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Purpose The Strength and Difficulties Questionnaire (SDQ) is widely used internationally, however less so in preschool populations and validations studies are thus needed. This study examined the psychometric properties of the Norwegian version parent report of the SDQ – preschool version (SDQ 2–4). Materials and methods Parents of 289 Norwegian children in the age span 1–6 years old filled out the SDQ 2–4, the Child Behavior Checklist (CBCL), and background information. Internal consistency, factor structure, and convergent validity were assessed. Results The results showed satisfying internal consistency for the total difficulties score, but worse for some of the subscales. The five-factor structure showed a good fit. Good convergent and divergent validity was found in terms of correlations with CBCL. Sex differences were found on all scales, boys scoring higher on all problem scales. Conclusions The SDQ 2–4 can be a promising instrument to screen for emotional and behavioral difficulties among Norwegian preschoolers, particularly in high-risk populations.

Background Congenital cytomegalovirus (cCMV) is the most common prenatal infection and the main infectious cause of neurodevelopmental abnormalities in developed countries. Long-term neuropsychological outcome of cCMV infection is still not well understood. This is the first study that presents linguistic follow-up data performed on adults who were infected in utero. Method All individuals from a universal newborn CMV screening study in Sweden sampled from 1977 to 1985 were invited to participate in a follow-up study. 34/71 persons (48%) with cCMV and 22/46 controls (48%) were enrolled. Participants were between 34 and 43 years. Linguistic ability was evaluated with two-word fluency tasks (FAS letter fluency and verb fluency), and a qualitative analysis of the participants’ word retrieval strategies was conducted. Results No statistically significant group differences were found in the total number of retrieved words. When related to Swedish norm data, 43% of participants with cCMV infection, all asymptomatic at birth, had adequate results on both FAS and verb fluency tasks, compared to 86% of the controls. Education level was the most important factor for word fluency ability in both groups. Adults with cCMV infection and higher education levels used less effective retrieval strategies on FAS letter fluency than controls. Conclusion This study suggests that adults with cCMV infection may have deficits in the word retrieval process, even in the absence of known neurodevelopmental disorders. Long-term effects of cCMV infection may exist even in those with asymptomatic infection at birth.

Purpose: The purpose of this pilot study was to explore the home language environment and language outcome of Brazilian toddlers who were hard of hearing, (HH) and controls with typical hearing (TH), and investigate the reliability of using the LENA recording system within a Brazilian Portuguese context. Metkods: Fourteen families participated in the study (seven children who were HH and seven controls with TH. Each family contributed with one all-day recording. A smaller portion of the recordings of the typically hearing toddlers were manually transcribed by two transcribers. An interrater agreement was conducted, and then the human transcript results were compared against the LENA-generated data for three measures: Adult Words (AW), Child Vocalizations (CV) and Conversational Turns (CT). Results: Data analyses revealed a moderate to strong interrater agreement for CV and AW. Weak to moderate agreement was found between the LENA estimates and the means of the human counts for CV and AW. Seemingly, LENA overestimated human counts for AW and underestimated numbers of CV. Comparative analysis suggested similarities in the language and listening environment of the two groups (TH vs. HoH). Children's language development was supported by higher numbers of parent-child interactions (CT). Conclusion: The findings imply that LENA may contribute as an ecologically valid tool in preventive family-centered intervention programs for Brazilian toddlers who are hard of hearing and their families, although further validation studies are needed.

Background The Parents’ Evaluation of Aural/Oral Performance of Children (PEACH+) is a parent reported questionnaire. It was first developed in Australia (2007) to assess the effectiveness of hearing devices in young children, and to register how oral children under the age of five hear and communicate with others. Objective No validated version of the Norwegian translation of PEACH+ exists. This study therefore aims to evaluate the validity and reliability of a back-translated Norwegian version of the PEACH+, from a sample of Norwegian children with typical hearing. Methods Parents of 255 children with typical hearing between 12 and 72 months were recruited through kindergartens and social media platforms. Participants were asked to fill in the PEACH+ questionnaire on behalf of their child, in a digital format. Results High internal consistency (Cronbach’s Alpha = .917) and satisfactory item-total correlation were found (.342-.678). Conclusion The Norwegian translation of PEACH+ shows good psychometric properties that are similar to the original version (Ching and Hill, 2007) and that of other translations. The PEACH+ questionnaire is therefore valid to use in a Norwegian context.

