lexical comprehension and production is directly evaluated for the first time in deaf signing children below the age of 3 years. A Picture Naming Task was administered to 8 deaf signing toddlers (aged 2-3 years) who were exposed to Sign Language since birth. Results were compared with data of hearing speaking controls. In both deaf and hearing children, comprehension was significantly higher than production. The deaf group provided a significantly lower number of correct responses in production than did the hearing controls, whereas in comprehension, the 2 groups did not differ. Difficulty and ease of items in comprehension and production was similar for signing deaf children and hearing speaking children, showing that, despite size differences, semantic development followed similar paths. For signing children, predicates production appears easier than nominals production compared with hearing children acquiring spoken language. Findings take into account differences in input modalities and language structures.

Linguistic and pragmatic skills in toddlers with cochlear implant.

BACKGROUND: An increasing number of deaf children received cochlear implants (CI) in the first years of life, but no study has focused on linguistic and pragmatic skills in children with CI younger than 3 years of age. AIMS: To estimate the percentage of children who had received a CI before 2 years of age whose linguistic skills were within the normal range; to compare linguistic skills of children implanted by 12 months of age with children implanted between 13 and 26 months of age; and to describe the relationship among lexical, grammar and pragmatic skills. METHODS & PROCEDURES: The participants consisted of children who were included on the patient lists of the Service of Audio-Vestibology of the Circolo Hospital in Varese, Italy, and met the following criteria: chronological age between 18 and 36 months; CI activated between 8 and 30 months of age; absence of other reported deficits; hearing parents; and not less than 6 months of CI experience. Language development was evaluated through MacArthur-Bates CDI; pragmatic skills (assertiveness and responsiveness) were evaluated through the Social Conversational Skills Rating Scale. The scores obtained were transformed into z-scores and compared with normative data. The relationship among lexical, grammar and pragmatic skills were tested using Spearman Rho correlations. Children with CI were divided into groups based on the age at CI activation and the differences between the two groups were tested using the Student's t-test. OUTCOMES & RESULTS: Data from 23 deaf children were collected. Fewer than half of the children were within the normal range for lexical production and use of sentences; more than one-third of them fell below the normal range for both lexical and grammar skills. No significant difference was found in vocabulary size or early grammar skills when comparing children who received the CI by 12 months of age with those implanted during the second year of life. Despite the strong relationship among lexical, grammar and pragmatic skills, the delays found for grammar and pragmatic skills were greater than expected based on the vocabulary size. Age at diagnosis of hearing loss was the only predictor of vocabulary size. CONCLUSIONS & IMPLICATIONS: CI may provide deaf children with a good opportunity to develop language skills, but severe difficulties in early social experiences and interaction mediated by language still remain. Delays in these aspects suggest that interventions improving pragmatic skills are recommended even on very young children with CI.

Is Specific Learning Disorder Predicted by Developmental Language Disorder? Evidence from a Follow-Up Study on Italian Children.

Specific Learning Disorder (SLD) is a complex disorder with a strong genetic component, characterized by varying manifestations and considerable differences among children. Several studies have highlighted that difficulties in language acquisition and the presence of Developmental Language Disorders (DLDs) are frequently associated with SLD, suggesting a continuity between the two disorders. This study aimed to add evidence on the proximal and distal predictors of SLD, focusing on the eventual continuity for the presence of DLD at 4-5 years, on some linguistic and communicative abilities at 27-30 months, and on biological and environmental factors. Our sample consisted of 528 families, whose children (Italian monolingual) participated in a screening program at the age of 27-30 months. When children were on average 8.05 years old, parents were asked to answer an interview aimed at collecting information about the children's language and learning development. Results showed that the prevalence of children with an SLD (7.01%) was in line with those reported in other similar studies. The diagnosis of SLD was significantly predicted by the previous diagnosis of DLD, by male sex/gender, and by the familial risk of SLD. Children with these characteristics had a 54% probability of presenting an SLD.

Early action and gesture "vocabulary" and its relation with word comprehension and production.

