Christina Samuelsson

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.

Towards assessment of prosodic abilities in Swedish children with language impairment

Swedish children with language impairment (LI) have prosodic problems at word and phrase level, possibly also at discourse level. The aim of this study was to investigate the reliability and validity of a newly developed comprehensive procedure to capture prosody at word level (e.g., tonal word accent), phrase level (e.g., copula) and discourse level (e.g., conversation) in Swedish children with LI. Twenty-nine children with LI participated in the study. The reliability of the total score of the procedure was found to be sufficiently high, as was inter-examiner agreement. The total score significantly correlated with language comprehension and grammatical abilities. Prosodic problems were found by perceptual assessment in one third of the children. t test for equality of variances for presence versus absence of prosodic problems showed that these two groups significantly differed in total score of the procedure. This indicates that the procedure is a valid measure of prosodic problems.

Prosodic problems in Swedish children with language impairment: towards a classification of subgroups

BACKGROUND Symptoms of prosodic problems have been found in Swedish children with language impairment at word and phrase level and possibly also at discourse level. AIMS The aim was twofold. First, to characterize a group of children with prosodic problems compared with children with normal language development. Second, to investigate the possibilities to classify subgroups of prosodic problems. METHODS & PROCEDURES A new Swedish assessment procedure for prosody that captures prosodic features at word, phrase and discourse level was used. Twenty-five children with prosodic problems and 25 children with typically developing language matched by age, gender and regional dialect participated in the study. Pretesting included tests of language comprehension, grammatical skills and oral motor skills. OUTCOMES & RESULTS The difference between the experimental and control groups was highly significant in all parts of the procedure. The total score of the procedure significantly correlated with grammatical abilities measured in the pretesting procedure, but there was no correlation with the other linguistic abilities measured in the pretesting procedure. CONCLUSIONS The results indicate a possible differentiation into two different subgroups, one with primarily phonetic and/or linguistic problems, the other with prosodic problems at discourse level possibly related to pragmatic problems.

Phonological development in children with obstructive sleep-disordered breathing

Adeno-tonsillar hypertrophy with obstructive sleep disordered breathing (OSDB) is known to affect oral-motor function, behaviour, and academic performance. Adeno-tonsillectomy is the most frequently performed operation in children, with total tonsillectomy (TE) being more common than partial resection, ‘tonsillotomy’ (TT). In the present study 67 children, aged 50–65 months, with OSBD were randomized to TE or TT. The childrens phonology was assessed pre-operatively and 6 months post-operatively. Two groups of children served as controls. Phonology was affected in 62.7% of OSBD children before surgery, compared to 34% in the control group (p < .001). Also, OSBD children had more severe phonological deficits than the controls (p < .001). Phonology improved 6 months equally after both surgeries. Despite improvement post-operatively, the gap to the controls increased. Other functional aspects, such as oral motor function, were normalized regardless of surgical method—TE or TT. The impact of OSBD should be considered as one contributing factor in phonological impairment.

Repetition of words and non-words in typically developing children: The role of prosody

In this study, segmental and prosodic aspects of word repetition and non-word repetition in typically developing children aged four to six years were investigated. Focus was on developmental differences, and on how tonal word accent and word length affect segment production accuracy. Prosodically controlled words and non-words were repeated by 44 Swedish-speaking children. Repetition accuracy for both words and non-words increased with age, and was higher for words than non-words. Further, tonal word accents I and II provided different conditions for segment repetition in favor of accent II during both word repetition and non-word repetition for older children, but only during word repetition for younger children. This suggests age-dependent differences regarding how prosody is stored and integrated with segments. The findings have theoretical significance regarding the role of prosody in the perception, processing and production of phonological information. There are also clinical implications concerning the interpretation of repetition tasks and the potential use of prosody in speech and language intervention.

How Simple is the Simple View of Reading

According to the Simple View of Reading, reading ability can be divided into decoding and language comprehension. In the present study, decoding and comprehensions contribution to reading ability was studied both in children with reading difficulties and in children with typical reading ability. Decoding and comprehension was further divided into sub-components, and the contribution from non-verbal ability and general processing speed was also studied. The results demonstrated that decoding made the largest contribution to reading ability for children with reading difficulties, while language comprehension contributed the most for children with typical reading ability. The contribution of non-verbal ability was not significant, and general processing speed only made a significant contribution to decoding for typical children. The two factors in the Simple View of Reading, decoding and comprehension, together explained less of the variance in reading ability for children with reading difficulties than for children with typical reading ability.

