Search

Purpose: This study investigated articulatory patterns for American English /ɹ/ in children with and without a history of residual speech sound disorder (RSSD). It was hypothesized that children without RSSD would favor bunched tongue shapes, similar to American adults reported in previous literature. Based on clinical cueing practices, it was hypothesized that children with RSSD might produce retroflex tongue shape patterns at a higher relative rate. Finally, it was hypothesized that, among children who use a mixture of bunched and retroflex shapes, phonetic context would impact tongue shape as reported in the adult literature. Method: These hypotheses were tested using ultrasound data from a stimul-ability task eliciting /ɹ/ in syllabic, postvocalic, and onset contexts. Participants were two groups of children/adolescents aged 9-15 years: 36 with RSSD who completed a study of ultrasound biofeedback treatment and 33 with no history of RSSD. Tongue shapes were qualitatively coded as bunched or retroflex using a flowchart from previous research. Results: Children with no history of RSSD were found to use bunched-only tongue shape patterns at a rate higher than adults, but those who used a mixture of shapes for /ɹ/ followed the expected phonetic contextual patterning. Children with RSSD were found to use retroflex-only patterns at a substantially higher rate than adults, and those using a mixture of shapes did not exhibit the expected patterning by phonetic context. Conclusions: These findings suggest that clients receiving ultrasound biofeedback treatment for /ɹ/ may be most responsive to clinician cueing of retroflex shapes, at least early on. However, retroflex-only cueing may be a limiting and insufficient strategy, particularly in light of our finding of a lack of typical variation across phonetic contexts in children with remediated /ɹ/. Future research should more specifically track cueing strategies to better understand the relationship between clinician cues, tongue shapes, and generalization across a range of contexts. [ABSTRACT FROM AUTHOR]

Purpose: The current study is a Phase I clinical study with the goal of determining feasibility and the effectiveness of the Kaufman Speech to Language Protocol (K-SLP) for children with childhood apraxia of speech (CAS) and comorbidities. We hypothesized that K-SLP intervention would result in improved outcomes and maintenance of treatment effect at 3–4 months postintervention. Method: Single-subject experimental design with multiple baselines across behaviors was replicated across a group of six children. Five out of six participants completed the study. The K-SLP intervention was administered in dyads four times a week for three consecutive weeks. Outcomes included assessment of word/syllable shapes, articulation accuracy, speech intelligibility, and functional communication. Treatment progress was measured through: (a) the administration of custom probe word lists and (b) assessments carried out at pretreatment, immediately following intervention and approximately 3–4 months after the study period. Results: Four out of five participants demonstrated significant improvements to words targeted in treatment and three out of five generalized these to untreated words. Furthermore, three out of five participants showed immediate and clinically significant posttreatment improvements in speech intelligibility and functional outcomes, and this increased to four out of five participants at 3–4 months follow-up. Conclusions: The study provides preliminary support for the effectiveness of the K-SLP program when delivered in dyads to children with CAS with comorbidities. The study replicates earlier findings and reaffirms the positive outcomes of K-SLP for children with CAS. [ABSTRACT FROM AUTHOR]

Purpose: A well-established set of language-specific norms for phonological development is imperative in the assessment of child speech sound difficulties. Currently, English norms are used clinically (in the absence of norms for local languages) to determine if a child displays age-appropriate, delayed or disordered speech patterns in Sinhala. This preliminary exploratory study aimed to document phonological processes observed in typically developing Sinhalaspeaking children aged 3;0–6;11 (years;months). Method: The Test of Articulation and Phonology–Sinhala, a picture-based assessment, was devised by the researchers and administered to 102 Sinhalaspeaking children from three geographical locations (Colombo, Kandy, and Gampaha). The quantitative measures included percent consonants correct, percent vowels correct, and percent phonemes correct, while the qualitative analysis identified phonological processes. Results: The quantitative results showed a marked influence of age on phoneme production accuracy with over 75% consonants correct by 3 years 6 months. The qualitative findings demonstrate common typical phonological processes and less common phonological processes in Sinhala compared to the speech pathology and cross-linguistic literature. Common phonological processes included fronting, stopping, and weak syllable deletion widely documented in linguistic and speech-language pathology literature. Many shared phonological processes were observed between Sinhala and Sri Lankan Tamil, the two main local languages, including fronting of retroflex sounds and lateralization. The phonological process of denasalization of prenasalized stops was observed in Sinhala, with no documentation of the phonological process found within the mainstream speech-language pathology literature. Conclusion and Implications: These findings reinforce the need to document and use language-specific typical phonological processes in Sinhala given the implications for early and accurate identification of speech difficulties and intervention. [ABSTRACT FROM AUTHOR]

Background: Children with speech sound disorders (SSD) form a heterogeneous group, with respect to severity, etiology, proximal causes, speech error characteristics, and response to treatment. Infants develop speech and language in interaction with neurological maturation and general perceptual, motoric, and cognitive skills in a social-emotional context. Purpose: After a brief introduction into psycholinguistic models of speech production and levels of causation, in this review article, we present an in-depth overview of mechanisms and processes, and the dynamics thereof, which are crucial in typical speech development. These basic mechanisms and processes are: (a) neurophysiological motor refinement, that is, the maturational articulatory mechanisms that drive babbling and the more differentiated production of larger speech patterns; (b) sensorimotor integration, which forms the steering function from phonetics to phonology; and (c) motor hierarchy and articulatory phonology describing the gestural organization of syllables, which underlie fluent speech production. These dynamics have consequences for the diagnosis and further analysis of SSD in children. We argue that current diagnostic classification systems do not do justice to the multilevel, multifactorial, and interactive character of the underlying mechanisms and processes. This is illustrated by a recent Dutch study yielding distinct performance profiles among children with SSD, which allows for a dimensional interpretation of underlying processing deficits. Conclusions: Analyses of mainstream treatments with respect to the treatment goals and the speech mechanisms addressed show that treatment programs are quite transparent in their aims and approach and how they contribute to remediating specific deficits or mechanisms. Recent studies into clinical reasoning reveal that the clinical challenge for speech-language pathologists is how to select the most appropriate treatment at the most appropriate time for each individual child with SSD. We argue that a process-oriented approach has merits as compared to categorical diagnostics as a toolbox to aid in the interpretation of the speech profile in terms of underlying deficits and to connect these to a specific intervention approach and treatment target. [ABSTRACT FROM AUTHOR]

Purpose: One of the strategies that can be used to support speech communication in deaf children is cued speech, a visual code in which manual gestures are used as additional phonological information to supplement the acoustic and labial speech information. Cued speech has been shown to improve speech perception and phonological skills. This exploratory study aims to assess whether and how cued speech reading proficiency may also have a beneficial effect on the acoustic and articulatory correlates of consonant production in children. Method: Eight children with cochlear implants (from 5 to 11 years of age) and with different receptive proficiency in Canadian French Cued Speech (three children with low receptive proficiency vs. five children with high receptive proficiency) are compared to 10 children with typical hearing (from 4 to 11 years of age) on their production of stop and fricative consonants. Articulation was assessed with ultrasound measurements. Results: The preliminary results reveal that cued speech proficiency seems to sustain the development of speech production in children with cochlear implants and to improve their articulatory gestures, particularly for the place contrast in stops as well as fricatives. Conclusion: This work highlights the importance of studying objective data and comparing acoustic and articulatory measurements to better characterize speech production in children. [ABSTRACT FROM AUTHOR]

Purpose: Neurogenic speech and language disorders--such as acquired apraxia of speech (AOS) and aphasia with phonemic paraphasia (APP)--are often misdiagnosed due to similarities in clinical presentation. Word syllable duration (WSD)--a measure of average syllable length in multisyllabic words--serves as a proxy for speech rate, which is an important and arguably more objective clinical characteristic of AOS and APP. This study reports stability of WSD over time for speakers with AOS (and aphasia). Method: Twenty-nine participants with AOS and aphasia (11 women and 18 men, Mage = 53.5 years, SD = 13.3) repeated 30 multisyllabic words (of three-, four-, and five-syllable lengths) on three occasions across 4 weeks. WSDs were calculated for each word and then averaged across each list (i.e., word length), as well as across combined lists (i.e., all 30 words) to yield four WSDs for each participant at each time point. Stability over time was calculated using Friedman's test for the group and using Spearman's rho for the individual level. Effects of time and word length were examined using robust mixed-effects linear regression. Results: Friedman's tests and correlations indicated no significant difference in WSDs across sampling occasions for each word length separately or combined. WSD correlated positively with AOS severity and negatively with intelligibility but was not correlated with aphasia severity. Regression analyses confirmed WSD to be stable over time, while WSD calculated from only five tokens (i.e., WSD-5) was less stable over time. Conclusions: Results indicate that WSD can be a stable measure over time, at the individual and group level, providing support for its use in diagnosis and/or as an outcome measure, both clinically and for research. In general, WSD outperformed WSD-5, suggesting that it may be better to calculate WSD from more than five tokens. Stability of WSD in other populations and suitability for differential diagnosis need to be determined. Currently, differentiating disorders by speaking rate, alone, is not recommended. [ABSTRACT FROM AUTHOR]

