Birgitta Sahlén

Non-word repetition in children with language impairment - pitfalls and possibilities

Specific language impairment has, although not without controversy, been considered as a consequence of a phonological memory deficit. Non-word repetition has been proposed as a reliable index of phonological memory and also as predictive of lexical and grammatical development in normally developing and language-impaired children. The main aim was to study the relationship between repetition of words and non-words and expressive language skills (phonology and grammar) in 27 5-year-old children with language impairment. The authors also wanted to explore the influence of lexical stress on repetition skills. The results showed that words were significantly easier to repeat than non-words and that non-word repetition skills were significantly correlated to phonological and grammatical development. The most important predictor of non-word repetition skills was output phonology. The conclusion is that non-word repetition is not a single, reliable index of phonological memory in preschool children with language impairment. Also, the influence of prosodic variables on segmental aspects of speech production should not be overlooked in non-word construction, since it was found that unstressed syllables were omitted six times more often in prestressed than in post-stressed positions of the words and non-words.

Working memory and novel word learning in children with hearing impairment and children with specific language impairment

BACKGROUND Working memory is considered to influence a range of linguistic skills, i.e. vocabulary acquisition, sentence comprehension and reading. Several studies have pointed to limitations of working memory in children with specific language impairment. Few studies, however, have explored the role of working memory for language deficits in children with hearing impairment. AIMS The first aim was to compare children with mild-to-moderate bilateral sensorineural hearing impairment, children with a preschool diagnosis of specific language impairment and children with normal language development, aged 9-12 years, for language and working memory. The special focus was on the role of working memory in learning new words for primary school age children. METHODS & PROCEDURES The assessment of working memory included tests of phonological short-term memory and complex working memory. Novel word learning was assessed according to the methods of. In addition, a range of language tests was used to assess language comprehension, output phonology and reading. OUTCOMES & RESULTS Children with hearing impairment performed significantly better than children with a preschool diagnosis of specific language impairment on tasks assessing novel word learning, complex working memory, sentence comprehension and reading accuracy. No significant correlation was found between phonological short-term memory and novel word learning in any group. The best predictor of novel word learning in children with specific language impairment and in children with hearing impairment was complex working memory. Furthermore, there was a close relationship between complex working memory and language in children with a preschool diagnosis of specific language impairment but not in children with hearing impairment. CONCLUSIONS Complex working memory seems to play a significant role in vocabulary acquisition in primary school age children. The interpretation is that the results support theories suggesting a weakened influence of phonological short-term memory on novel word learning in school age children.

Is age at implant the only factor that counts? The influence of working memory on lexical and grammatical development in children with cochlear implants

In this study, we explored the influence of time factors (age at implant, time with cochlear implant and age), complex working memory and phonological short-term memory on lexical and grammatical development in congenitally deaf children with cochlear implants. Fifteen children (aged 5 years 4 months to 11 years 5 months) were examined with the use of several linguistic and cognitive measures after a minimum of 18 months of implant use. Phonological short-term memory was assessed with non-word repetition, where the percentage of correctly repeated consonants and vowels was counted. For the assessment of lexical acquisition, a novel word learning task was administered. Receptive and expressive grammar was tested. Our results corroborate earlier findings on the influence of phonological short-term memory on novel word learning. The percentage of vowels correctly produced in non-word repetition was more important in this group than age at implant, not only for novel word learning, but also for receptive and expressive grammar. Sumario En este estudio, exploramos la influencia sobre el desarrollo léxico y gramatical de los factores temporales (edad de implantación, edad y tiempo transcurrido con el implante), de la memoria activa compleja y de la memoria fonológica a corto plazo, en niños con sorderas congénitas y portadores de un implante coclear. Se examinaron quince niños (con edades de 5 años y 4 meses a 11 años y 5 meses) por medio de varias medidas cognitivas y lingüísticas, luego de un mínimo de 18 meses de uso del implante. La memoria fonológica a corto plazo fue evaluada por medio de la repetición de sonidos sin contenido semántico, donde se tabuló el porcentaje de vocales y consonantes correctamente repetidas. Para la evaluación de la adquisición del léxico, se administró una novedosa tarea de aprendizaje de palabras y se evaluó la gramática receptiva y expresiva. Nuestros resultados corroboraron hallazgos anteriores sobre la influencia de la memoria fonológica a corto plazo en el aprendizaje de nuevas palabras. El porcentaje de vocales correctamente producidas por medio de la repetición de sonidos sin contenido semántico fue más importante en este grupo que la edad de implantación, no sólo para el aprendizaje de palabras nuevas, sino también en cuanto a la gramática receptiva y expresiva.

Conversation versus narration in pre-school children with language impairment

The study focuses on two elicitation methods for language sampling in children with language impairment: conversation and narration. It has been noted in other studies on different clinical groups that language elicited in different speaking contexts varies in aspects such as MLU, fluency and syntactic complexity. The purpose of this study was to compare genre effects on different aspects of language production in a group of pre-school children with language impairment. The results show that there are differences in language production during conversation compared with narration. Intelligibility and fluency were found to be higher in conversation than in narration, whereas MLU in words was higher in narration. The narrative task elicited more phrasal expansions and grammatical morphemes per utterance than the conversation. However, the children used more complex verb forms in conversation than in narration. The results are discussed in relation to recent research.

