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Purpose: The purpose of this study was to delineate differences between children with specific language impairment (SLI), typical age–matched (TAM) children, and typical younger (TY) children in learning and mastering an undisclosed artificial morphological rule (AMR) through exposure and usage. Method: Twenty-six participants (eight 10-year-old children with SLI, 8 TAM children, and ten 8-year-old TY children) were trained to master an AMR across multiple training sessions. The AMR required a phonological transformation of verbs depending on a semantic distinction: whether the preceding noun was animate or inanimate. All participants practiced the application of the AMR to repeated and new (generalization) items, via judgment and production tasks. Results: The children with SLI derived significantly less benefit from practice than their peers in learning most aspects of the AMR, even exhibiting smaller gains compared to the TY group in some aspects. Children with SLI benefited less than TAM and even TY children from training to judge and produce repeated items of the AMR. Nevertheless, despite a significant disadvantage in baseline performance, the rate at which they mastered the task-specific phonological regularities was as robust as that of their peers. On the other hand, like 8-year-olds, only half of the SLI group succeeded in uncovering the nature of the AMR and, consequently, in generalizing it to new items. Conclusions: Children with SLI were able to learn language aspects that rely on implicit, procedural learning, but experienced difficulties in learning aspects that relied on the explicit uncovering of the semantic principle of the AMR. The results suggest that some of the difficulties experienced by children with SLI when learning a complex language regularity cannot be accounted for by a broad, languagerelated, procedural memory disability. Rather, a deficit— perhaps a developmental delay in the ability to recruit and solve language problems and establish explicit knowledge regarding a language task—can better explain their difficulties in language learning. [ABSTRACT FROM AUTHOR]