Data from 492 Italian infants (8-18 months) were collected with the parental questionnaire MacArthur Bates Communicative Development Inventories to describe early actions and gestures (A-G) "vocabulary" and its relation with spoken vocabulary in both comprehension and production. A-G were more strongly correlated with word comprehension than word production. A clear developmental pattern for the different types of A-G was found. These findings are similar to those of different Western languages, indicating a common biological and cultural basis. The analysis of individual A-G and their relations with early words with a related meaning showed interesting similarities between the production of A-G with and without object manipulation and the comprehension and production of corresponding words. Results indicate that the transition from A-G to spoken language is mediated by word comprehension.

Do Spoken Vocabulary and Gestural Production Distinguish Children with Transient Language Delay from Children Who Will Show Developmental Language Disorder? A Pilot Study.

The literature on the role of gestures in children with language delay (LD) is partial and controversial. The present study explores gestural production and modality of expression in children with LD and semantic and temporal relationships between gestures and words in gesture + word combinations. Thirty-three children participated (mean age, 26 months), who were recruited through a screening programme for LD. Cognitive skills, lexical abilities, and the use of spontaneous gestures in a naming task were evaluated when the children were 32 months old. When the children were 78 months old, their parents were interviewed to collect information about an eventual diagnosis of developmental language disorder (DLD). According to these data, the children fell into three groups: children with typical development (n = 13), children with LD who did not show DLD (transient LD; n = 9), and children with LD who showed DLD (n = 11). No significant differences emerged between the three groups for cognitive and lexical skills (comprehension and production), for number of gestures spontaneously produced, and for the sematic relationships between gestures and words. Differences emerged in the modality of expression, where children with transient LD produced more unimodal gestural utterances than typical-development children, and in the temporal relationships between gestures and words, where the children who would show DLD provided more frequent representational gestures before the spoken answer than typical-development children. We suggest a different function for gestures in children with T-LD, who used representational gestures to replace the spoken word they were not yet able to produce, and in children with LD-DLD, who used representational gestures to access spoken words.

Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review.

BACKGROUND: Developmental Language Disorder (DLD) is frequent in childhood and may have long-term sequelae. By employing an evidence-based approach, this scoping review aims at identifying (a) early predictors of DLD; (b) the optimal age range for the use of screening and diagnostic tools; (c) effective diagnostic tools in preschool children. METHODS: We considered systematic reviews, meta-analyses, and primary observational studies with control groups on predictive, sensitivity and specificity values of screening and diagnostic tools and psycholinguistic measures for the assessment of DLD in preschool children. We identified 37 studies, consisting of 10 systematic reviews and 27 primary studies. RESULTS: Delay in gesture production, receptive and/or expressive vocabulary, syntactic comprehension, or word combination up to 30 months emerged as early predictors of DLD, a family history of DLD appeared to be a major risk factor, and low socioeconomic status and environmental input were reported as risk factors with lower predictive power. Optimal time for screening is suggested between age 2 and 3, for diagnosis around age 4. Because of the high variability of sensitivity and specificity values, joint use of standardized and psycholinguistic measures is suggested to increase diagnostic accuracy. CONCLUSIONS: Monitoring risk situations and employing caregivers' reports, clinical assessment and multiple linguistic measures are fundamental for an early identification of DLD and timely interventions.

Lexical and grammatical abilities in deaf Italian preschoolers: the role of duration of formal language experience.

We evaluated language development in deaf Italian preschoolers with hearing parents, taking into account the duration of formal language experience (i.e., the time elapsed since wearing a hearing aid and beginning language education) and different methods of language education. Twenty deaf children were matched with 20 hearing children for age and with another 20 hearing children for duration of experience. Deaf children showed a significant delay in both vocabulary and grammar when compared to same-age hearing children yet a similar development compared to hearing children matched for duration of formal language experience. The delay in linguistic development could be attributable to shorter formal language experience and not to deafness itself. Deaf children exposed to spoken language accompanied by signs tended to understand and produce more words than children exposed only to spoken language. We suggest that deaf children be evaluated based on their linguistic experience and cognitive and communicative potential.

Attentional orienting to social and nonsocial cues in early deaf adults.