Purpose: This article reports on jaw articulation, in connection with the segmental articulations of tongue tip and lips. The jaw is considered a syllable articulator as it opens and closes for each syllable, and the amount of jaw opening is related to syllable strength, given the same phonemic vowel. Here, we investigate the syllabic and the segmental articulations relationships to the acoustic segments. Method: We analyze electromagnetic articulography data of 18 Southern Swedish speakers by testing hypotheses based on the Descriptive Approach to Segmental Articulations. In this approach, articulatory movements are divided into fast intervals and steady states, and the crucial ("primary") articulators' deceleration and acceleration peaks align with the acoustic segment boundaries. Results: Previous findings on the lips and the tongue tip are confirmed. New results are the jaw as noncrucial ("nonprimary") does not align with the acoustic segment boundaries: Its steady states are shorter than consonant and vowel segments. Moreover, place of articulation of the coda affects the jaw cycle, while syllable type only affects jaw closing. No such effects are found on the edges of the jaw cycle, instead only gender affects jaw deceleration at syllable onset. Conclusions: The jaw is not crucial for the timing of the acoustic segment boundaries; also, syllable borders seem to not be affected by place of segmental articulation. The results strengthen the view of the jaw as syllable articulator providing a frame and the other articulators (e.g., lips and tongue tip) as the segmental articulators providing the content. [ABSTRACT FROM AUTHOR]

Purpose: Typically developing toddlers extract patterns from their input to add words to their spoken lexicons, yet some evidence suggests that late talkers leverage the statistical regularities of the ambient language differently than do peers. Using the extended statistical learning account, we sought to compare lexical-level statistical features of spoken vocabularies between late talkers and two typically developing comparison groups. Method: MacArthur-Bates Communicative Developmental Inventories American English Words and Sentences (N = 1,636) were extracted from Wordbank, a database of CDIs. Inventories were divided into three groups: (a) a late talker group (n = 202); (b) a typically developing age-matched group (n = 1,238); and (c) a younger, typically developing group (n = 196) matched to the late talkers on expressive language. Neighborhood density and word frequency were calculated for each word produced by each participant and standardized to z scores. Mixed-effects models were used to evaluate group differences. Results: The late talker and younger, language-matched groups' spoken vocabularies consist, on standardized average, of words from denser phonological neighborhoods and words higher in frequency of occurrence in parent-child speech, compared to older, typically developing toddlers. Conclusions: These findings provide support for the extended statistical learning account. Late talkers appear to generally be extracting and using similar patterns from their language input as do younger toddlers with similar levels of expressive vocabulary. This suggests that late talkers may be following a delayed, not deviant, trajectory of expressive language growth. [ABSTRACT FROM AUTHOR]

3 years of age is challenging. Among early risk factors, research has focused on having a positive familial history (FH+) for language or literacy problems and on late language emergence, that is, late-talker (LT) status. The interaction between these two risk factors and their cumulative effect is still debated. Here, we (a) investigate the effect of FH+ on 24-month language development, (b) test for cumulative effects of FH+ status and early language delay on 36-month language outcomes, and (c) disentangle the direct and indirect effects of familial history (FH) on the language outcome. Method: One hundred eighty-five Italian children were followed up longitudinally between 24 and 36 months of age (64 FH+ and 121 FH-) through parental questionnaires and direct child assessment. Results: At the age of 24 months, the FH+ group showed worse expressive vocabulary and higher prevalence of LT. At the age of 36 months, main effects of LT and FH were identified on lexical and phonological performances, respectively. Interestingly, significant interaction effects were identified on expressive vocabulary and phonological processing. Path analysis highlights that FH had a direct effect on later measures of phonology, whereas its effect on 36-month lexical abilities was indirect, via measures of expressive vocabulary at 24 months. Conclusions: The study suggests specific predictive roles of FH and LT status on language development. Interestingly, FH+ seems to represent an additive risk for LT children. The use of cumulative risk measures is confirmed as a powerful approach to identify those children with the highest probability of developing persistent language difficulties. [ABSTRACT FROM AUTHOR]

Purpose: For non-autistic children, it is well established that linguistic awareness skills support their success with reading and spelling. Few investigations have examined whether these same linguistic awareness skills play a role in literacy development for autistic elementary school-age children. This study serves as a first step in quantifying the phonological, prosodic, orthographic, and morphological awareness skills of autistic children; how these skills compare to those of non-autistic children; and their relation to literacy performance. Method: We measured and compared the phonological, prosodic, orthographic, and morphological awareness skills of 18 autistic (with average nonverbal IQs) and 18 non-autistic elementary school-age children, matched in age, nonverbal IQ, and real-word reading. The relations between linguistic awareness and the children's word-level literacy and reading comprehension skills were examined, and we explored whether the magnitude of these relations was different for the two groups. Regression analyses indicated the relative contribution of linguistic awareness variables to performance on the literacy measures for the autistic children. Results: The non-autistic children outperformed the autistic children on most linguistic awareness measures. There were moderate-to-strong relations between performances on the linguistic awareness and literacy measures for the non-autistic children, and most associations were not reliably different from those for the autistic children. Regression analyses indicate that the performance on specific linguistic awareness variables explains unique variance in autistic children's literacy performance. Conclusion: Although less developed than those of their non-autistic peers, the linguistic awareness skills of autistic elementary school-age children are important for successful reading and spelling. [ABSTRACT FROM AUTHOR]

Purposes: This study examines English vowel perception in Spanish-English bilingual preschoolers, comparing bilinguals' perception patterns to those of monolinguals and examining how child internal (age) and external variables (input quantity and input diversity) predict perceptual performance. Method: Sixty children between 3;6 and 5;6 (years;months) of age participated in the study, 28 of whom were Spanish-English bilinguals and 32 English monolinguals. Perception was assessed through a forced-choice minimal-pair identification task in which children heard synthesized audio stimuli (i.e., "sheep" and "ship") that varied systematically along the / continuum and were asked to match them with one of two pictures. The data were analyzed with Bayesian mixed-effects logistic regression analyses, modeling responses as a function of continuum step, language background (monolingual or bilingual), age, English exposure (i.e., input quantity), and number of English input providers (i.e., input diversity). Results: The results indicate that, despite displaying nonnative English stop voicing perception in a previous study, the same bilingual children showed English /i-1/ perception patterns that did not differ from those of monolinguals. While age did not predict vowel perception, input quantity and diversity jointly interacted to moderate how well children perceived the /i-1/ contrast. Specifically, diverse input promoted perceptual performance in children who received high levels of English exposure--and who presumably had more advanced English language skills, whereas it limited perceptual performance in children with more limited English exposure and skills. Conclusions: This study shows that bilingual children can show monolinguallike perception patterns for some sounds while displaying nontarget perception for others. This is the first study to demonstrate that language exposure mediates the role of input diversity on speech sound development, suggesting that varied input can be more or less beneficial for speech sound development based on the learner's language learning stage. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated relationships within and between perceptual, acoustic, and kinematic measures in speakers with and without dysarthria due to Parkinson's disease (PD) across different clarity conditions. Additionally, the study assessed the predictive capabilities of selected acoustic and kinematic measures for intelligibility and articulatory precision ratings. Method: Forty participants, comprising 22 with PD and 18 controls, read three phrases aloud using conversational, less clear, and more clear speaking conditions. Acoustic measures and their theoretical kinematic parallel measures (i.e., acoustic and kinematic distance and vowel space area [VSA]; second formant frequency [F2] slope and kinematic speed) were obtained from the diphthong /a/ and selected vowels in the sentences. A total of 368 listeners from crowdsourcing provided ratings for intelligibility and articulatory precision. The research questions were examined using correlations and linear mixed-effects models. Results: Intelligibility and articulatory precision ratings were highly correlated across all speakers. Acoustic and kinematic distance, as well as F2 slope and kinematic speed, showed moderately positive correlations. In contrast, acoustic and kinematic VSA exhibited no correlation. Among all measures, acoustic VSA and kinematic distance were robust predictors of both intelligibility and articulatory precision ratings, but they were stronger predictors of articulatory precision. Conclusions: The findings highlight the importance of measurement selection when examining cross-domain relationships. Additionally, they support the use of behavioral modifications aimed at eliciting larger articulatory gestures to improve intelligibility in individuals with dysarthria due to PD. [ABSTRACT FROM AUTHOR]

