Cecilia Nakeva von Mentzer

Computer-assisted training of phoneme–grapheme correspondence for children who are deaf and hard of hearing : Effects on phonological processing skills

OBJECTIVE Examine deaf and hard of hearing (DHH) childrens phonological processing skills in relation to a reference group of children with normal hearing (NH) at two baselines pre intervention. Study the effects of computer-assisted phoneme-grapheme correspondence training in the children. Specifically analyze possible effects on DHH childrens phonological processing skills. METHODS The study included 48 children who participated in a computer-assisted intervention study, which focuses on phoneme-grapheme correspondence. Children were 5, 6, and 7 years of age. There were 32 DHH children using cochlear implants (CI) or hearing aids (HA), or both in combination, and 16 children with NH. The study had a quasi-experimental design with three test occasions separated in time by four weeks; baseline 1 and 2 pre intervention, and 3 post intervention. Children performed tasks measuring lexical access, phonological processing, and letter knowledge. All children were asked to practice ten minutes per day at home supported by their parents. RESULTS NH children outperformed DHH children on the majority of tasks. All children improved their accuracy in phoneme-grapheme correspondence and output phonology as a function of the computer-assisted intervention. For the whole group of children, and specifically for children with CI, a lower initial phonological composite score was associated with a larger phonological change between baseline 2 and post intervention. Finally, 18 DHH children, whereof 11 children with CI, showed specific intervention effects on their phonological processing skills, and strong effect sizes for their improved accuracy of phoneme-grapheme correspondence. CONCLUSION For some DHH children phonological processing skills are boosted relatively more by phoneme-grapheme correspondence training. This reflects the reciprocal relationship between phonological change and exposure to and manipulations of letters.

Segmental and suprasegmental properties in nonword repetition – An explorative study of the associations with nonword decoding in children with normal hearing and children with bilateral cochlear implants

Abstract This study explored nonword repetition (NWR) and nonword decoding in normal-hearing (NH) children and in children with bilateral cochlear implants (CI). Participants were 11 children, with CI, 5:0–7:11 years (M = 6.5 years), and 11 NH children, individually age-matched to the children with CI. This study fills an important gap in research, since it thoroughly describes detailed aspects of NWR and nonword decoding and their possible associations. All children were assessed after having practiced with a computer-assisted reading intervention with a phonics approach during four weeks. Results showed that NH children outperformed children with CI on the majority of aspects of NWR. The analysis of syllable number in NWR revealed that children with CI made more syllable omissions than did the NH children, and predominantly in prestressed positions. In addition, the consonant cluster analysis in NWR showed significantly more consonant omissions and substitutions in children with CI suggesting that reaching fine-grained levels of phonological processing was particularly difficult for these children. No significant difference was found for nonword-decoding accuracy between the groups, as measured by whole words correct and phonemes correct, but differences were observed regarding error patterns. In children with CI phoneme, deletions occurred significantly more often than in children with NH. The correlation analysis revealed that the ability to repeat consonant clusters in NWR had the strongest associations to nonword decoding in both groups. The absence of as frequent significant associations between NWR and nonword decoding in children with CI compared to children with NH suggest that these children partly use other decoding strategies to compensate for less precise phonological knowledge, for example, lexicalizations in nonword decoding, specifically, making a real word of a nonword.

Hearing and cognitive development in deaf and hearing-impaired children: effects of intervention

Hearing and cognitive development in deaf and hearing-impaired children : effects of intervention

Semantic Processing in Deaf and Hard-of-Hearing Children: Large N400 Mismatch Effects in Brain Responses, Despite Poor Semantic Ability

Difficulties in auditory and phonological processing affect semantic processing in speech comprehension for deaf and hard-of-hearing (DHH) children. However, little is known about brain responses related to semantic processing in this group. We investigated event-related potentials (ERPs) in DHH children with cochlear implants (CIs) and/or hearing aids (HAs), and in normally hearing controls (NH). We used a semantic priming task with spoken word primes followed by picture targets. In both DHH children and controls, cortical response differences between matching and mismatching targets revealed a typical N400 effect associated with semantic processing. Children with CI had the largest mismatch response despite poor semantic abilities overall; Children with CI also had the largest ERP differentiation between mismatch types, with small effects in within-category mismatch trials (target from same category as prime) and large effects in between-category mismatch trials (where target is from a different category than prime), compared to matching trials. Children with NH and HA had similar responses to both mismatch types. While the large and differentiated ERP responses in the CI group were unexpected and should be interpreted with caution, the results could reflect less precision in semantic processing among children with CI, or a stronger reliance on predictive processing.