Cognitive and linguistic skills in Swedish children with cochlear implants – measures of accuracy and latency as indicators of development

The purpose of the present study was to examine working memory (WM) capacity, lexical access and phonological skills in 19 children with cochlear implants (CI) (5;7-13;4 years of age) attending grades 0-2, 4, 5 and 6 and to compare their performance with 56 children with normal hearing. Their performance was also studied in relation to demographic factors. The findings indicate that children with CI had visuospatial WM capacities equivalent to the comparison group. They had lower performance levels on most of the other cognitive tests. Significant differences between the groups were not found in all grades and a number of children with CI performed within 1 SD of the mean of their respective grade-matched comparison group on most of the cognitive measures. The differences between the groups were particularly prominent in tasks of phonological WM. The results are discussed with respect to the effects of cochlear implants on cognitive development.

What's the story? Narration and comprehension in Swedish preschool children with language impairment

This study investigated the possibility of identifying narrative problems at an early age (5-year-old children with language impairment). Furthermore, we explored the relationship between the comprehension of a story and the ability to structure the contents of the same story in a group of preschool children with language impairment. The results showed that the participants did not exhibit age-appropriate narrative skills. We also found that good comprehension of the narrative is a prerequisite for the ability to produce a story with a content structure in a retelling task. Methodological issues are discussed and the clinical implications highlighted.

Cognitive development in children with cochlear implants: Relations to reading and communication

The purpose of the present article is to present an overview of a set of studies conducted in our own laboratory on cognitive and communicative development in children with cochlear implants (CI). The results demonstrate that children with CIs perform at significantly lower levels on the majority of the cognitive tasks. The exceptions to this trend are tasks with relatively lower demands on phonological processing. A fairly high proportion of the children can reach a level of reading comprehension that matches hearing children, despite the fact that they have relatively poor phonological skills. General working memory capacity is further correlated with the type of questions asked in a referential communication task. The results are discussed with respect to issues related to education and rehabilitation.

Cognitive development, reading and prosodic skills in children with cochlear implants

This report summarizes some of the results of studies in our laboratory exploring the development of cognitive, reading and prosodic skills in children with cochlear implantation (CI). The children with CI performed at significantly lower levels than the hearing comparison group on the majority of cognitive tests, despite showing levels of nonverbal ability. The differences between children with CI and hearing children were most pronounced on tasks with relatively high phonological processing demands, but they were not limited to phonological processing. Impairment of receptive and productive prosody was also evident in children with CI. Despite these difficulties, 75% of the children with CI reached a level of reading skill comparable to that of hearing children. The results are discussed with respect to compensation strategies in reading.

Can a ‘single hit’ cause limitations in language development? A comparative study of Swedish children with hearing impairment and children with specific language impairment

BACKGROUND Studies of language in children with mild-to-moderate hearing impairment (HI) indicate that they often have problems in phonological short-term memory (PSTM) and that they have linguistic weaknesses both in vocabulary and morphosyntax similar to children with specific language impairment (SLI). However, children with HI may be more likely than children with SLI to acquire typical language skills as they get older. It has been suggested that the more persisting problems in children with SLI are due to a combination of factors: perceptual, cognitive and/or linguistic. AIMS The main aim of this study was to explore language skills in children with HI in comparison with children with SLI, and how children with both HI and language impairment differ from those with non-impaired spoken language skills. METHODS & PROCEDURES PSTM, output phonology, lexical ability, receptive grammar and verb morphology were assessed in a group of children with mild-to-moderate HI (n = 11) and a group of children with SLI (n = 12) aged 5 years 6 months to 9 years 0 months. OUTCOMES & RESULTS The HI group tended to score higher than the SLI group on the language measures, although few of the differences were significant. The children with HI had their most obvious weaknesses in PSTM, vocabulary, receptive grammar and inflection of novel verbs. The subgroup of children with HI (five out of 10) who also showed evidence of grammatical output problems was significantly younger than the remaining children with HI. Correlation analysis showed that the language variables were not associated with age, whereas hearing level was associated with PSTM. CONCLUSIONS Children with HI are at risk for at least a delay in lexical ability, receptive grammar and grammatical production. The problems seen in the HI group might be explained by their low-level perceptual deficit and weak PSTM. For the SLI group the impairment is more severe. From a clinical perspective an important conclusion is that the language development in children with even mild-to-moderate HI deserves attention and support.

A methodological contribution to the assessment of nonword repetition-a comparison between children with specific language impairment and hearing-impaired children with hearing aids or cochlear implants.

Poor nonword repetition is considered as a clinical marker of specific language impairment (SLI). In children with expressive language problems, the analysis and scoring procedures are often insufficiently described. We argue for a combined analysis of segmental and suprasegmental accuracy in nonword repetition tasks as well as an appreciation of gender differences. The view is taken based on empirical findings in a comparison between children with specific language impairment, children with mild/moderate hearing impairment and hearing aids (HI), and children with severe to profound hearing impairment with cochlear implants (CI). With age and gender taken into consideration, the main effects of both group and syllable level on a combined measure of segmental and suprasegmental accuracy remained. Although not necessarily an index of limited working memory capacity, persistently poor imitation of nonwords might be an indication of language impairment in children with mild/moderate HI and in children with CI.