Purpose:The aim of this study was to explore the path to Listening and Spoken Language Specialist (LSLS) certification from the professional's viewpoint as well as to address motivation, self-perceived gains, challenges, and barriers to certification in an international cohort with the purpose of guiding future change within the existing certification system. Method:Members of the AG Bell Academy for Listening and Spoken Language (AG Bell Academy) Global Matters Committee created an online survey disseminated by the AG Bell Academy in English and Spanish for professionals who were certified LSLSs, mentees currently pursuing the certification, and professionals interested in the certification. Participants (N = 295) were from different parts of the world. Of the respondents, 48% reported English as their first language, 19% reported Spanish as their first language, and the remaining 33% reported one of 26 other languages as their first language. Approximately 40% of the total respondents were certified LSLSs (n = 117), and 50% of them lived in the United States. Results:The findings indicate that certified LSLSs perceived significant growth in knowledge and skills as a result of the certification process. Personal motivation drove individuals to pursue certification. A common barrier among all participants was limited resources, such as time, funds, and access to a mentor who speaks the same language. Conclusions:There is a need for more awareness of the significant gains LSLS certification can bring to professionals. There is further need to address, minimize, and overcome perceived barriers in the process. Future similar research is warranted to explore the gains and barriers of obtaining the LSLS certification outside the English-speaking countries and in a larger, more population-based sample.

Purpose: Kenett et al. (2013) report that the sematic networks, measured by using an oral semantic fluency task, of children with cochlear implants (CI) are less structured compared to the sematic networks of children with typical hearing (TH). This study aims to evaluate if such differences are only evident if children with CI are compared to children with TH matched on chronological age, or also if they are compared to children with TH matched on hearing age. Method: The performance of a group of children with CI on a verbal fluency task was compared to the performance of a group of chronological-age matched children with TH. Subsequently, computational network analysis was used to compare the semantic network structure of the groups. The same procedure was applied to compare a group of children with CI to a group of hearing-age matched children with TH. Results: The children with CI perform on the same level on an oral semantic verbal fluency task as the children with TH matched on hearing age. There are significant differences in terms of the structure of the semantic network between the groups. The magnitude of these differences is very small and they are non-significant for a proportion of nodes included in the bootstrap analysis. This indicates that there is no true difference between the networks. Hearing age, but not age at implantation was found to be significantly positively correlated with semantic verbal fluency performance for the children with CI. Conclusions: The results from the current study indicate that length of exposure to the tested language is an important factor for the structure of the semantic network and the performance on a semantic verbal fluency task for children with CI. Further studies are needed to explore the role of the accessibility of the language input for the development of semantic networks of children with CI.

Purpose: Shared parenting among caregivers of different gender is common in the Swedish society. It is unclear if this includes shared contribution for children's language development. The objective of this cross-sectional study was to explore the natural language environment of children who were hard-of-hearing compared to typically hearing controls. Methods: Seventy-two families with children aged 7-35 months participated; 22 children who were hard-of-hearing (Cochlear implants, n=11; Hearing aids, n=11) and 50 controls with typical hearing. The majority of caregivers had higher education background level, especially in the control group. Families conducted a daylong recording with the Language Environment Analysis technology, when both parents were present at home. An Interpreted Time Segmental analysis was performed to extract information about female versus male caregivers quantitative word use. Results: The results showed significant gender differences related to number of adult words, with less male words than female words (p <0.001). Male caregivers of children who were hard-of-hearing contributed with around 27 % of adult words during the recordings while males in the control group contributed with 37 %. There was a larger variation in number of female words in the study group than for controls, especially in mothers of children with cochlear implants. Conclusions: Female caregivers talk significantly more close to young children than male caregivers, and especially in the subgroup of children with cochlear implants. Children who are hard-of-hearing are dependent on a rich language environment, and might be especially vulnerable if male caregivers are less involved as language facilitators. More studies are needed to explore caregiver gender differences, both related to quantitative and qualitative language stimulation.

Background: Decision-making on treatment and (re)habilitation needs to be based on clinical expertise and scientific evidence. Research evidence for the impact of permanent unilateral hearing impairment (UHI) on children's development has been mixed and, in some of the reports, based on fairly small, heterogeneous samples. Additionally, treatment provided has been highly variable, ranging from no action taken or watchful waiting up to single-sided cochlear implantation. Published information about the effects of treatment has also been heterogeneous. Moreover, earlier reviews and meta-analyses published on the impact of UHI on children's development have generally focused on select areas of development. Objectives: This systematic review aimed to summarize the impact of children's congenital or early onset unilateral hearing impairment on listening and auditory skills, communication, speech and language development, cognitive development, educational achievements, psycho-social development, and quality of life. Methods: Literature searches were performed to identify reports published from inception to February 16th, 2018 with the main electronic bibliographic databases in medicine, psychology, education, and speech and hearing sciences as the data sources. PubMed, CINALH, ERIC, LLBA, PsychINFO, and ISI Web of Science were searched for unilateral hearing impairment with its synonyms and consequences of congenital or early onset unilateral hearing impairment. Eligible were articles written in English, German, or Swedish on permanent unilateral hearing impairments that are congenital or with onset before three years of age. Hearing impairment had to be of at least a moderate degree with PTA >= 40 dB averaged over frequencies 0.5 to 2 or 0.5-4 kHz, hearing in the contralateral ear had to have PTA(0.5-2 kHz) or PTA(0.5-4 kHz) <= 20 dB, and consequences of unilateral hearing impairment needed to be reported in an unanimously defined population in at least one of the, Funding Agencies:University of Oulu Örebro University, School of Medical Sciences Örebro University Hospital, Audiological Research Center, Örebro, Sweden Stiftelsen Acta Otolaryngologica, Sweden

