Browsing by Subject "Language development"

Now showing 1 - 8 of 8
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    Are Outcomes of Extremely Preterm Infants Improving? Impact of Bayley Assessment on Outcomes
    (Elsevier, 2012) Vohr, Betty R.; Stephens, Bonnie E.; Higgins, Rosemary D.; Bann, Carla M.; Hintz, Susan R.; Epi, M. S.; Das, Abhik; Newman, Jamie E.; Peralta-Carcelen, Myriam; Yolton, Kimberly; Dusick, Anna M.; Evans, Patricia W.; Goldstein, Ricki F.; Ehrenkranz, Richard A.; Pappas, Athina; Adams-Chapman, Ira; Wilson-Costello, Deanne E.; Bauer, Charles R.; Bodnar, Anna; Heyne, Roy J.; Vaucher, Yvonne E.; Dillard, Robert G.; Acarregui, Michael J.; McGowan, Elisabeth C.; Myers, Gary J.; Fuller, Janell; Eunice Kennedy Shriver National Institute of Child Health and Network Human Development Neonatal Research; Pediatrics, School of Medicine
    Objectives: To compare 18- to 22-month cognitive scores and neurodevelopmental impairment (NDI) in 2 time periods using the National Institute of Child Health and Human Development's Neonatal Research Network assessment of extremely low birth weight infants with the Bayley Scales of Infant Development, Second Edition (Bayley II) in 2006-2007 (period 1) and using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III), with separate cognitive and language scores, in 2008-2011 (period 2). Study design: Scores were compared with bivariate analysis, and regression analyses were run to identify differences in NDI rates. Results: Mean Bayley III cognitive scores were 11 points higher than mean Bayley II cognitive scores. The NDI rate was reduced by 70% (from 43% in period 1 to 13% in period 2; P < .0001). Multivariate analyses revealed that Bayley III contributed to a decreased risk of NDI by 5 definitions: cognitive score <70 and <85, cognitive or language score <70; cognitive or motor score <70, and cognitive, language, or motor score <70 (P < .001). Conclusion: Whether the Bayley III is overestimating cognitive performance or whether it is a more valid assessment of emerging cognitive skills than the Bayley II is uncertain. Because the Bayley III identifies significantly fewer children with disability, it is recommended that all extremely low birth weight infants be offered early intervention services at the time of discharge from the neonatal intensive care unit, and that Bayley scores be interpreted with caution.
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    Developmental Effects of Family Environment on Outcomes in Pediatric Cochlear Implant Recipients
    (Wolters Kluwer, 2013) Frush Holt, Rachael; Beer, Jessica; Kronenberger, William G.; Pisoni, David B.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Objective: To examine and compare the family environment of preschool- and school-age children with cochlear implants and assess its influence on children's executive function and spoken language skills. Study design: Retrospective between-subjects design. Setting: Outpatient research laboratory. Patients: Prelingually deaf children with cochlear implants and no additional disabilities and their families. Intervention(s): Cochlear implantation and speech-language therapy. Main outcome measures: Parents completed the Family Environment Scale and the Behavior Rating Inventory of Executive Function (or the preschool version). Children were tested using the Peabody Picture Vocabulary Test-4 and either the Preschool Language Scales-4 or the Clinical Evaluation of Language Fundamentals-4. Results: The family environments of children with cochlear implants differed from normative data obtained from hearing children, but average scores were within 1 standard deviation of norms on all subscales. Families of school-age children reported higher levels of control than those of preschool-age children. Preschool-age children had fewer problems with emotional control when families reported higher levels of support and lower levels of conflict. School-age children had fewer problems with inhibition but more problems with shifting of attention when families reported lower levels of conflict. School-age children's receptive vocabularies were enhanced by families with lower levels of control and higher levels of organization. Conclusion: Family environment and its relation to language skills and executive function development differed across the age groups in this sample of children with cochlear implants. Because family dynamics is one developmental/environmental factor that can be altered with therapy and education, the present results have important clinical implications for family-based interventions for deaf children with cochlear implants.