Purpose: This study explores the role of overt and covert contrasts in speech perception by children with speech sound disorder (SSD). Method: Three groups of preschool-aged children (typically developing speech and language [TD], SSD with /s/~/ʃ/ contrast [SSD-contrast], and SSD with /s/~/ʃ/ collapse [SSD-collapse]) completed an identification task targeting /s/~/ʃ/ minimal pairs. The stimuli were produced by 3 sets of talkers: children with TD, children with SSD, and the participant himself/herself. We conducted a univariate general linear model to investigate differences in perception of tokens produced by different speakers and differences in perception between the groups of listeners. Results: The TD and SSD-contrast groups performed similarly when perceiving tokens produced by themselves or other children. The SSD-collapse group perceived all speakers more poorly than the other 2 groups of children, performing at chance for perception of their own speech. Children who produced a covert contrast did not perceive their own speech more accurately than children who produced no identifiable acoustic contrast. Conclusion: Preschool-aged children have not yet developed adultlike phonological representations. Collapsing phoneme production, even with a covert contrast, may indicate poor perception of the collapsed phonemes. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the intelligibility of children’s atypical speech in relation to listeners’ language background. Method: Forty-eight participants listened to and transcribed isolated words repeated by children with speech sound disorders. Participants were divided into, on the one hand, a multilingual group (n = 29) that was further divided into subgroups based on age of acquisition (early, 0–3 years; intermediate, 4–12 years; and late, > 12 years) and, on the other hand, a monolingual comparison group (n = 19). Results: The monolingual listeners obtained higher intelligibility scores than the multilingual listeners; this difference was statistically significant. Participants who acquired Swedish at an older age (> 4 years) were found to have lower scores than other listeners. The later the age of acquisition, the less of the atypical speech was decoded correctly. A further analysis of the transcriptions also revealed a higher level of nonwords among the incorrect transcriptions of the multilinguals than that of the monolinguals who used more real words, whereas both groups were equally prone to using blanks when they did not perceive a word. Conclusions: This indicates a higher risk of communicative problems between late acquirers of Swedish and children with speech sound disorders. Clinical implications, such as involving communication partners in the intervention process, are discussed as well as possible linguistic explanations to the findings. This study could be seen as a starting point in the field of research regarding the relations between the language background of the listener and the ability to perceive atypical speech. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the characteristics of diplophonia using an auditory perception and multimodal simultaneous examination, which included sound waveform analysis, electroglottography (EGG), digital kymography (DKG), and 2-dimensional scanning digital kymography (2D DKG). Additionally, we compared the diagnostic accuracy of each method using a binary classifier in confusion matrix and convenience of discrimination, based on the time required for interpretation. Method: One normophonic male, 12 patients with diplophonia, and 12 dysphonia patients without diplophonia were enrolled. A multimodal simultaneous evaluation was used to analyze the vibration pattern of diplophonia. Sensitivity, specificity, accuracy, area under the curve, and interpretation time were used to compare the various diagnostic methods. Discrimination was determined by 3 raters. Results: There are 3 types of asymmetric vibratory patterns in diplophonia. The types are based on the oscillators vibrating at different frequencies: asymmetry of the left and right cords (6 subjects with unilateral palsy and 1 subject with vocal polyps), asymmetry of anterior and posterior cords (2 subjects with vocal polyps), and asymmetry of true and false cords (3 subjects with muscle tension dysphonia). All evaluation methods were useful as diagnostic tools, with all areas under the curve > .70. The diagnostic accuracy was highest with DKG (95.83%), followed by 2D DKG (83.33%), EGG (81.94%), auditory-perceptual evaluation (80.56%), and sound waveform (77.78%). The interpretation time was the shortest for auditory-perceptual evaluation (6.07 ± 1.34 s), followed by 2D DKG (10.04 ± 3.00 s), EGG (12.49 ± 2.76 s), and DKG (13.53 ± 2.60 s). Conclusions: Auditory-perceptual judgment was the easiest and fastest method for experienced raters, but its diagnostic accuracy was lower than that of DKG or 2D DKG. The diagnostic accuracy of DKG was the highest, but 2D DKG allowed rapid interpretation and showed relatively high diagnostic accuracy, except in cases with space-occupying lesions. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies of speech articulation have shown that individuals who can perceive smaller differences between similar-sounding phonemes showed larger contrasts in their productions of those phonemes. Here, a similar relationship was examined between the perception and production of breathy voice quality. Method: Twenty females with healthy voices were recruited to participate in both a voice production and a perception experiment. Each participant produced repetitions of a sustained vowel, and acoustic correlates of breathiness were calculated. Identification and discrimination tasks were performed with a series of synthetic stimuli along a breathiness continuum. Categorical boundary location and boundary width were obtained from the identification task as a measurement of perception of breathiness. Spearman’s correlation analysis was performed to estimate associations between values of boundary location and width and the acoustic correlates of breathiness from the participants’ voices. Results: Significant correlations between boundary width (r = −.53 to −.6) and some acoustic correlates were found, but no significant relationships were observed between boundary location and the acoustic correlates. Conclusions: Speakers with small boundary widths, which suggest higher perceptual precision in differentiating breathiness, had typical voices that were less breathy, as estimated with acoustic measures, compared to speakers with large boundary widths. Our findings may support a link between perception and production of breathy voice quality. [ABSTRACT FROM AUTHOR]

Objective: This study investigated pressurized transient evoked otoacoustic emission (TEOAE) responses and wideband absorbance (WBA) in healthy ears and ears with negative middle ear pressure (NMEP). Method: In this cross-sectional study, TEOAE amplitude, signal-to-noise ratio, and WBA were measured at ambient and tympanometric peak pressure (TPP) in 36 ears from 25 subjects with healthy ears (age range: 3.1-13.0 years) and 88 ears from 76 patients with NMEP (age range: 2.0-13.1 years), divided into 3 groups based on NMEP (Group 1 with TPP between -101 and -200 daPa, Group 2 with TPP between -201 and -300 daPa, and Group 3 with TPP between -301 and -400 daPa). Results: Mean TEOAE amplitude, signal-to-noise ratio, and WBA were increased at TPP relative to that measured at ambient pressure between 0.8 and 1.5 kHz. Further decrease in TPP beyond -300 daPa did not result in further increases in the mean TEOAE or WBA at TPP. The correlation between TEOAE and WBA was dependent on the frequency, pressure conditions, and subject group. There was no difference in pass rates between the 2 pressure conditions for the control group, while the 3 NMEP groups demonstrated an improvement in pass rates at TPP. With pressurization, the false alarm rate for TEOAE due to NMEP was reduced by 17.8% for NMEP Group 1, 29.2% for NMEP Group 2, and 15.8% for NMEP Group 3. Conclusion: Results demonstrated the feasibility and clinical benefits of measuring TEOAE and WBA under pressurized conditions. Pressurized TEOAE and WBA should be used for assessment of ears with NMEP in hearing screening programs to reduce false alarm rates. [ABSTRACT FROM AUTHOR]