In 2 experiments we investigated attentional orienting to nonpredictive social and nonsocial cues in deaf observers. In Experiment 1a, 22 early deaf adults and 23 hearing controls performed a peripheral shape-discrimination task, while uninformative central gaze cues validly and invalidly cued the location of the target. As an adaptation to the lack of audition, we expected deaf adults to show a larger impact of gaze cuing on attentional orienting compared with hearing controls. However, contrary to our predictions, deaf participants did not respond faster to cued compared with uncued targets (gaze-cuing effect; GCE), and this behavior partly correlated with early sign language acquisition. Experiment 1b showed a reliable GCE in 13 hearing native signers, thus excluding a key role of early sign language acquisition in explaining the lack of GCE in the response times of deaf participants. To test whether the resistance to uninformative central cues extends to nonsocial cues, in Experiment 2 nonpredictive arrow cues were presented to 14 deaf and 14 hearing participants. Both groups of participants showed a comparable arrow-cuing effect. Together, our findings suggest that deafness may selectively limit attentional-orienting triggered by central irrelevant gaze cues. Possible implications for plasticity related to deafness are discussed.

Visual word recognition in deaf readers: lexicality is modulated by communication mode.

Evidence indicates that adequate phonological abilities are necessary to develop proficient reading skills and that later in life phonology also has a role in the covert visual word recognition of expert readers. Impairments of acoustic perception, such as deafness, can lead to atypical phonological representations of written words and letters, which in turn can affect reading proficiency. Here, we report an experiment in which young adults with different levels of acoustic perception (i.e., hearing and deaf individuals) and different modes of communication (i.e., hearing individuals using spoken language, deaf individuals with a preference for sign language, and deaf individuals using the oral modality with less or no competence in sign language) performed a visual lexical decision task, which consisted of categorizing real words and consonant strings. The lexicality effect was restricted to deaf signers who responded faster to real words than consonant strings, showing over-reliance on whole word lexical processing of stimuli. No effect of stimulus type was found in deaf individuals using the oral modality or in hearing individuals. Thus, mode of communication modulates the lexicality effect. This suggests that learning a sign language during development shapes visuo-motor representations of words, which are tuned to the actions used to express them (phono-articulatory movements vs. hand movements) and to associated perceptions. As these visuo-motor representations are elicited during on-line linguistic processing and can overlap with the perceptual-motor processes required to execute the task, they can potentially produce interference or facilitation effects.

Bilingual vocabulary size and lexical reading in Italian.

In the present study we investigated how the vocabulary size of English-Italian bilinguals affects reading aloud in Italian (L2) modulating the reader's sensitivity to lexical aspects of the language. We divided adult bilinguals in two groups according to their vocabulary size (Larger - LV, and smaller - SV), and compared their naming performance to that of native Italian (NI) readers. In Experiment 1 we investigated the lexicality and word frequency effects in reading aloud. Similarly to NI, both groups of bilinguals showed these effects. In Experiment 2 we investigated stress assignment - which is not predictable by rule - to Italian words. The SV group made more stress errors in reading words with a non-dominant stress pattern compared to the LV group. The results suggest that the size of the reader's L2 lexicon affects the probability of correct reading aloud. Overall, the results indicate that proficient adult bilinguals show a similar sensibility to the statistical and distributional properties of the language as compared to Italian monolinguals.

Cochlear implant in the second year of life: lexical and grammatical outcomes.

PURPOSE: The authors studied the effect of the cochlear implant (CI) on language comprehension and production in deaf children who had received a CI in the 2nd year of life. METHOD: The authors evaluated lexical and morphosyntactic skills in comprehension and production in 17 Italian children who are deaf (M = 54 months of age) with a CI and in 2 control groups of children with normal hearing (NH; 1 matched for chronological age and the other whose chronological age corresponded to the duration of CI activation). The authors also compared children with unilateral CI to children with bilateral CI. RESULTS: Children with CI appeared to keep pace with NH children matched for time since CI activation in terms of language acquisition, and they were similar to same-age NH children in lexical production. However, children with CI showed difficulties in lexical comprehension when a task required phonological discrimination as well as in grammar comprehension and production. Children with bilateral CI showed better comprehension than did children with unilateral CI; the 2 groups were similar for production. CONCLUSIONS: Activation of CI in the 2nd year of life may provide children who are deaf with a good opportunity to develop language skills, although some limitations in phonological and morphological skills are still present 3 years after auditory reafferentation.