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    Differential At-Risk Pediatric Outcomes of Parental Sensitivity Based on Hearing Status
    (American Speech-Language-Hearing Association, 2021) Jamsek, Izabela A.; Holt, Rachael Frush; Kronenberger, William G.; Pisoni, David B.; Psychiatry, School of Medicine
    Purpose: The aim of this study was to investigate the role of parental sensitivity in language and neurocognitive outcomes in children who are deaf and/or hard of hearing (DHH). Method: Sixty-two parent–child dyads of children with normal hearing (NH) and 64 of children who are DHH (3–8 years) completed parent and child measures of inhibitory control/executive functioning and child measures of sentence comprehension and vocabulary. The dyads also participated in a video-recorded, free-play interaction that was coded for parental sensitivity. Results: There was no evidence of associations between parental sensitivity and inhibitory control or receptive language in children with NH. In contrast, parental sensitivity was related to children's inhibitory control and all language measures in children who are DHH. Moreover, inhibitory control significantly mediated the association between parental sensitivity and child language on the Clinical Evaluation of Language Fundamentals–Fifth Edition Following Directions subscale (6–8 years)/Clinical Evaluation of Language Fundamentals Preschool–Second Edition Concepts and Following Directions subscale (3–5 years). Follow-up analyses comparing subgroups of children who used hearing aids (n = 29) or cochlear implants (CIs; n = 35) revealed similar correlational trends, with the exception that parental sensitivity showed little relation to inhibitory control in the group of CI users. Conclusions: Parental sensitivity is associated with at-risk language outcomes and disturbances in inhibitory control in young children who are DHH. Compared to children with NH, children who are DHH may be more sensitive to parental behaviors and their effects on emerging inhibitory control and spoken language. Specifically, inhibitory control, when scaffolded by positive parental behaviors, may be critically important for robust language development in children who are DHH.
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    Effects of Simultaneous Speech and Sign on Infants' Attention to Spoken Language
    (Wiley, 2012) Ting, Jonathan Y.; Bergeson, Tonya R.; Miyamoto, Richard T.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Objectives: To examine the hypothesis that infants receiving a degraded auditory signal have more difficulty segmenting words from fluent speech if familiarized with the words presented in both speech and sign compared to familiarization with the words presented in speech only. Study design: Experiment utilizing an infant-controlled visual preference procedure. Methods: Twenty 8.5-month-old normal-hearing infants completed testing. Infants were familiarized with repetitions of words in either the speech + sign (n = 10) or the speech only (n = 10) condition. Infants were then presented with four six-sentence passages using an infant-controlled visual preference procedure. Every sentence in two of the passages contained the words presented in the familiarization phase, whereas none of the sentences in the other two passages contained familiar words. Results: Infants exposed to the speech + sign condition looked at familiar word passages for 15.3 seconds and at nonfamiliar word passages for 15.6 seconds, t (9) = -0.130, p = .45. Infants exposed to the speech only condition looked at familiar word passages for 20.9 seconds and to nonfamiliar word passages for 15.9 seconds. This difference was statistically significant, t (9) = 2.076, p = .03. Conclusions: Infants' ability to segment words from degraded speech is negatively affected when these words are initially presented in simultaneous speech and sign. The current study suggests that a decreased ability to segment words from fluent speech may contribute towards the poorer performance of pediatric cochlear implant recipients in total communication settings on a wide range of spoken language outcome measures.
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    Family Environmental Dynamics Differentially Influence Spoken Language Development in Children With and Without Hearing Loss
    (American Speech-Language-Hearing Association, 2022) Holt, Rachael Frush; Kronenberger, William G.; Pisoni, David B.; Psychiatry, School of Medicine
    Purpose: The aim of this study was to evaluate whether families of children with sensorineural hearing loss (SNHL) are organized similarly to those of typically developing, typically hearing (TH) children and whether the dimensions of family dynamics and environment are related to spoken language development similarly in children with and without SNHL. Method: Primary caregivers of children with SNHL (n = 63) or TH (n = 65) completed the Family Environment Scale-Fourth Edition (FES-4) to assess multiple dimensions of family environment. Children's receptive vocabulary was assessed with the Peabody Picture Vocabulary Test-Fourth Edition, and their receptive language was assessed by an age-appropriate version of the Concepts and Following Directions subtest of the Clinical Evaluation of Language Fundamentals and the Sentence Comprehension subscale of the Comprehensive Assessment of Spoken Language-Second Edition. Principal component analysis was used to examine the dimensional structure of the family environment. Results: Three higher order components were derived from FES-4 subscales for both families of children with SNHL and with TH: Supportive, Controlling, and Conflicted. However, the composition of the factors themselves differed between the two groups. For the TH group, most family environment measures on the FES-4 were not associated with language outcomes. In contrast, for children with SNHL, families who were more supportive, less controlling, and less conflicted had children with better language skills. Conclusions: Three well-accepted dimensions of family dynamics and functioning apply to families of children with SNHL, but their composition differs from those of families with TH children. Family environmental dynamics were much more strongly associated with language outcomes in children with SNHL than in their TH peers. The spoken language development of children with SNHL, in particular, is better in families that provide high levels of support for each other and, in particular, low levels of control, disorganization, and conflict, reflecting the fragile nature of their spoken language development.