Purpose: Research in cross-language speech production indicates that, although the production of nonnative consonant clusters is often difficult, speakers of American English can produce some nonnative clusters (e.g., /fn/) with high accuracy. This ease of production for select nonnative clusters may occur due to similarity of phonetic structure with native clusters (e.g., nonnative /fn/and native /sm/ are both fricative-nasal sequences). The current study tested this hypothesis by examining the extent of transfer of articulatory coordination from phonetically similar native onset clusters (i.e., /fl/, /sm/) to nonnative /fn/ clusters. Method: Using electromagnetic articulography, lip, tongue, and jaw movements were recorded in nine participants during the production of 22 nonwords (eight tokens per nonword) containing the native and nonnative clusters in different carrier phrases. We examined the temporal lags between each consonantal gesture in a cluster and the flanking vowel gesture, which were compared to the matched singleton conditions. Results: Analyses revealed that, as in native speech, when the syllable onset became more complex (i.e., CV CCV [C as consonant, V as vowel]), there was an increase in lag (less temporal overlap) between the leftmost consonantal gesture and the vocalic gesture, whereas there was a decrease in lag (more temporal overlap) between the rightmost consonant and the vocalic gesture (i.e., C-center timing). However, the segmental makeup of the cluster and type of carrier phrase used were also found to influence this change in temporal organization, raising new questions for future research. Conclusions: By and large, the findings are in agreement with the idea that the temporal coordination of articulator movements may be transferred from native clusters to phonetically similar nonnative clusters. However, kinematic measures of a broader range of nonnative clusters in different contexts are needed to fully explore this position. [ABSTRACT FROM AUTHOR]

Purpose: There is a need for stimuli that can be used in the assessment of apraxia of speech (AOS) characteristics. AOS often presents with aphasia, and the Western Aphasia Battery--Revised (WAB-R) is administered extensively in clinical practice for the assessment of aphasia. This preliminary study investigated error production of differentially diagnostic characteristics of AOS (phonetic and prosodic errors) in response to existing spoken language subtest stimuli of the WAB-R in individuals with concomitant AOS and aphasia and aphasia only. Method: Ten participants presenting with aphasia and potential motor speech impairment were included. Presence of AOS was determined for five individuals. Speech production errors were analyzed using narrow transcription methods in response to the Naming, Repetition, and Spontaneous Speech subtests of the WAB-R for both AOS and aphasia and aphasia-only groups. Results: Differences in total error production for both phonetic and prosodic errors were reported between the AOS and aphasia and aphasia-only groups. In addition, the phonetic complexity of the stimuli correlated to the phonetic and prosodic error production in both groups. An effect of WAB-R subtest was not reported for either group. Conclusion: The diversity of elicited spoken language production across multiple contexts makes the use of the spoken language subtest stimuli a feasible component of a comprehensive AOS assessment, since AOS is often concomitant with aphasia. [ABSTRACT FROM AUTHOR]

Purpose: Limited research exists assessing speech perception in school-age children with speech sound disorder (SSD) and childhood apraxia of speech (CAS); despite early evidence that speech perception may lead to error-prone motor planning/programming. In this study, we examine speech perception performance in school-age children with and without speech production deficits. Method: Speech perception was assessed using the Wide Range Acoustic Accuracy Scale to determine the just-noticeable difference in discrimination for three consonant-vowel syllable contrasts (/bɑ/-/wɑ/, /dɑ/-/gɑ/, /ɹɑ/-/wɑ/), each varying along a single acoustic parameter for seven children with CAS with rhotic errors, seven children with SSD with rhotic errors, and seven typically developing (TD) children. Results: Findings revealed statistically significant mean differences between perceptual performance of children with CAS when compared to TD children for discrimination of /ɹɑ/-/wɑ/ contrasts. Large effect sizes were also observed for comparisons of /ɹɑ/-/wɑ/ contrasts between children with CAS, SSD, and TD peers. Additionally, large effect sizes were observed for /dɑ/-/gɑ/ contrasts between children with CAS and SSD and TD children despite nonsignificant mean differences in group performance. Conclusions: Overall, mean outcome scores suggest that school-age children with CAS and persistent rhotic errors demonstrated less accurate speech perception skills relative to TD children for the /ɹɑ/-/wɑ/ contrasts. However, the relatively small sample sizes per group limit the extent to which these findings may be generalized to the broader population. [ABSTRACT FROM AUTHOR]

Purpose: This study examines how ultrasound biofeedback and intensive treatment distribution affect speech sound generalization during an evidence-based treatment, Speech Motor Chaining, for children with persisting speech errors associated with childhood apraxia of speech (CAS). Method: In a 2 x 2 factorial randomized controlled trial, children ages 9-17 years meeting CAS criteria were randomized to receive (a) a distributed treatment (20 sessions twice weekly over 10 weeks) or intensive treatment (20 hr in 5 weeks, with 10 hr in Week 1) and (b) treatment with or without biofeedback. Due to the COVID pandemic, some participants were randomized to distributed/intensive telepractice treatment only. The primary outcome was percent target sounds correct on untreated phrases (i.e., generalization) at the 10-week time point. More than 50,000 narrow phonetic transcriptions were analyzed. Results: Forty-eight participants completed treatment. Intensive treatment significantly increased generalization at all time points. The effect of biofeedback was significant at 5 weeks from the start of treatment but not significant at the primary 10-week time point. However, when comparing each group immediately after their 20 hr of treatment finished, generalization was significantly greater in intensive over distributed treatment and greater in ultrasound over no-ultrasound treatment (with a significant interaction favoring intensive treatment with ultrasound). Only the advantage of intensive treatment remained significant 5 weeks after groups finished treatment. There was no significant difference between face-to-face and telepractice modalities. Conclusions: When the number of treatment hours is fixed, an intensive schedule of Speech Motor Chaining facilitated greater improvement than a distributed schedule. Ultrasound biofeedback initially accelerated learning, but the benefits may dissipate as treatment continues or after it ends. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to pilot the efficacy of rapid syllable transition (ReST) treatment when provided once per week for a 50-min treatment session for 12 weeks with five children with childhood apraxia of speech. Of central importance was the children's retention and generalization of gains from treatment as indicators of speech motor learning. Method: A multiple-baseline across-participant design was employed to investigate (a) treatment effect on the 20 treated pseudowords, (b) generalization to 40 untreated real words and 10 untreated polysyllabic word sentences, and (c) maintenance of any treatment and generalization goals to up to 4 months posttreatment. To investigate any difference between in-session performance and retention, a comparison was made between data collected during treatment and probe sessions. Results: Treatment data collected during therapy showed all children improving across their 12 treatment sessions. Three of the five children showed a treatment effect on treated pseudowords in the probe sessions, but only one child showed generalization to untreated real words, and no children showed generalization to sentences. Conclusions: ReST treatment delivered at a dose frequency of once per week was efficacious for only one of the five children. In-session treatment data were not a reliable indicator of children's learning. One session per week of ReST therapy is therefore not recommended. Supplemental Material: https://doi.org/10.23641/asha.23751018 [ABSTRACT FROM AUTHOR]

Purpose: Babble Boot Camp (BBC) is a parent-implemented telepractice intervention for infants at risk for speech and language disorders. BBC uses a teach-model-coach-review approach, delivered through weekly 15-min virtual meetings with a speech-language pathologist. We discuss accommodations needed for successful virtual follow-up test administration and preliminary assessment outcomes for children with classic galactosemia (CG) and controls at age 2.5 years. Method: This clinical trial included 54 participants, 16 children with CG receiving BBC speech-language intervention from infancy, age 2 years, five children receiving sensorimotor intervention from infancy and changing to speech-language intervention at 15 months until 2 years of age, seven controls with CG, and 26 typically developing controls. The participants' language and articulation were assessed via telehealth at age 2.5 years. Results: The Preschool Language Scale-Fifth Edition (PLS-5) was successfully administered with specific parent instruction and manipulatives assembled from the child's home. The GFTA-3 was successfully administered to all but three children who did not complete this assessment due to limited expressive vocabularies. Referrals for continued speech therapy based on PLS-5 and GFTA-3 scores were made for 16% of children who received BBC intervention from infancy as compared to 40% and 57% of children who began BBC at 15 months of age or did not receive BBC intervention, respectively. Conclusions: With extended time and accommodations from the standardized administration guidelines, virtual assessment of speech and language was possible. However, given the inherent challenges of testing very young children virtually, in-person assessment is recommended, when possible, for outcome measurements. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this tutorial is to (a) provide an updated review of the literature pertaining to proposed early features of childhood apraxia of speech (CAS), (b) discuss the findings of recent treatment studies of infants and toddlers with suspected CAS (sCAS), and (c) present evidence-based strategies and tools that can be used for the identification of and intervention for infants and toddlers with sCAS or at high risk for the disorder. Method: Since Davis and Velleman's (2000) seminal work on assessment and intervention in infants and toddlers with sCAS, limited research has guided clinicians in the complex task of identifying and treating early speech motor difficulties prior to a definitive diagnosis of CAS. Following the structure of Davis and Velleman, we explore the proposed early characteristics of CAS with reference to contemporary research. Next, we describe the limited treatment studies that have investigated intervention for infants and toddlers at risk of or suspected of having CAS. Finally, we present practical suggestions for integrating this knowledge into clinical practice. Conclusions: Many of the originally proposed correlates of CAS in infants and toddlers now have research supporting their presence. However, questions remain about the developmental trajectory of the disorder. Although limited in number and restricted by lack of experimental control, emerging treatment studies can help guide clinicians in providing appropriate intervention to infants and toddlers with sCAS who need not wait for a definitive diagnosis to initiate intervention. [ABSTRACT FROM AUTHOR]