Purpose: Functional imaging is often used to try to elucidate the pathophysiological mechanism of tinnitus. Residual inhibition, the temporary suppression of tinnitus after application of a masking noise, could be an interesting technique to modulate tinnitus perception in functional imaging paradigms. The purposes of this study were to primarily assess reproducibility of the (partial) positive residual inhibition response duration in patients with tinnitus and to explore its utility in experimental designs. Method: Patients with tinnitus exhibiting a (partial) positive residual inhibition response or tinnitus reduction after a 1-min white noise presentation were selected from a broad consulting tinnitus population. In 27 patients, this response was tested 4 times: twice during initial testing and twice during a retest of the psychoacoustic tinnitus measures, 4-8 weeks after initial consultation. In 17 patients with stable residual inhibition responses, reproducibility of response duration, the duration of tinnitus reduction up to pretesting state, was analyzed. Results: Initial testing showed a residual inhibition duration of 29.5 s on average. Test-retest reproducibility of response duration was shown to be reliable with an ICC(3, 4) of .871 (95% CI [0.733, 0.948]) and a standard error of measurement of 6.64 s. Conclusions: This study indicates the good test-retest reproducibility of residual inhibition duration in our subset of 17 patients with stable (partial) positive residual inhibition. Residual inhibition is, therefore, a technique that can potentially be used for temporary tinnitus manipulation in experimental paradigms to unravel tinnitus pathophysiology. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the relationships between text reading comprehension and oral idiom comprehension in adolescents. We also examined the more specific relationships between inference in text comprehension and inference in idiom comprehension. Method: We selected participants from an initial sample of 140 students aged 13-15 years to form 2 groups, according to their decoding and reading comprehension abilities: 1 group of good comprehenders/good decoders (n = 49) and 1 group of less skilled comprehenders but with adequate decoding skills (n = 20). The reading comprehension task comprised both literal and inferential (text-based and knowledge-based) questions. These 2 groups were then compared on an idiom comprehension task. In this task, idioms were presented orally, and students were placed in a situation that simulated a real-life oral interaction. The idioms were novel for the students (translated from a foreign language), either transparent or opaque, and presented either with a supportive context or without any context. Results: Good reading comprehenders outperformed less skilled ones on the idiom task. Both groups benefited from the supportive context, especially the good comprehenders. Knowledge-based inferences in written text comprehension were related to contextual inferences for opaque idioms, while semantic inferences for transparent idioms were related to literal text comprehension, but not to textconnecting inferences. Conclusion: These results are discussed both theoretically, in terms of cross-modal comprehension processes, and practically, in terms of implications for remediation. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated vocabulary growth from 18 to 24 months of age in young children with repaired cleft palate (CP), children with otitis media, and typically developing (TD) children. In addition, the contributions of factors such as hearing level, middle ear status, size of consonant inventory, maternal education level, and gender to the development of expressive vocabulary were explored. Method: Vocabulary size of 40 children with repaired CP, 29 children with otitis media, and 25 TD children was measured using the parent report on MacArthur-Bates Communicative Development Inventories: Words and Sentences (Fenson et al., 2007) at 18 and 24 months of age. All participants underwent sound field audiometry at 12 months of age and tympanometry at 18 months of age. A multiple linear regression with and without covariates was used to model vocabulary growth from 18 to 24 months of age across the 3 groups. Results: Children with CP produced a significantly smaller number of words at 24 months of age and showed significantly slower rate of vocabulary growth from 18 to 24 months of age when compared to TD children (p < .05). Although middle ear status was found to predict vocabulary growth from 18 to 24 months of age across the 3 groups (p < .05), the confidence interval was large, suggesting the effect should be interpreted with caution. Conclusions: Children with CP showed slower expressive vocabulary growth relative to their age-matched TD peers. Middle ear status may be associated with development of vocabulary skills for some children. [ABSTRACT FROM AUTHOR]