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    Nonword Repetition as a Predictor of Long-Term Speech and Language Skills in Children with Cochlear Implants
    (Wolters Kluwer, 2013) Casserly, Elizabeth D.; Pisoni, David B.; Psychology, School of Science
    Hypothesis: The rapid phonological processing skills of children with cochlear implants early in life (ages 8-10), as measured by nonword repetition performance, will predict their language development 8 years later (ages 16-18). This core processing ability will also correlate with concurrent measures of language at both ages of testing. Background: Understanding the causes of the wide range of performance in pediatric cochlear implant users currently constitutes a major barrier to clinical and research progress in the field. Research into children's neurocognitive abilities such as working memory capacity and verbal rehearsal speed, in addition to conventional demographic variables, has shown that these foundational skills play a key role in determining outcomes. Here, we investigate the impact of rapid phonological processing, an ability which is critical in spoken language use, for children with cochlear implants. Methods: Fifty-two deaf children with cochlear implants completed a battery of 14 clinical and research measures of language, neurocognitive, and nonword repetition skills in 2 testing sessions 8 years apart. Results: Performance on the nonword repetition task at both testing sessions correlated significantly with concurrent language abilities. Importantly, nonword repetition accuracy at age 8 to 10 also significantly predicted performance on measures of language ability at age 16 to 18 in a wide range of domains, from speech intelligibility to sentence recognition in noise. These relations were significant even when other neurocognitive measures were controlled. Conclusion: Early nonword repetition performance in children with cochlear implants predicts later language development and, therefore, may identify those children at high risk for poor outcomes.
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    Verbal Short-Term Memory Development and Spoken Language Outcomes in Deaf Children with Cochlear Implants
    (Wolters Kluwer, 2013) Harris, Michael S.; Kronenberger, William G.; Gao, Sujuan; Hoen, Helena M.; Miyamoto, Richard T.; Pisoni, David B.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Objectives: Cochlear implants (CIs) help many deaf children achieve near-normal speech and language (S/L) milestones. Nevertheless, high levels of unexplained variability in S/L outcomes are limiting factors in improving the effectiveness of CIs in deaf children. The objective of this study was to longitudinally assess the role of verbal short-term memory (STM) and working memory (WM) capacity as a progress-limiting source of variability in S/L outcomes after CI in children. Design: Longitudinal study of 66 children with CIs for prelingual severe-to-profound hearing loss. Outcome measures included performance on digit span forward (DSF), digit span backward (DSB), and four conventional S/L measures that examined spoken-word recognition (Phonetically Balanced Kindergarten word test), receptive vocabulary (Peabody Picture Vocabulary Test ), sentence-recognition skills (Hearing in Noise Test), and receptive and expressive language functioning (Clinical Evaluation of Language Fundamentals Fourth Edition Core Language Score; CELF). Results: Growth curves for DSF and DSB in the CI sample over time were comparable in slope, but consistently lagged in magnitude relative to norms for normal-hearing peers of the same age. For DSF and DSB, 50.5% and 44.0%, respectively, of the CI sample scored more than 1 SD below the normative mean for raw scores across all ages. The first (baseline) DSF score significantly predicted all endpoint scores for the four S/L measures, and DSF slope (growth) over time predicted CELF scores. DSF baseline and slope accounted for an additional 13 to 31% of variance in S/L scores after controlling for conventional predictor variables such as: chronological age at time of testing, age at time of implantation, communication mode (auditory-oral communication versus total communication), and maternal education. Only DSB baseline scores predicted endpoint language scores on Peabody Picture Vocabulary Test and CELF. DSB slopes were not significantly related to any endpoint S/L measures. DSB baseline scores and slopes taken together accounted for an additional 4 to 19% of variance in S/L endpoint measures after controlling for the conventional predictor variables. Conclusions: Verbal STM/WM scores, process measures of information capacity, develop at an average rate in the years after cochlear implantation, but were found to consistently lag in absolute magnitude behind those reported for normal-hearing peers. Baseline verbal STM/WM predicted long-term endpoint S/L outcomes, but verbal STM slopes predicted only endpoint language outcomes. Verbal STM/WM processing skills reflect important underlying core elementary neurocognitive functions and represent potential intervention targets for improving endpoint S/L outcomes in pediatric CI users.
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    Word learning in deaf children with cochlear implants: effects of early auditory experience
    (Wiley, 2012) Houston, Derek M.; Stewart, Jessica; Moberly, Aaron; Hollich, George; Miyamoto, Richard T.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Word-learning skills were tested in normal-hearing 12- to 40-month-olds and in deaf 22- to 40-month-olds 12 to 18 months after cochlear implantation. Using the Intermodal Preferential Looking Paradigm (IPLP), children were tested for their ability to learn two novel-word/novel-object pairings. Normal-hearing children demonstrated learning on this task at approximately 18 months of age and older. For deaf children, performance on this task was significantly correlated with early auditory experience: Children whose cochlear implants were switched on by 14 months of age or who had relatively more hearing before implantation demonstrated learning in this task, but later implanted profoundly deaf children did not. Performance on this task also correlated with later measures of vocabulary size. Taken together, these findings suggest that early auditory experience facilitates word learning and that the IPLP may be useful for identifying children who may be at high risk for poor vocabulary development.