Purpose: Speech-Music Therapy for Aphasia (SMTA), a method that combines speech therapy and music therapy, is introduced as a treatment method for childhood apraxia of speech (CAS). SMTA will be evaluated in a proof-of-principle study. The first case study is presented herein. Method: SMTA was evaluated in a study with a single-subject experimental design comparing 10 weeks of treatment with 2 months of no treatment. The research protocol included a pretest, baseline phase, treatment phase, posttest, no-treatment phase, and follow-up test. The participant was a boy with CAS aged 5;8 (years;months). Outcome measures were selected to reflect both intelligibility in daily communication as well as features of CAS and speech motor planning and programming. Results: Results on the Intelligibility in Context Scale-Dutch (ICS-Dutch) and in the analysis of a spontaneous speech sample suggest generalization of treatment effects. Improvements were found in measures that reflect complex speech motor skills, that is, the production of consonant clusters and consistency. Conclusions: This case study showed that speech production of the participant improved after treatment with SMTA. Although intelligibility as measured with the ICS-Dutch improved over the study period, objectifying changes at the level of intelligibility in daily communication proved to be difficult. Additional measures may be necessary to gain more insight into treatment effects at this level. Overall, the results of this first case study provide sufficient support and important leads for further evaluation of SMTA in the treatment of CAS in a proof-of-principle study. [ABSTRACT FROM AUTHOR]

Introduction: Transcribing disordered speech can be useful when diagnosing motor speech disorders such as primary progressive apraxia of speech (PPAOS), who have sound additions, deletions, and substitutions, or distortions and/or slow, segmented speech. Since transcribing speech can be a laborious process and requires an experienced listener, using automatic speech recognition (ASR) systems for diagnosis and treatment monitoring is appealing. This study evaluated the efficacy of a readily available ASR system (wav2vec 2.0) in transcribing speech of PPAOS patients to determine if the word error rate (WER) output by the ASR can differentiate between healthy speech and PPAOS and/or among its subtypes, whether WER correlates with AOS severity, and how the ASR's errors compare to those noted in manual transcriptions. Method: Forty-five patients with PPAOS and 22 healthy controls were recorded repeating 13 words, 3 times each, which were transcribed manually and using wav2vec 2.0. The WER and phonetic and prosodic speech errors were compared between groups, and ASR results were compared against manual transcriptions. Results: Mean overall WER was 0.88 for patients and 0.33 for controls. WER significantly correlated with AOS severity and accurately distinguished between patients and controls but not between AOS subtypes. The phonetic and prosodic errors from the ASR transcriptions were also unable to distinguish between subtypes, whereas errors calculated from human transcriptions were. There was poor agreement in the number of phonetic and prosodic errors between the ASR and human transcriptions. Conclusions: This study demonstrates that ASR can be useful in differentiating healthy from disordered speech and evaluating PPAOS severity but does not distinguish PPAOS subtypes. ASR transcriptions showed weak agreement with human transcriptions; thus, ASR may be a useful tool for the transcription of speech in PPAOS, but the research questions posed must be carefully considered within the context of its limitations. [ABSTRACT FROM AUTHOR]

Purpose: Despite the general agreement that dysarthria characteristics are largely language-independent, few efforts have attempted a systematic comparison across languages. To examine the role of native languages in the perception of speech characteristics of dysarthria secondary to Parkinson's disease (PD), auditory-perceptual ratings of dysarthria, and confidence level of the judgments were compared between two listener groups: language-matched and language-crossed. Method: A total of 60 listeners (35 native speakers of Korean and 25 native speakers of American English) estimated speech abnormality for 20 speech dimensions using a visual analog scale method for both language-matched and language-crossed speech stimuli. Speech stimuli were passage readings of the respective languages obtained from individuals with and without PD. Results: For speech dimension ratings, eight of 20 speech dimensions revealed significant differences in response to PD speech between the two listener groups, for most of which, language-crossed listeners' estimation was lower (i.e., more impaired) than language-matched listeners. For confidence-level ratings, language-matched listeners were less confident in the ratings of speakers with PD compared to the language-crossed listeners. Conclusions: The data support both language-universal and language-specific aspects in perceiving dysarthria characteristics, such that native language plays a role, especially when rating articulatory- and rhythmic-related characteristics. The findings are discussed with respect to the role of linguistic information, such as phonetic inventories and prosodic structures, in perceiving dysarthria characteristics. [ABSTRACT FROM AUTHOR]

Purpose: Hearing aid (HA) processing delay results in asynchronous overlap of the input sound and the delayed amplified sound at the eardrum in open-ear fittings. This may distort the temporal cues used for stop-consonant voicing distinctions. The current study evaluated the impact of HA processing delay on voiced--voiceless categorization of syllable initial consonants /d/ and /t/ for a range of voice onset times (VOTs). Method: Nineteen older listeners (Mage = 73 years) with mild--moderate sensorineural hearing loss participated. All listeners performed the voiced--voiceless categorization task in double-blind within-subjects design. Thirteen stimulus tokens along the /di:/ - /ti:/ continuum were created by varying VOTs. Stimuli were then processed using an HA simulator, which simulated the overall sound pressure levels measured at the eardrum in open-ear fittings with four processing delay times (0, 0.5, 5, and 8 ms). Individualized stimuli were generated for each listener based on their audiogram and presented via calibrated ear inserts at the most comfortable listening level. Performance across all VOT intervals was fitted with psychometric functions, which were then used to estimate the voiced--voiceless crossover point and the slope parameter for each simulated delay condition. Results: The crossover point along the voiced--voiceless continuum shifted systematically with increased processing delay toward voiced /di:/ over unvoiced /ti:/ percepts. The shift in the crossover point between the 0-ms reference condition and the 8-ms processing delay condition corresponded to 5.8 ms of change in VOT. The 8-ms processing delay condition resulted in significantly shallower categorization slopes compared to the 0- and 0.5-ms delay conditions. Conclusions: Temporal distortions created by HA processing delay in open-ear fittings impacted voicing perception of syllable initial stop-consonant stimuli near the voiced--voiceless crossover point. Short HA processing delay should be considered for open-ear fittings to preserve the natural VOT cues used for voicing detection. [ABSTRACT FROM AUTHOR]

Purpose: We investigated speech and nonspeech auditory processing of temporal and spectral cues in people who do and do not stutter. We also asked whether self-reported stuttering severity was predicted by performance on the auditory processing measures. Method: People who stutter (n = 23) and people who do not stutter (n = 28) completed a series of four auditory processing tasks online. These tasks consisted of speech and nonspeech stimuli differing in spectral or temporal cues. We then used independent-samples t-tests to assess differences in phonetic categorization slopes between groups and linear mixed-effects models to test differences in nonspeech auditory processing between stuttering and nonstuttering groups, and stuttering severity as a function of performance on all auditory processing tasks. Results: We found statistically significant differences between people who do and do not stutter in phonetic categorization of a continuum differing in a temporal cue and in discrimination of nonspeech stimuli differing in a spectral cue. A significant proportion of variance in self-reported stuttering severity was predicted by performance on the auditory processing measures. Conclusions: Taken together, these results suggest that people who stutter process both speech and nonspeech auditory information differently than people who do not stutter and may point to subtle differences in auditory processing that could contribute to stuttering. We also note that these patterns could be the consequence of listening to one's own speech, rather than the cause of production differences. [ABSTRACT FROM AUTHOR]