Purpose: This study sought to determine if (a) children with childhood apraxia of speech (CAS), other speech sound disorders (SSDs), and typical development (TD) would perform differently on a standardized motor assessment and (b) whether comorbid language impairment would impact group differences. Method: Speech, language, and motor abilities were assessed in children with CAS (n = 10), SSD (n = 16), and TD (n = 14) between the ages of 43 and 105 months. Motor skills were evaluated using the Movement Assessment Battery for Children-Second Edition (Henderson, Sugden, & Barnett, 2007), a behavioral assessment that is sensitive in identifying fine/gross motor impairments in children with a range of motor and learning abilities. Data were reanalyzed after reclassifying children by language ability. Results: The CAS group performed below the normal limit on all components of the motor assessment and more poorly than the TD and SSD groups on Aiming and Catching and Balance. When children were reclassified by language ability, the comorbid CAS + language impairment group performed worse than the SSD-only and TD groups on Manual Dexterity and Balance and worse than the TD group on Aiming and Catching; all 7 children with CAS + language impairment evidenced performance in the disordered range compared to 1 of 3 children in the CAS-only group and 2 of 6 children in the SSD + language impairment group. Conclusions: Children with CAS + language impairment appear to be at an increased risk for motor impairments, which may negatively impact social, academic, and vocational outcomes; referrals for motor screenings/assessments should be considered. Findings may suggest a higher order deficit that mediates cognitive-linguistic and motor impairments in this population. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to examine 2 aspects of treatment intensity in treatment for childhood apraxia of speech (CAS): practice amount and practice distribution. Method: Using an alternating-treatments single-subject design with multiple baselines, we compared high versus low amount of practice, and massed versus distributed practice, in 6 children with CAS. Conditions were manipulated in the context of integral stimulation treatment. Changes in perceptual accuracy, scored by blinded analysts, were quantified with effect sizes. Results: Four children showed an advantage for high amount of practice, 1 showed an opposite effect, and 1 showed no condition difference. For distribution, 4 children showed a clear advantage for massed over distributed practice post treatment; 1 showed an opposite pattern, and 1 showed no clear difference. Follow-up revealed a similar pattern. All children demonstrated treatment effects (larger gains for treated than untreated items). Conclusions: High practice amount and massed practice were associated with more robust speech motor learning in most children with CAS, compared to low amount and distributed practice, respectively. Variation in effects across children warrants further research to determine factors that predict optimal treatment conditions. Finally, this study adds to the evidence base supporting the efficacy of integral stimulation treatment for CAS. [ABSTRACT FROM AUTHOR]

Purpose: Anterior tongue shape during /s/ production is often described as "tip-up" or apical, versus "tip-down" or laminal. Typically, this is determined by observing the shape of the anterior midline tongue. The purpose of this study was to identify methods of curvature calculation that quantify the observed shape differences and to examine whether the shape differences were affected by palate shape. Previous work shows that palate height has some effect (Grimm et al., 2017). Method: Four curvature-based measures were applied to a series of points selected along the tongue surface in midsagittal cine magnetic resonance images during speech. The measures were minimal curvature, averaged largest curvature (ALC), normalized ALC, and interpolated normalized ALC. These measures were compared to visual judgments of apical and laminal /s/. Anterior palate shape was measured from dental casts. Results: The apical /s/ contained a flat or concave region in the anterior tongue, while the laminal /s/ had a convex shape along the entire tongue. Thus, the laminal shape was less complex than the apical. The last 2 metrics, based on averages of multiple normalized curvatures, captured this complexity difference. Subjects with a more steeply sloped anterior palate tended to use laminal /s/. Conclusions: The tongue shape for the 2 /s/ types was best defined by complexity of the shape, rather than local anterior shape. Statistical quantities that measured curvature in multiple locations, and normalized across subjects, were best at distinguishing the 2 /s/ shapes. Interpolating additional points between the manually selected ones did not improve the method. [ABSTRACT FROM AUTHOR]

Purpose: Recognizing the need to advance the treatment of pediatric feeding disorders, an emerging area of inquiry focuses on therapeutic techniques that address expulsion and packing possibly associated with oral-motor dysfunction. In the current study, we documented the use of modifiedbolus placement in the treatment of pediatric feeding disorders at an intensive, multidisciplinary day-treatment center over a 26-month period. Method: The retrospective observational cohort study involved patients admitted for the assessment and treatment of chronic food refusal from August 2013 to October 2015. Results: Patients (n = 23) who received modified bolus placement displayed moderate-to-severe oral-motor deficits. Use of modified-bolus placement was associated with reduced expulsion and packing of bites during meals, and treatment gains coincided with a threefold increase in grams consumed per meal. Conclusion: Results provide additional support for the potential therapeutic benefits of enhancing bolus placement onto the tongue as a means to improve mealtime performance in children with pediatric feeding disorders when included as an adjunct to more traditional behavioral approaches. [ABSTRACT FROM AUTHOR]