Introduction: Two important events have changed the prerequisites for children with severe-profound hearing impairment (HI). The first is the universal newborn hearing screening (UNHS) that enables early detection and identification of congenital or early-acquired HI. The second factor is the possibility of cochlear implant (CI) intervention at younger ages. There has been little previous interest in studying lexical-semantic ability in the new generation of children with CI who are implanted at a fairly young age, often bilaterally, in relation to the cognitive capacities that influence on use and knowledge of words. Aim: The general aim was to explore lexical-semantic ability and development in a group of school-aged children with CI and in comparison with age-matched normal hearing (NH) children. Method: The four studies examined different aspects of lexical-semantic ability in children aged 6-9 years. The cohort consisted of 34 children with CI and 39 age-matched children with NH (Study I-IV). In addition, two other clinical groups: children with language impairment (LI) (n=12) and children with autism spectrum disorder (ASD) (n=12) participated in Study II. A broad test battery was used, especially examining lexical-semantic ability but also non-verbal cognitive ability as well as phonological and learning ability. An error response analysis was conducted on a picture-naming test and a linguistic cluster analysis was performed on two different word fluency tasks with the purpose of examining strategies that the participants used when they retrieved words from their long-term-memory (LTM). Study IV had a partly longitudinal approach where a subgroup of children with CI (n=18) were examined more closely over time and in comparison with other age-matched groups at the age of 8-9 years. Statistical analyses were made primarily to examine group differences. Results: Many children with CI reached age-equivalent lexical-semantic ability at the age of 8-9 years. Semant

Objective Lexical-semantic ability was investigated among children aged 6–9 years with cochlear implants (CI) and compared to clinical groups of children with language impairment (LI) and autism spectrum disorder (ASD) as well as to age-matched children with normal hearing (NH). In addition, the influence of age at implantation on lexical-semantic ability was investigated among children with CI. Methods 97 children divided into four groups participated, CI (n = 34), LI (n = 12), ASD (n = 12), and NH (n = 39). A battery of tests, including picture naming, receptive vocabulary and knowledge of semantic features, was used for assessment. A semantic response analysis of the erroneous responses on the picture-naming test was also performed. Results The group of children with CI exhibited a naming ability comparable to that of the age-matched children with NH, and they also possessed a relevant semantic knowledge of certain words that they were unable to name correctly. Children with CI had a significantly better understanding of words compared to the children with LI and ASD, but a worse understanding than those with NH. The significant differences between groups remained after controlling for age and non-verbal cognitive ability. Conclusions The children with CI demonstrated lexical-semantic abilities comparable to age-matched children with NH, while children with LI and ASD had a more atypical lexical-semantic profile and poorer sizes of expressive and receptive vocabularies. Dissimilar causes of neurodevelopmental processes seemingly affected lexical-semantic abilities in different ways in the clinical groups.

The aim of the study was to examine grammatical sentence understanding (TROG-2) in 6-9 year old children with cochlear implants (CI), and compare their performance to age-matched children with normal hearing (NH). Receptive vocabulary, picture naming, semantic feature knowledge, word fluency, non-word discrimination (phonology), word learning and non-verbal cognitive ability were examined as possible predicting factors for TROG-2. Age at implantation, hearing age, and speech recognition were also investigated in children with CI. For TROG-2, 6-7 year old children with CI performed similar to controls, and 50 % of them reached one year or more above the age-equivalent norm level. Speech recognition and age at 2nd implantation were associated with better results on TROG-2. Non-verbal cognitive ability and picture naming predicted grammatical sentence understanding in children with CI. Earlier age at implantation and a shorter period between 1st and 2nd implantation might also have a positive influence on TROG-2 for younger children with CI. The predicting factors of grammatical sentence understanding in the group of children with NH were related to non-word discrimination and breadth and depth in receptive vocabulary.

Word fluency was examined in 73 Swedish children aged 6–9 years divided into two age groups, 6–7 and 8–9 years; 34 deaf children with cochlear implants (CI) (15 girls/19 boys) and 39 age-matched children with normal hearing (NH) (20 girls/19 boys). One purpose was to compare the ability to retrieve words in two different word fluency tasks; one phonemically based (FAS letter fluency) and one semantically based (animal fluency). A second purpose was to examine retrieval strategies in the two tasks by conducting an analysis of clustering and switching of word sequences. In general we found that age was an important factor for word fluency ability, in both the CI and the NH groups. It was also demonstrated that children with CI aged 8–9 years retrieved significantly fewer words and used less efficient strategies in the retrieval process, especially on the phonemically based task compared to children with NH of the same ages, whereas children 6–7 years performed similarly in both groups regarding number of retrieved words and use of strategies. The results are discussed with respect to factors such as age differences in performance for children with CI, especially for the phonemically based task., The authors wish to thank Annika Johnson for assistance in the data collection procedure. We also want to thank all the participating children and their parents for their contribution. This research was supported by Karolinska Institutet, Aina Börjesonfonden, Stingerfonden and Sunnerdahls Handikappfond.