Purpose: There are well-established guidelines for the recording, transcription, and analysis of spontaneous oral language samples by researchers, educators, and speech pathologists. In contrast, there is presently no consensus regarding methods for the written documentation of sign language samples. The Handshape Analysis Recording Tool (HART) is an innovative method for documenting and analyzing word level samples of signed languages in real time. Fluent sign language users can document the expressive sign productions of children to gather data on sign use and accuracy. Method: The HART was developed to document children’s productions in Australian Sign Language (Auslan) in a bilingual–bicultural educational program for the Deaf in Australia. This written method was piloted with a group of fluent signing Deaf educational staff in 2014–2016, then used in 2022–2023 with a group of fluent signing professionals to examine inter- and intrarater reliability when coding parameters of sign accuracy. Results: Interrater reliability measured by Gwet’s Agreement Coefficient, was “good” to “very good” across the four phonological parameters that are components of every sign: location, movement, handshape, and orientation. Conclusions: The findings of this study indicate that the HART can be a reliable tool for coding the accuracy of location, orientation, movement, and handshape parameters of Auslan phonology when used by professionals fluent in Auslan. The HART can be utilized with any sign language to gather word level sign language samples in a written form and document the phonological accuracy of signed productions. [ABSTRACT FROM AUTHOR]

Purpose: According to the American Speech-Language-Hearing Association (ASHA), prevention, identification, assessment, and intervention of children who are learning to read and write are within the scope of practice for school-based speech-language pathologists (SLPs). Furthermore, for SLPs who work in the school setting, it is not uncommon to have struggling readers and poor spellers on their caseloads. Importantly, for students who have difficulty in spelling, their spelling errors are among the early indicators of dyslexia and can provide a means for identifying readers who may benefit from early intervention. SLPs can both assess spelling skills and implement evidence-based spelling and literacy diagnosis and instruction. Spelling instruction in kindergarten through the high school grades that is heavily grounded in metalinguistic activities can provide access to mental representations of word spellings, pronunciations, and meanings; links between whole-word and phonics approaches to reading instruction; and a foundation for reading fluency and comprehension. Conclusions: Learning to spell is essential for learning to read. Accordingly, this tutorial aims to elucidate how to (a) assess and identify phases of spelling development and (b) teach spelling to facilitate reading through a listening-first approach. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study was to investigate the relationship between speechreading ability, phonological skills, and word reading ability in typically developing children. Method: Sixty-six typically developing children (6–7 years old) completed tasks measuring word reading, speechreading (words, sentences, and short stories), alliteration awareness, rhyme awareness, nonword reading, and rapid automatized naming (RAN). Results: Speechreading ability was significantly correlated with rhyme and alliteration awareness, phonological error rate, nonword reading, and reading ability (medium effect sizes) and RAN (small effect size). Multiple regression analyses showed that speechreading was not a unique predictor of word reading ability beyond the contribution of phonological skills. A speechreading error analysis revealed that children tended to use a phonological strategy when speechreading, and in particular, this strategy was used by skilled speechreaders. Conclusions: The current study provides converging evidence that speechreading and phonological skills are positively related in typically developing children. These skills are likely to have a reciprocal relationship, and children may benefit from having their attention drawn to visual information available on the lips while learning letter sounds or learning to read, as this could augment and strengthen underlying phonological representations. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the clinical practice, self-efficacy, and beliefs about assessing and treating written language among speech-language pathologists (SLPs) working with school-aged clients (aged 5–21 years) in school and non-school settings in the United States. Method: A survey was completed by a nationwide sample of 344 SLPs working with school-aged clients in the United States. Statistical analyses were conducted to determine differences between (a) SLPs’ self-efficacy in assessing and treating spoken versus written language and (b) school-based and non–school-based SLPs’ clinical practice, self-efficacy, and beliefs about their roles with written language. Results: All respondents reported significantly lower rates of self-efficacy in assessing and treating written language compared to spoken language, and their self-efficacy had a significant, positive relationship with the amount of clinical time devoted to written language. School-based SLPs devoted a significantly lower percentage of clinical time to written language, had significantly lower self-efficacy in addressing written language, and had lower rates of agreement on statements about their roles and responsibilities with written language compared to non–school-based SLPs. These differences were not found with spoken language. The most prevalent written language needs on respondents’ workloads were reported as written expression (69.3%) and reading comprehension (66%). Conclusions: School-based and non–school-based SLPs report different levels of clinical time devoted to written language, self-efficacy in addressing written language, and beliefs about their roles in addressing written language. There is a need to investigate the reasons for these differences and the potential impact of preservice and in-service training in ameliorating them. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to test the efficacy of the Teaching Early Literacy and Language (TELL) curriculum package for improving the early literacy and oral language skills of preschoolers from low-income families. Method: In a randomized controlled trial (RCT), TELL was implemented in 30 TELL and 28 business-as-usual classrooms. TELL is a Tier 1 whole-class curriculum package that includes a scope and sequence of instruction, lesson plans and materials, high-quality books, curriculum-based measures (CBMs), and professional development training and coaching. Results: Implementation fidelity was high; however, due to COVID-19 school closures, we did not collect end-of-year data for our third cohort of teachers. Results indicated significant TELL effects on all code-related CBMs and two code-related distal measures as well as receptive and expressive vocabulary CBMs. No significant differences were found on distal measures of oral language/vocabulary or listening comprehension. Conclusions: Results of the present study, paired with findings from an earlier TELL RCT with children with developmental speech and/or language impairments, suggest that children enrolled in TELL classrooms achieve higher outcomes on a variety of code-related and vocabulary measures by the end of their final preschool year. [ABSTRACT FROM AUTHOR]

Purpose: This study used structural equation modeling to investigate the dimensionality of language in Spanish–English bilingual kindergartners. Five theoretical models were compared, including (a) a unidimensional model; (b) a two-dimensional model by language (Spanish, English); (c) a three-dimensional model by domain of language (phonology, semantics, morphosyntax); (d) a second-order model organized first by language (Spanish, English), with each language dimension comprising three domain-specific dimensions (phonology, semantics, morphosyntax); and (e) a six-dimensional model with freely covarying language-specific domains. Method: Participants included 238 Spanish–English bilingual kindergartens, as identified by parent report of current language exposure and direct language measures. All participants completed a battery of phonology, semantics, and morphosyntactic test items in English and in Spanish. Results: The six-dimensional covarying model constrained by domain and language provided the best fit for the data, with six separate factors for phonology, morphosyntax, and semantics in English and Spanish. The excellent model fit is supported by findings of a X² to df (degrees of freedom) ratio < 2 with no significance, comparative fit index > .95, standardized root-mean-square residual < .08, and root-mean-square error of approximation values ≤ .05. Conclusions: Results support emergent theories of bilingual language development. Application of the results to the evaluation and intervention of oral language abilities in bilingual children entering the formal education setting are considered. [ABSTRACT FROM AUTHOR]

Purpose: There is a dearth of literature in determining whether language groups for whom aspiration and/or voicing is phonologically contrastive show better perception relative to those who do not use these features contrastively and whether the cue type modulates perception in noise. This study addresses perception of laryngeal cues (voicing and aspiration) by Hindi, English, and Tamil listeners, in quiet and in noise. Method: Sixteen participants between 20 and 45 years of age were included in each of the three language groups. The stimuli were bilabial stops that contrasted phonetically in voicing and aspiration, voicing-lead [ba], short-lag [pa], and long-lag aspirated [pha], with one set corresponding to the Hindi phonemes /ba/, /pa/, and /ph a/ and the second set to the English phonemes /ba/ and /pa/ (which are phonetically [pa] and [pha], respectively). Tamil includes only the short-lag [pa] as a bilabial stop consonant. The stimuli were presented at 70 dB SPL, in quiet and in speech-shaped noise at a signal-to-noise ratio of 0. Participants performed two speech identification tasks and a speech discrimination task. Results: Patterns of perceptual assimilation related to the first language were observed in all three language groups, and accuracy was generally higher in quiet than in noise. Hindi participants identified the English /pa/ as Hindi /ph a/ and English /ba/ as Hindi /pa/. The American English participants identified Hindi /ph a/ as English /pa/ and both the Hindi /pa/ and Hindi /ba/ as English /ba/. In contrast, Tamil listeners generally perceived both Hindi and English bilabial stops as one category, regardless of voicing and aspiration. English and Hindi participants generally showed higher accuracy for native language stimuli. Patterns of assimilation in quiet and noise differed across language groups for each stimulus type. The aspirated stimuli were most likely to be misperceived in noise by all groups (often as /ha/). Conclusions: The results serve as evidence that listeners accurately access native language speech cues, even in noise. The results contribute toward a better understanding of cross-linguistic speech processing in noise. [ABSTRACT FROM AUTHOR]

Purpose: We examined the neurocognitive bases of lexical morphology in children of varied reading abilities to understand the role of meaning-based skills in learning to read with dyslexia. Method: Children completed auditory morphological and phonological awareness tasks during functional near-infrared spectroscopy neuroimaging. We first examined the relation between lexical morphology and phonological processes in typically developing readers (Study 1, N = 66, Mage = 8.39), followed by a more focal inquiry into lexical morphology processes in dyslexia (Study 2, N = 50, Mage = 8.62). Results: Typical readers exhibited stronger engagement of language neurocircuitry during the morphology task relative to the phonology task, suggesting that morphological analyses involve synthesizing multiple components of sublexical processing. This effect was stronger for more analytically complex derivational affixes (like + ly) than more semantically transparent free base morphemes (snow + man). In contrast, children with dyslexia exhibited stronger activation during the free base condition relative to derivational affix condition. Taken together, the findings suggest that although children with dyslexia may struggle with derivational morphology, they may also use free base morphemes’ semantic information to boost word recognition. Conclusion: This study informs literacy theories by identifying an interaction between reading ability, word structure, and how the developing brain learns to recognize words in speech and print. [ABSTRACT FROM AUTHOR]