Development of cognitive and reading skills in deaf children with CIs

Auditory stimulation provided by a cochlear implant (CI) to deaf or severely hearing-impaired children has an impact on their development in most areas (Geers et al., 2008; Lyxell et al., 2008, 2009; Pisoni et al., 2008; Wass, 2009; Wass et al., 2008). This is especially obvious in the cognitive and communicative domains (Pisoni et al., 2008; Wass, 2009). Previous research indicates that deaf children with CIs generally outperform deaf children without CI implants in most cognitive and communicative tasks. Early implantation is also more beneficial for cognitve development than later implantation (Pisoni et al., 2008; Sharma et al., 2005; Tait et al., 2007; Wass, 2009). The purpose of the present article is to present an overview and summary of results from some recent studies carried out in our own laboratory. Focus is on the development of working memory (WM) capacity, phonological, and lexical skills (AskerArnason et al., 2007; Lyxell et al., 2008; Wass, 2009; Wass et al., 2008). These three basic cognitive components were chosen because they are central to development of a number of other fundamental cognitive activities including reading, mental arithmetic, and verbal communication. WM refers to the ability to simultaneously store and process information over a short period of time (12–15 seconds). Previous research has demonstrated that children with CI have shorter verbal memory spans compared to age-matched hearing children (Pisoni, 2008). In our own studies we have attempted to further examine WM by examining different components of the WM system (i.e. the central executive, the visual, and phonological part, cf., Repovs and Baddeley, 2006). Phonological processing skill refers to the ability to identify and manipulate phonological-related material. Phonological skills are highly correlated in hearing children with literacy skills, such as reading and writing. Atypical development is often associated with reading problems. The empirical picture from previous research is very clear. Children with CI perform at a substantially lower level than agematched hearing children. Lexical access refers to speed and accuracy in finding and retrieving verbal labels from long-term memory. Lexical access is a strong predictor of reading and spelling performance in hearing children. Previous research has revealed that deaf children with CI can reach levels of reading comprehension comparable to those of normal hearing children, although not all of them do so (c.f., Geers et al., 2008). Focus in our studies has been on two aspects of reading, comprehension, and decoding of words and non-words.

Experiences from Two Swedish Speech and Language Pathology Education Programmes Using Different Approaches to Problem-Based Learning

In many programmes within higher education, including speech language pathology (SLP) education, students are expected to develop collaborative skills alongside acquisition of theoretical knowledge. The focus of the present chapter is to evaluate SLP graduates’ opinions on how well prepared for the professional life they feel after their education. A questionnaire, focusing on perceived professional skills in relation to education, was distributed to former SLP students from two programmes with different applications of problem-based learning (PBL). A total of 55 students (69%) completed the questionnaire. PBL has been identified as one efficient way to facilitate the development of speech and language pathology students’ abilities to meet the demands of self-directed learning in everyday worklife. Moreover, it has been shown that the use of PBL throughout the programme is beneficial to the perception of attaining general competencies. It is also demonstrated that the students from both the PBL throughout and the semi-PBL curricula rated themselves high on many specific competencies.

Prosody intervention: A single subject study of a Swedish boy with prosodic problems

Swedish has a complicated prosodic system, compared, for example, with English. A large proportion of Swedish children with language impairment (LI) have prosodic problems to some extent. There are few descriptions in the literature of prosody intervention, which means that clinicians must rely on their overall linguistic and therapeutic knowledge when designing intervention for prosodic problems. The aim of the present study is to design an intervention package for prosodic problems in children and to evaluate this intervention. The article reports a single subject multiple baselines case study. The participant was a boy (aged 4 years and 6 months) with prosodic problems, mainly on word level but also on phrase and discourse level. The intervention was devised to address his problems and focused on word level prosody. The intervention was carried out over 6 weeks, comprising six 60-minute sessions. Post-intervention assessments were carried out immediately after intervention and 9 weeks later. The participant improved his overall prosodic skills significantly, as assessed by a procedure designed to capture prosody at word, phrase and discourse level. An evaluation of a spontaneous speech sample was also made by a panel of three experienced listeners, and they found some improvement in the participant’s prosody in connected speech, although this was not significant.

Intonational patterns of nonverbal vocalizations in people with dementia.

Nonverbal vocalizations in dementia are important clinically since they generally have been regarded as disruptive behavior that is disturbing. The aim of the present study is to describe the interactional pattern, including the prosodic package, of nonverbal vocalizations in a participant in a late stage of dementia. The acoustic analysis shows that the vocalizations do not differ significantly from the verbal utterances regarding mean fundamental frequency or pitch range. The mean fundamental frequency, F0, of the utterances from Anna was significantly higher than the mean F0 from the other elderly participants. The analysis demonstrates that there is a singing-like type of vocalizations that does not resemble the previously described patterns of nonverbal vocalizations. This pattern of the nonverbal vocalization does not resemble the intonation of Anna’s verbal utterances. The other participants perceive Anna’s vocalizations as potentially meaningful turns. Nonverbal vocalizations in clinical settings should be taken as communicative contributions.