Purpose: Individuals with Parkinson's disease (PD) demonstrate language- and emotion-related impairments; however, emotional language production has received little attention within the literature despite the fact that deficits could significantly impact one's daily interactions with loved ones and others. Multitasking (i.e., dual tasking), specifically while completing language tasks, is a common everyday occurrence and typically impacts performance on 1 or both tasks. This study compared emotional word use during discourse production in individuals with PD and healthy older adults (HOAs) under single- and dual-task conditions. Method: Participants completed a discourse task while sitting in a quiet room and while stationary cycling. Discourse output was analyzed along several emotional and intellectual language dimensions obtained from the Linguistic Inquiry and Word Count program (Pennebaker, Booth, & Francis, 2007). Results: Groups did not differ on any outcome measure in the single-task condition. However, HOAs produced a higher percentage of words associated with affective processes and positive emotion while completing the dual-task condition, whereas the PD group exhibited a decrease in production of these words. Compared to the single-task condition, during cycling, individuals with PD also produced a lower percentage of inhibition-related words. Conclusions: These results suggest that cycling, like other types of exercise, improves mood as manifested in discourse word choice in HOAs; however, it may lead to reduced use of emotional words in individuals with PD. Expressing emotion may also be more difficult in those with PD than in HOAs and, therefore, easily disrupted in distracting circumstances. [ABSTRACT FROM AUTHOR]

Purpose: When breakdowns in communication occur, children may request a repair to increase understanding of the message. Unrepaired communication breakdowns may cause confusions, limit conversational exchanges, and restrict children's learning opportunities. Relatively little is known regarding the conditions under which children produce repair requests. Thus, this study examined the verbal communication repair requests produced by typically developing children and evaluated the relationship between children's repair requests and performance on a theory of mind task. Method: Participants included 25 typically developing 4-year-old children who completed standardized, normreferenced assessments of their expressive language, receptive language, and IQ; a theory of mind task; and a shared book reading task. In the shared book reading task, the examiner elicited child repair requests using questions and statements that contained insufficient information. Results: Participants produced a statistically significant greater number of repair requests when presented with questions with insufficient information compared to statements with insufficient information (p < .001). There were no differences in total repair requests between participants who passed or failed the theory of mind task (p = .45). Conclusion: Among preschool-age children, the shared book reading task provided a naturalistic medium that facilitated the examination of children's repair requests. Results from this study provide baseline information to which the repair requests produced by other populations, such as children with autism spectrum disorder, can be compared. [ABSTRACT FROM AUTHOR]

Purpose: The aims of the study were to determine dualtask effects on content accuracy, delivery speed, and perceived effort during narrative discourse in people with moderate, mild, or no aphasia and to explore subjective reactions to retelling a story with a concurrent task. Method: Two studies (1 quantitative and 1 qualitative) were conducted. In Study 1, participants with mild or moderate aphasia and neurotypical controls retold short stories in isolation and while simultaneously distinguishing between high and low tones. Story retell accuracy (speech productivity and efficiency), speed (speech rate, repetitions, and pauses), and perceived effort were measured and compared. In Study 2, participants completed semistructured interviews about their story retell experience. These interviews were recorded, transcribed orthographically, and coded qualitatively using thematic analysis. Results: The dual task interfered more with spoken language of people with aphasia than controls, but different speed accuracy trade-off patterns were noted. Participants in the moderate aphasia group reduced accuracy with little alteration to speed, whereas participants in the mild aphasia group maintained accuracy and reduced their speed. Participants in both groups also reported more negative emotional and behavioral reactions to the dual-task condition than their neurotypical peers. Intentional strategies for coping with the cognitive demands of the dual-task condition were only reported by participants with mild aphasia. Conclusion: The findings suggest that, although communicating with a competing task is more difficult for people with aphasia than neurotypical controls, participants with mild aphasia may be better able to cope with cognitively demanding communication situations than participants with moderate aphasia. [ABSTRACT FROM AUTHOR]