Purpose: This study aims at investigating the phonological development of the six guttural consonants of Jordanian Arabic, /χ/, /ʁ/, /ħ/, /ʕ/, /ʔ/, and /h/. Method: An articulation test is designed to involve two tasks: picture naming and repetition. The test includes 54 words for picture naming and 18 words for repetition, representing all possible positions of the targeted guttural sounds. Samples are collected from 40 typically developing Ammani-Jordanian Arabic– speaking monolingual children, living in Amman, Jordan. Respondents are equally divided into eight age-related trajectories: 2–2;6, 2;6–3, 3–3;6, 3;6–4, 4– 4;6, 4;6–5, 5–5;6, and 5;6–6 (years;months). No child with a history of hearing, speech, or vision disorders is included. The data are analyzed using production accuracy, where the three developmental trajectories of production (customary, acquisition, and mastery) are determined for each guttural, and error analysis, addressed based on perceptual judgments, providing details of every mispronounced or deleted guttural. Results: The results show that /χ/, /ħ/, /ʕ/, and /ʔ/ are acquired before the age of 6 years, while /ʁ/ and /h/ are still not acquired by this age. Respondents use relatively variant alternatives for the mispronounced cognates, including guttural, nonguttural sounds, and vowel substitution. The /ʁ/ is the guttural with the highest number of alternatives, while /ʔ/ gets the least. The analysis also reveals patterns of guttural deletion, with variations across different guttural sounds and positions. Despite errors/deviations made, respondents score accuracy percentages that gradually increase in correlation with age. The guttural /ʁ/ starts with the lowest accuracy percentages, while /ʔ/ and /ħ/ start with the highest. Conclusions: These findings illuminate on the developmental trajectory of guttural acquisition and enrich our understanding of children’s evolving perception and production abilities. They offer valuable insights into the patterns of guttural sound production in Jordanian Arabic–speaking children, laying the groundwork for further research and the development of targeted assessment and intervention strategies to support phonological development in this population. [ABSTRACT FROM AUTHOR]

Purpose: Researchers often use identification or goodness rating tasks to assess speech perception for different populations. These tasks provide useful information about a listener’s willingness to accept a range of acoustically variable stimuli as belonging to the same category and also about assessing how stimuli that are labeled the same may not be perceived as equally good versions of a particular speech sound. Many methodological aspects of these simple tasks have been tested, but one aspect that has not is the choice of label. In this study, we examine response patterns to images versus letters, as studies with different populations (children vs. adults) or different methods (typical behavioral study vs. visual world paradigm) may vary in the type of label used. Method: Eighty-one adult listeners completed phoneme identification and goodness ratings tasks with either images of response options (a picture of a bear and a picture of a pear) or with letter labels (a capital B and P). Results: The results suggest that choice of label does not alter performance within the tasks studied here. In addition, the results did show the expected finding that the slope of the response curve is steeper in an identification task than in a goodness rating task. Conclusion: These results suggest that it is possible to compare across studies that use different response options, a benefit to research and practice because letter labels can be used for non-imageable words and nonwords, whereas images may be best used for participants who are younger or have poorer reading skills. [ABSTRACT FROM AUTHOR]

Purpose: Repetitive transcranial magnetic stimulation (rTMS) can enhance aphasia recovery. Most studies have used inhibitory stimulation targeting the right inferior frontal gyrus. However, the motor cortex, observed to contribute to the prediction of aphasia recovery, is involved in word production and could be an appropriate target for rTMS. We aimed to observe behavioral changes in a picture naming task induced by inhibitory rTMS targeting the right motor cortex of the lips in people with poststroke aphasia. Method: Using a single-case experimental design, we included three participants with chronic poststroke aphasia who had phonological deficits. Each participant performed a verbal picture naming task 3 times a week for 2, 3, or 4 weeks (pseudorandom across participants) to establish a baseline naming ability for each participant. These were not therapy sessions, and no feedback was provided. Then, each participant received the intervention, inhibitory continuous theta burst stimulation targeting the right motor cortex of the lips, 3 times a week for 2 weeks. Naming testing continued 3 times a week, for these latter 2 weeks. No therapy was performed at any time during the study. Results: Visual analysis of the graphs showed a positive effect of rTMS for P2 and P3 on picture naming accuracy and a tendency toward improvement for P1. Statistical analysis showed an improvement after rTMS for P1 (τ = 0.544, p = .013, SETau = 0.288) and P2 (τ = 0.708, p = .001, SETau = 0.235). For P3, even if the intervention allowed some improvement, this was statistically nonsignificant due to a learning effect during the baseline naming testing, which lasted the longest, 4 weeks. Regarding specific language features, phonological errors significantly decreased in all patients. Conclusions: The motor cortex of the lips could be an appropriate target for rTMS to improve naming in people with poststroke aphasia suffering from a phonological deficit. This suggests the possibility to individualize the target for rTMS, according to the patient's linguistic impairment. [ABSTRACT FROM AUTHOR]

Purpose: The Chinese Emotional Speech Audiometry Project (CESAP) aims to establish a new material set for Chinese speech audiometry tests, which can be used in both neutral and emotional prosody settings. As the first endeavor of CESAP, this study demonstrates the development of the material foundation and reports its validation in neutral prosody. Method: In the development step, 40 phonetically balanced word lists consisting of 30 Chinese disyllabic words with neutral valence were first generated. In a following affective rating experiment, 35 word lists were qualified for validation based on the familiarity and valence ratings from 30 normal-hearing (NH) participants. For validation, performance-intensity functions of each word list were fitted with responses from 60 NH subjects under six presentation levels (−1, 3, 5, 7, 11, and 20 dB HL). The final material set was determined by the intelligibility scores at each decibel level and the mean slopes. Results: First, 35 lists satisfied the criteria of phonetic balance, limited repetitions, high familiarity, and neutral valence and were selected for validation. Second, 15 lists were compiled in the final material set based on the pairwise differences in intelligibility scores and the fitted 20%–80% slopes. The established material set had high reliability and validity and was sensitive to detect intelligibility changes (50% slope: 6.20%/dB; 20%–80% slope: 5.45%/dB), with small covariance of variation for thresholds (15%), 50% slope (12%), and 20%–80% slope (12%). Conclusion: Our final material set of 15 word lists takes the initiative to control the emotional aspect of audiometry tests, which enriches available Mandarin speech recognition materials and warrants future assessments in emotional prosody among populations with hearing impairments. [ABSTRACT FROM AUTHOR]

Purpose: Nonword repetition (NWR) has been described as a clinical marker of developmental language disorder (DLD), as NWR tasks consistently discriminate between DLD and typical development (TD) cross-linguistically, with Cantonese as the only reported exception. This study reexamines whether NWR is able to generate TD/DLD group differences in Cantonese-speaking children by reporting on a novel set of NWR stimuli that take into account factors known to affect NWR performance and group differentiation, including lexicality, sublexicality, length, and syllable complexity. Method: Sixteen Cantonese-speaking children with DLD and 16 age-matched children with TD repeated two sets of high-lexicality nonwords, where all constituent syllables are morphemic in Cantonese but meaningless when combined, and one set of low-lexicality nonwords, where all constituent syllables are nonmorphemic. Low-lexicality nonwords were further classified on sublexicality in terms of consonant–vowel (CV) combination attestedness (whether or not CV combinations in nonword syllables occur in real Cantonese words). Results: Children with DLD scored significantly below their peers with TD. Effect sizes showed that high-lexicality nonwords and nonword syllables with attested CV combinations offered the greatest TD/DLD group differentiation. Nonword length and syllable complexity did not affect TD/DLD group differentiation. Conclusions: NWR can capture TD/DLD group differences in Cantonese speaking children. Lexicality and sublexicality effects must be considered in designing NWR stimuli for TD/DLD group differentiation. Future studies should replicate the present study on a larger sample size and a younger population as well as examine the diagnostic accuracy of this NWR test. [ABSTRACT FROM AUTHOR]