The Phonics Approach in Swedish Children using Cochlear Implants or Hearing Aids: Inspecting Phonological Gain

The present study investigated cognitive abilities (i.e. Phonological Processing Skills (PhPS), lexical access, complex and visual Working Memory (WM), and letter knowledge) in Deaf and Hard of Hearing children (DHH) 5, 6 and 7 years of age using cochlear implants or hearing aids. Children with Normal Hearing (NH) served as a reference group. All children took part of a computer-assisted intervention with a phonics approach for 4 weeks aimed to support PhPS. The first aim of the study was to examine associations between cognitive abilities and Phonological Processing Skills (PhPS) pre intervention in DHH and NH children respectively. The second aim was to examine cognitive predictors of phonological gain post intervention. Finally, the influence of background variables on phonological gain was examined in NH and DHH respectively and in DHH children with weak PhPS particularly. Results showed comparable performance level in NH and DHH children on the majority of cognitive tasks, but weaker PhPS and lexical access in the DHH children. A significant association between PhPS and complex WM was only evident in DHH children. This finding suggests that DHH recruit more cognitive resources in phonological processing. A phonological representation task was the single predictor of phonological gain in DHH children. Children with initial weak performance on this task but had letter-naming skills, displayed relatively more phonological gain from the phonics training. Children with difficulties with the phonological representation task were older when diagnosed and had an older age at amplification. Further, these children displayed broader cognitive difficulties, suggesting that reduced access to auditory stimulation may have wide ranging effects on cognitive development.

Using a multi-feature paradigm to measure mismatch responses to minimal sound contrasts in children with cochlear implants and hearing aids

Our aim was to explore whether a multi-feature paradigm (Optimum-1) for eliciting mismatch negativity (MMN) would objectively capture difficulties in perceiving small sound contrasts in children with hearing impairment (HI) listening through their hearing aids (HAs) and/or cochlear implants (CIs). Children aged 5-7 years with HAs, CIs and children with normal hearing (NH) were tested in a free-field setting using a multi-feature paradigm with deviations in pitch, intensity, gap, duration, and location. There were significant mismatch responses across all subjects that were positive (p-MMR) for the gap and pitch deviants (F(1,43) = 5.17, p = 0.028 and F(1,43) = 6.56, p = 0.014, respectively) and negative (MMN) for the duration deviant (F(1,43) = 4.74, p = 0.035). Only the intensity deviant showed a significant group interaction with MMN in the HA group and p-MMR in the CI group (F(2,43) = 3.40, p = 0.043). The p-MMR correlated negatively with age, with the strongest correlation in the NH subjects. In the CI group, the late discriminative negativity (LDN) was replaced by a late positivity with a significant group interaction for the location deviant. Children with severe HI can be assessed through their hearing device with a fast multi-feature paradigm. For further studies a multi-feature paradigm including more complex speech sounds may better capture variation in auditory processing in these children.

Assessing speech perception in Swedish school-aged children: preliminary data on the Listen–Say test

Abstract To meet the need for a linguistic speech perception test in Swedish, the ‘Listen-Say test’ was developed. Minimal word pairs were used as speech material to assess seven phonetic contrasts in two auditory backgrounds. In the present study, children’s speech discrimination skills in quiet and in four-talker (4T) speech background were examined. Associations with lexical-access skills and academic achievement were explored. The study included 27 school children 7–9 years of age. Overall, the children discriminated phonetic contrasts well in both conditions (quiet: Mdn 95%; 4T speech; Mdn 91% correct). A significant effect of 4T speech background was evident in three of the contrasts, connected to place of articulation, voicing and syllable complexity. Reaction times for correctly identified target words were significantly longer in the quiet condition, possibly reflecting a need for further balancing of the test order. Overall speech discrimination accuracy was moderately to highly correlated with lexical-access ability. Children identified as having high concentration ability by their teacher had the highest speech discrimination scores in both conditions followed by children identified as having high reading ability. The first wave of data collection with the Listen-Say test indicates that the test appears to be sensitive to predicted perceptual difficulties of phonetic contrasts particularly in noise. The clinical benefit of using a procedure where speech discrimination, lexical-access ability and academic achievement are taken into account is discussed as well as issues for further test refinement.