Purpose: Recent studies have shown that an acoustic measure, relative fundamental frequency (RFF), has potential for the assessment of excessive laryngeal tension and vocal effort associated with functional and neurological voice disorders. This study presents an analysis of the test-retest reliability of RFF in individuals with healthy voices and a comparison of reliability between RFF and conventional measures of voice. Method: Acoustic and aerodynamic measurements and Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) were performed on 28 individuals with healthy voices on 5 consecutive days. Participants produced RFF stimuli, a sustained /a/, and a reading passage to allow for extraction of acoustic measures and CAPE-V ratings; /pa/ trains were produced to allow for extraction of aerodynamic measures. Results: Moderate reliabilities (intraclass correlation coefficient [ICC] = .64-.71) were found for RFF values. Mean vocal fundamental frequency, smoothed cepstral peak prominence, shimmer, harmonics-to-noise ratio, and mean airflow rate exhibited good-to-excellent reliabilities (ICC = .76-.99). ICCs for jitter and phonation threshold pressure were moderately reliable (ICC = .67-.74). ICCs for subglottal pressure estimates and all CAPE-V parameters showed poor reliabilities (ICC = .31-.58). Conclusion: RFF has comparable reliability to conventional measures of voice. This expands the potential for clinical application of RFF. [ABSTRACT FROM AUTHOR]

Purpose: For listeners with single-sided deafness, a cochlear implant (CI) can improve speech understanding by giving the listener access to the ear with the better target-to-masker ratio (TMR; head shadow) or by providing interaural difference cues to facilitate the perceptual separation of concurrent talkers (squelch). CI simulations presented to listeners with normal hearing examined how these benefits could be affected by interaural differences in loudness growth in a speechon- speech masking task. Method: Experiment 1 examined a target-masker spatial configuration where the vocoded ear had a poorer TMR than the nonvocoded ear. Experiment 2 examined the reverse configuration. Generic head-related transfer functions simulated free-field listening. Compression or expansion was applied independently to each vocoder channel (powerlaw exponents: 0.25, 0.5, 1, 1.5, or 2). Results: Compression reduced the benefit provided by the vocoder ear in both experiments. There was some evidence that expansion increased squelch in Experiment 1 but reduced the benefit in Experiment 2 where the vocoder ear provided a combination of head-shadow and squelch benefits. Conclusions: The effects of compression and expansion are interpreted in terms of envelope distortion and changes in the vocoded-ear TMR (for head shadow) or changes in perceived target-masker spatial separation (for squelch). The compression parameter is a candidate for clinical optimization to improve single-sided deafness CI outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Evidence exists that changes in language performance may be an early indicator of mild cognitive impairment (MCI), often a harbinger of dementing disease. The purpose of this study was the evaluation of language performance in individuals at risk for MCI by virtue of age and self-concern and its relation to performance on tests of memory, visuospatial function, and mental status. Method: Eighty-three individuals 55 years or older were administered the Arizona Battery for Communication Disorders of Dementia (Bayles & Tomoeda, 1993), a standardized battery with normative data from 86 healthy older adults (HOAs) and 86 individuals with Alzheimer's dementia, the most common dementing disease. A performance criterion of 1-1.5 SDs below the mean of HOAs defined MCI, as recommended in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We hypothesized that (a) the majority of at-risk participants would score 1 SD or more below the mean of HOAs on 1 or more subtests and (b) language performance tests would present a greater challenge than memory, mental status, and visuospatial construction tests. Results: Both hypotheses were confirmed. Sixty-two participants (74.6%) met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria on at least 1 subtest. Moreover, language subtests were those most likely to elicit a performance 1 SD or more below the mean of HOAs. Conclusions: Language performance deficits can appear early before impairment in episodic memory, visuospatial construction ability, or mental status in individuals at risk for MCI. Speech-language pathologists are uniquely qualified to identify subtle changes in language, and standardized language tests with normative data should be used when testing for MCI. [ABSTRACT FROM AUTHOR]