Purpose: Pitch variations (tone productions) have been reported as a measure to differentiate Cantonese-speaking children with and without childhood apraxia of speech (CAS). This study aims to examine fundamental frequency (F0) changes within syllables and the effects of syllable structure, lexical status, and syllable positions on F0 in Cantonese-speaking preschool children with and without CAS. Method: Six children with CAS, six children with non-CAS speech sound disorder plus language disorder (S&LD), 22 children with speech sound disorder only (SSD), and 63 children with typical speech-language development (TD) performed the tone sequencing task (TST). Growth curve analysis was employed to analyze and compare the F0 values within syllables with three Cantonese tones (high level, high rising, and low falling). The analysis considered the effects of syllable structure (vowel and consonant–vowel), lexical status (word and nonword), and syllable position (initial, medial, and final) on F0, as well as comparisons within and between groups. Results: Within each group, the effects of syllable structure and position on F0 values were found with different patterns. Between-group comparisons showed that the CAS group had reduced F0 contrasts. The CAS group could be differentiated from the control groups based on interactions of F0 with syllable structure and position, but not lexical status. The dissimilarity of F0 values detected between the CAS and SSD/TD groups was more prominent than that observed between the CAS and S&LD groups. Conclusions: This study demonstrated that Cantonese-speaking children with CAS had difficulty in varying F0 within syllables as compared to those without CAS, suggesting pitch variation difficulty and language-specific impairment profiles in CAS. Future investigations of objective measures for identifying Cantonese speakers with CAS and cross-linguistic investigations using growth curve analysis and the TST are suggested. [ABSTRACT FROM AUTHOR]

Purpose: Gurevich and Kim (2023a) developed speech stimuli with full phonetic coverage and phonemic balance to comprehensively examine production and perception of consonants. They identify a hierarchy of positional variants with functional importance to intelligibility (FITI). The FITI stimuli are well suited for assessing intelligibility. Multiple studies report that clinicians prefer nonstandard materials (e.g., reading passages, word lists) over formal tools (e.g., Frenchay Dysarthria Assessment--Second Edition [FDA-2]; Enderby & Palmer, 2008), citing time constraints among reasons. Having analyzed the phonetic coverage of the three standard passages (Gurevich & Kim, 2022), the purpose herein is to provide a similar analysis for the FDA-2 and to construct an alternative list of stimuli that achieves strategic coverage of priority intelligibility targets and is adaptable to time constraints. Method: The FDA-2 word list was analyzed in terms of its coverage of the 466 allowable contexts for the 24 English consonants and its coverage of priority FITI targets. A subset of the stimuli from Gurevich and Kim (2023a) was used to construct phrases organized in modules from highest to lowest FITI priority. Results: The full FDA-2 word list covers 35.41% of the allowable 466 contexts, compared to 83.05% by the 308 FITI word list from Gurevich and Kim (2023a). It also underperforms in covering priority FITI targets but does capture some of the hierarchy if all 115 words are used. Fifteen modules were constructed from the 308 FITI words with one to five phrases per module, presented in order of highest to lowest FITI priority. Conclusions: The newly constructed list of phrases has comprehensive phonetic coverage, follows the FITI hierarchy, and is built in autonomous modules. Using the modular FITI phrases to investigate speech is adaptable to time constraints in a manner that prioritizes intelligibility targets. [ABSTRACT FROM AUTHOR]

Purpose: Emerging bilingual children represent a diverse population with regard to their language learning histories and individual factors. When assessing a bilingual child, it is important to accurately differentiate typical second-language learning characteristics from differences that indicate a disorder. The Iranian scholarly and clinical communities have established essential linguistic norms and identified linguistic and nonlinguistic indicators of speech and language disorder in Farsi-speaking children. The community has also developed assessment tools that are useful when evaluating the language skills of bilingual Farsi- English--speaking children. Method: We present some relevant characteristics of the Farsi-speaking community and summarize the literature related to linguistic norms and the characteristics of the Farsi language, particularly related to the phonological and morphosyntactic structure of Farsi. To illustrate the diversity in bilingual children's profiles and the need for individualized assessment, we present two case studies of sequential emerging Farsi--English bilingual children. Results: We present the children's assessment results and report clinical indicators of a language disorder. The case examples are used to highlight several recommendations for conducting individualized and culturally sensitive assessments. Conclusions: This tutorial highlights the need for a comprehensive and individualized assessment of a bilingual child. Specific assessment tools and procedures are outlined to support clinicians in completing accurate and sensitive evaluations of Farsi--English bilingual children. [ABSTRACT FROM AUTHOR]

Purpose: Diversity considerations are of paramount significance in the clinical assessment and treatment of speech disorders in bilingual children and adults who speak a less common language (and/or its dialects). While comprehensive assessment is essential for culturally and linguistically diverse (CLD) populations, this is clinically challenging due to the indeterminacy entailed in the process and incumbrances in access to resources. This clinical tutorial outlines key considerations necessary for holistic, ecological, and dynamic assessments of speech disorders internationally, focusing on Greek. Method: Pertinent literature is reviewed to provide the relevant theoretical backdrop for the ecosystemic protocol, both conceptually and schematically. Greek is utilized as an example language, aiming to underscore knowledge, tools, and other resources on clinically relevant aspects of dialectal, interlanguage (adult second language [L2]), and child multilingual (L2/third language) variation in Greek-dominant speakers. Results: The tutorial highlights facets of Greek speech and scripts a primary assessment model for clinical use mostly targeting clinicians that are not speakers or cognizant of the language, also viewing speech in linguistic diversity as a sociolinguistic construct. Recommendations for clinical practices are outlined proposing a specific action plan, exemplified by a case scenario. Conclusions: The demonstrated ecosystemic paradigm in holistic, ecological protocols for clinical assessment of speech disorder in CLD speakers addresses the need for nonlinear, multilevel assessment of variable language exposure and use; being sensitive to individual speaker specificities; the sociolinguistic environment; and employing people-first, culturally sensitive, and dynamic strategies in clinical assessment. The stance also simplifies disambiguation tasks regarding the difference disorder dichotomy, enhancing existing clinical procedures. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this tutorial is to introduce speech-language pathologists to the salient characteristic of the creole language of Hawai'i. This language variety is called Hawai'i Creole by linguists, but speakers of the language variety generally call it Pidgin. Conclusions: This tutorial reviews the available literature on this understudied language variety to provide a brief overview of Pidgin's historical development and social context and its clinically salient linguistic features. Suggestions for culturally and linguistically responsive assessment of Pidgin-speaking children as well as suggestions for further reading on Pidgin are also provided. [ABSTRACT FROM AUTHOR]

Purpose: Shared reading provides preschool-age children with the opportunity to learn novel, low-frequency words. Abundant empirical evidence demonstrates that children can learn the meanings of such words during shared reading, referred to as “semantic learning.” However, less is known about whether children learn the spellings of words during shared reading, referred to as “orthographic learning,” and whether this learning is related to early word reading. The present study tested relations between individual differences in 4- to 6-year-old children’s semantic and, critically, orthographic learning during shared reading and their early word reading skill. Method: In an adaptation of the self-teaching paradigm, children listened to a storybook about novel inventions referred to with nonword names. Children then completed orthographic and semantic choice tests, as well as standardized measures of early word reading and phonological awareness. Results: Individual differences in orthographic, but not semantic, learning during shared reading were related to early word reading, after controls for age and phonological awareness. Conclusions: This study provides a novel test of learning during shared reading, helping to specify the relation between orthographic and semantic learning and early word reading skill. These findings hold implications for theoretical perspectives on relations between learning during shared reading and early word reading, as well as implications for educational practice [ABSTRACT FROM AUTHOR]

Objective: This study aimed to develop a Digital Speech Assessment Instrument to evaluate the phonological and motor speech skills of Brazilian Portuguese–speaking children and adolescents through six tasks: (a) word naming, (b) word imitation, (c) pseudoword imitation, (d) word repetition, (e) pseudoword repetition, and (f) diadochokinesis. Method: The assessment instrument was developed and validated in a seven-step process, beginning with stimulus selection and ending with Pilot Study 1 (involving children and adolescents with typical speech development) and Pilot Study 2 (involving children and adolescents with speech sound disorders [SSDs]). Participants of the study included expert and nonexpert judges, children, and adolescents. Results: The Digital Speech Assessment Instrument contains 91 real words (61 in the naming task, 51 in the imitation task, and five in the repetition task), 26 pseudowords (26 in the imitation task and four in the repetition task), and six stimuli for diadochokinesis. The test contains stimuli in the form of images as well as audio and video recordings and allows for the analysis and storage of participant data in a virtual database. Conclusions: This study described the development of the Digital Speech Assessment Instrument, available in Brazilian Portuguese for the evaluation of several aspects of speech production (including word and pseudoword naming, imitation, and repetition and diadochokinesis). The test was developed for children aged 2;0 (years;months) to 17;11 and is administered fully online. In the future, the instrument can be used to provide a timely and accurate diagnosis of SSDs. [ABSTRACT FROM AUTHOR]

Objectives: We provide a novel application of psycholinguistic theories and methods to the field of auditory training to provide preliminary data regarding which minimal pair contrasts are more difficult for listeners with typical hearing to distinguish in real-time. Design: Using eye-tracking, participants heard a word and selected the corresponding image from a display of four: the target word, two unrelated words, and a word from one of four contrast categories (i.e., voiced-initial [e.g., peachbeach], voiced-final [e.g., back-bag], manner-initial [e.g., talk-sock], and mannerfinal [e.g., bat-bass]). Results: Fixations were monitored to measure how strongly words compete for recognition depending on the contrast type (voicing, manner) and location (word-initial or final). Manner contrasts competed more for recognition than did voicing contrasts, and contrasts that occurred in word-final position were harder to distinguish than word-initial position. Conclusion: These results are an important initial step toward creating an evidence-based hierarchy for auditory training for individuals who use cochlear implants. [ABSTRACT FROM AUTHOR]

Purpose: The present study investigates the perception of vowel nasality in French-speaking children with cochlear implants (CIs; CI group) and children with typical hearing (TH; TH group) aged 4–12 years. By investigating the vocalic nasality feature in French, the study aims to document more broadly the effects of the acoustic limitations of CI in processing segments characterized by acoustic cues that require optimal spectral resolution. The impact of various factors related to children’s characteristics, such as chronological/auditory age, age of implantation, and exposure to cued speech, has been studied on performance, and the acoustic characteristics of the stimuli in perceptual tasks have also been investigated. Method: Identification and discrimination tasks involving French nasal and oral vowels were administered to two groups of children: 13 children with CIs (CI group) and 25 children with TH (TH group) divided into three age groups (4– 6 years, 7–9 years, and 10–12 years). French nasal vowels were paired with their oral phonological counterpart (phonological pairing) as well as to the closest oral vowel in terms of phonetic proximity (phonetic pairing). Post hoc acoustic analyses of the stimuli were linked to the performance in perception. Results: The results indicate an effect of the auditory status on the performance in the two tasks, with the CI group performing at a lower level than the TH group. However, the scores of the children in the CI group are well above chance level, exceeding 80%. The most common errors in identification were substitutions between nasal vowels and phonetically close oral vowels as well as confusions between the phoneme /u/ and other oral vowels. Phonetic pairs showed lower discrimination performance in the CI group with great variability in the results. Age effects were observed only in TH children for nasal vowel identification, whereas in children with CIs, a positive impact of cued speech practice and early implantation was found. Differential links between performance and acoustic characteristics were found within our groups, suggesting that in children with CIs, selective use of certain acoustic features, presumed to be better transmitted by the implant, leads to better perceptual performance. Conclusions: The study’s results reveal specific challenges in children with CIs when processing segments characterized by fine spectral resolution cues. However, the CI children in our study appear to effectively compensate for these difficulties by utilizing various acoustic cues assumed to be well transmitted by the implant, such as cues related to the temporal resolution of stimuli. [ABSTRACT FROM AUTHOR]

Purpose: This study examined speech changes induced by deep-brain stimulation (DBS) in speakers with Parkinson’s disease (PD) using a set of auditoryperceptual and acoustic measures. Method: Speech recordings from nine speakers with PD and DBS were compared between DBS-On and DBS-Off conditions using auditory-perceptual and acoustic analyses. Auditory-perceptual ratings included voice quality, articulation precision, prosody, speech intelligibility, and listening effort obtained from 44 listeners. Acoustic measures were made for voicing proportion, second formant frequency slope, vowel dispersion, articulation rate, and range of fundamental frequency and intensity. Results: No significant changes were found between DBS-On and DBS-Off for the five perceptual ratings. Four of six acoustic measures revealed significant differences between the two conditions. While articulation rate and acoustic vowel dispersion increased, voicing proportion and intensity range decreased from the DBS-Off to DBS-On condition. However, a visual examination of the data indicated that the statistical significance was mostly driven by a small number of participants, while the majority did not show a consistent pattern of such changes. Conclusions: Our data, in general, indicate no-to-minimal changes in speech production ensued from DBS stimulation. The findings are discussed with a focus on large interspeaker variability in PD in terms of their speech characteristics and the potential effects of DBS on speech. [ABSTRACT FROM AUTHOR]

Purpose: This study builds upon an established effective training method to investigate the advantages of high variability phonetic identification training for enhancing lexical tone perception and production in Mandarin-speaking pediatric cochlear implant (CI) recipients, who typically face ongoing challenges in these areas. Method: Thirty-two Mandarin-speaking children with CIs were quasirandomly assigned into the training group (TG) and the control group (CG). The 16 TG participants received five sessions of high variability phonetic training (HVPT) within a period of 3 weeks. The CG participants did not receive the training. Perception and production of Mandarin tones were administered before (pretest) and immediately after (posttest) the completion of HVPT via lexical tone recognition task and picture naming task. Both groups participated in the identical pretest and posttest with the same time frame between the two test sessions. Results: TG showed significant improvement from pretest to posttest in identifying Mandarin tones for both trained and untrained speech stimuli. Moreover, perceptual learning of HVPT significantly facilitated trainees’ production of T1 and T2 as rated by a cohort of 10 Mandarin-speaking adults with normal hearing, which was corroborated by acoustic analyses revealing improved fundamental frequency (F0) median for T1 and T2 production and enlarged F0 movement for T2 production. In contrast, TG children’s production of T3 and T4 showed nonsignificant changes across two test sessions. Meanwhile, CG did not exhibit significant changes in either perception or production. Conclusions: The results suggest a limited and inconsistent transfer of perceptual learning to lexical tone production in children with CIs, which challenges the notion of a robust transfer and highlights the complexity of the interaction between perceptual training and production outcomes. Further research on individual differences with a longitudinal design is needed to optimize the training protocol or tailor interventions to better meet the diverse needs of learners. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this tutorial is to clarify the use of speech sounds as stimuli for auditory evoked potentials and how these might contribute to our understanding of speech, language, learning, and hearing disorders. Speechevoked auditory brainstem responses (ABRs), auditory steady-state responses, auditory middle latency responses, mismatch negativity, P300, cortical onset responses, and the acoustic change complex are reviewed. Method: The author drew upon her scholarship in this area from over 4 decades of research and teaching to summarize the major findings when using speech stimuli to evoke auditory potentials that have been used in clinical contexts. Results: Speech-evoked auditory potentials contribute to our understanding of how the brain processes the acoustic features of speech sounds, providing information that is complementary to psychophysical tests. When psychophysical tests cannot be performed owing to neurodevelopmental immaturity or disability, or cognitive disability, speech-evoked auditory potentials may be used to estimate the benefit of amplification or implantation for speech, language, and hearing. Conclusions: The benefit of using auditory evoked potentials for evaluation is that they provide insight into the brain mechanisms underlying hearing and listening disorders that audiologists aim to treat. While we can use the known correlations between perceptual and electrophysiological responses for "crosschecking" our evaluation results, examining when discrepancies occur is also especially meaningful. For example, the complex ABR reveals subcortical issues in temporal processing that would not be evident in ABRs to clicks or tone bursts, nor in behavioral testing. P300 can document slower neural processing of speech stimuli that may be relevant to the rehabilitation of older adults, even when word recognition scores appear to be congruent with the pure-tone audiogram. In these ways, auditory evoked potentials for speech provide audiologists with tools for demonstrating to clients how their brain responds to speech and opening the conversation for rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: Word-final disfluency (WFD), also referred to as end-word repetition and echo dysphemia, takes the form of a final rhyme repetition involving a whole or partial syllable (e.g., "lock-ock" and "ca-ake"). Although WFD has been documented in case studies, therapeutic programs have not yet been reported. Our purpose was to report therapy data for 20 cases of WFD using a single therapy protocol called Structured Awareness Therapy for Word-Final Disfluency. The authors report the effects of therapy in routine clinical practice and describe the therapy program to contribute practice-based evidence that may narrow the research--practice gap and improve service delivery for those with WFD. Method: The participants included 20 children (13 boys and seven girls; age range: 5-11 years). Parents reported a diagnosis of autism in five of the 20 participants. The children and their families participated in weekly and biweekly therapy sessions. Pre- and posttherapy spontaneous speech samples were analyzed and compared. Parents' responses to follow-up surveys were reported. Results: All 20 children had successfully reduced (to less than 1.5% WFD) or eliminated WFD in their spontaneous speech with short-term therapy (average, 9 weeks). Parental follow-up surveys confirmed the long-term durability of the therapy. Conclusions: Therapy data support the functional and long-term outcomes of the reduction or elimination of WFD in routine clinical practice. The authors described the therapy program and offered perspectives on the causes or functions of WFD. Suggestions for future directions include research needs and a call for treatment efficacy studies to broaden trusted therapy options for WFD. [ABSTRACT FROM AUTHOR]