Purpose: Intelligibility is a core concept of speechlanguage pathology, central both to the assessment of speech disorders and to intervention in such disorders. One purpose of this study was to investigate the reliability and usability of a single-word assessment procedure, the Swedish Test of Intelligibility for Children (STI-CH), in a clinical setting. Another purpose was to investigate the validity and reliability of an assessment method designed to assess functional intelligibility: the Intelligibility in Context Scale (ICS). Method: Thirty children aged 4;1-10;1 years;months were recruited from speech-language pathology clinics in Western Sweden. Each child's treating speech-language pathologist served as listener in the STI-CH assessment while the ICS was completed by each child's parents. External listeners (2 last-year speech-language pathology students) were used to assess the validity of the speech-language pathology. Results: The mean duration of the test procedure for the STI-CH was about 19 min, and 57% of the test sessions were reported as difficult. There was a weak but statistically significant correlation between the results from the STI-CH and the ICS (r = .40, p < .05), and both methods showed high reliability in terms of interlistener reliability (intraclass correlation exceeding .97) and internal consistency, respectively. Conclusions: The STI-CH had high reliability and was time efficient but had some procedural problems. The ICS had moderate validity but high reliability. The STI-CH is promising for clinical use but needs to be developed further. The validity of the ICS can be discussed and needs to be further investigated. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare biomechanical swallowing outcomes and perceived effort as well as detraining effects of the established Head Lift Exercise (HLE) and the novel Recline Exercise (RE) in healthy older adults. Method: Twenty-two healthy older adults were randomized to perform either the RE or the HLE for a period of 6 weeks. Subjects underwent videofluoroscopic swallowing studies at 3 time points (baseline, postexercise, and following a 6-week detraining period). Primary outcome measures included biomechanical measures of superior and anterior hyoid excursion and upper esophageal sphincter opening, obtained using kinematic analyses on the recorded swallows. Perceived exertion ratings during exercise, as measured by the Borg scale, were included as a secondary outcome measure. Linear mixed-effects models were utilized to compare exercise groups and evaluation time points. Results: The 2 exercise groups did not differ significantly in age, body mass index, or body fat percentage at baseline. Significant postexercise increases were seen in superior hyoid excursion, F(2, 36.7) = 24.01, p ≤ .0001, and anterior hyoid excursion, F(2, 36.7) = 5.40, p = .0088, for both exercise groups. Upper esophageal sphincter opening did not increase significantly following the exercise regimens, F(2, 36.5) = 2.14, p = .1322. Both groups displayed a significant decrease in perceived exertion levels over the course of the exercises, F(5, 98) = 23.73, p ≤ .0001. On average, Borg ratings were 20% lower for the RE group than the HLE group at all time points, F(5, 20) = 7.94, p = .0106, indicating that this exercise was perceived as easier to perform. Eighteen participants were followed after detraining, and no differences in detraining effects were seen between groups. In general, gains in biomechanical measures were better maintained on larger bolus types. Conclusions: In healthy older adults, the HLE and the RE produced similar gains and detraining effects in biomechanical swallow outcomes. The RE exercise, however, required significantly less effort. These findings suggest that the RE is easier to perform for healthy older adults and thus may be a valuable treatment option for individuals who have difficulty performing the HLE. Further investigation in patients with dysphagia is warranted. [ABSTRACT FROM AUTHOR]

Purpose: It is well established that (a) infants prefer listening to infant-directed speech (IDS) over adult-directed speech (ADS), and (b) IDS facilitates speech, language, and cognitive development, compared with ADS. The main purpose of this study was to determine whether infants with hearing aids (HAs), similar to their peers with normal hearing (NH), show a listening preference for IDS over ADS. Method: A total of 42 infants participated in the study. In Experiment 1, 9 infants with hearing loss, who had approximately 12 months of experience (mean chronological age of 17.57 months) with HAs, and 9 infants with NH, who had similar chronological age (17.54 months), were tested. In Experiment 2, 10 infants with hearing loss, who had approximately 4 months of experience (mean chronological age of 9.86 months) with HAs, and 14 infants with NH, who had similar chronological age (9.09 months), were tested. Infants were tested on their listening preference in 3 randomized blocks: IDS versus silence, ADS versus silence, and IDS versus ADS blocks, using the central fixation preference procedure. Results: Experiment 1 showed that infants with HAs, similar to their peers with NH, listened longer to both IDS and ADS relative to silence; however, neither infants with HAs nor infants with NH showed a listening preference for IDS over ADS. In Experiment 2, both infants with HAs and infants with NH showed a listening preference for IDS and ADS relative to silence; in addition, both groups preferred listening to IDS over ADS. Conclusions: Infants with HAs appear to have sufficient access to the acoustic cues in the speech that allow them to develop an age-equivalent IDS preference. This may be attributed to a combination of being able to use the hearing they do have before receiving HAs and early device fitting. Given previously demonstrated positive associations between IDS preference and language development, this research encourages early interventions focusing on maximizing early auditory experience in infants with hearing loss. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates differences between preschool children with cochlear implants and age-matched children with normal hearing during an initial stage in word learning to evaluate whether they (a) match novel words to unfamiliar objects and (b) solicit information about unfamiliar objects during play. Method: Twelve preschool children with cochlear implants and 12 children with normal hearing matched for age completed 2 experimental tasks. In the 1st task, children were asked to point to a picture that matched either a known word or a novel word. In the 2nd task, children were presented with unfamiliar objects during play and were given the opportunity to ask questions about those objects. Results: In Task 1, children with cochlear implants paired novel words with unfamiliar pictures in fewer trials than children with normal hearing. In Task 2, children with cochlear implants were less likely to solicit information about new objects than children with normal hearing. Performance on the 1st task, but not the 2nd, significantly correlated with expressive vocabulary standard scores of children with cochlear implants. Conclusion: This study provides preliminary evidence that children with cochlear implants approach mapping novel words to and soliciting information about unfamiliar objects differently than children with normal hearing. [ABSTRACT FROM AUTHOR]

Purpose: This research note reports on an unexpected negative finding related to behavior change in a controlled trial designed to test whether partner training improves the conversational skills of volunteers. Method: The clinical trial involving training in "Supported Conversation for Adults with Aphasia" utilized a singleblind, randomized, controlled, pre-post design. Eighty participants making up 40 dyads of a volunteer conversation partner and an adult with aphasia were randomly allocated to either an experimental or control group of 20 dyads each. Descriptive statistics including exact 95% confidence intervals were calculated for the percentage of control group participants who got worse after exposure to individuals with aphasia. Results: Positive outcomes of training in Supported Conversation for Adults with Aphasia for both the trained volunteers and their partners with aphasia were reported by Kagan, Black, Felson Duchan, Simmons-Mackie, and Square in 2001. However, post hoc data analysis revealed that almost one third of untrained control participants had a negative outcome rather than the anticipated neutral or slightly positive outcome. Conclusions: If the results of this small study are in any way representative of what happens in real life, communication partner training in aphasia becomes even more important than indicated from the positive results of training studies. That is, it is possible that mere exposure to a communication disability such as aphasia could have negative impacts on communication and social interaction. Thismay be akin to what is known as a "nocebo" effect--something for partner training studies in aphasia to take into account. [ABSTRACT FROM AUTHOR]

Purpose: The aims of the study were to assess and compare grammatical deficits in written and spoken language production in subjects with agrammatic primary progressive aphasia (agPPA) and in subjects with agrammatism in the context of dominant apraxia of speech (DAOS) and to investigate neuroanatomical correlates. Method: Eight agPPA and 21 DAOS subjects performed the picture description task of the Western Aphasia Battery (WAB) both in writing and orally. Responses were transcribed and coded for linguistic analysis. agPPA and DAOS were compared to 13 subjects with primary progressive apraxia of speech (PPAOS) who did not have agrammatism. Spearman correlations were performed between the written and spoken variables. Patterns of atrophy in each group were compared, and relationships between the different linguistic measures and integrity of Broca's area were assessed. Results: agPPA and DAOS both showed lower mean length of utterance, fewer grammatical utterances, more nonutterances, more syntactic and semantic errors, and fewer complex utterances than PPAOS in writing and speech, as well as fewer correct verbs and nouns in speech. Only verb ratio and proportion of grammatical utterances correlated between modalities. agPPA and DAOS both showed greater involvement of Broca's area than PPAOS, and atrophy of Broca's area correlated with proportion of grammatical and ungrammatical utterances and semantic errors in writing and speech. Conclusions: agPPA and DAOS subjects showed similar patterns of agrammatism, although subjects performed differently when speaking versus writing. Integrity of Broca's area correlates with agrammatism. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the impact of code-switching on Spanish/English bilingual listeners' speech recognition of English and Spanish words in the presence of competing speech-shaped noise. Method: Participants were Spanish/English bilingual adults (N = 27) who were highly proficient in both languages. Target stimuli were English and Spanish words presented in speech-shaped noise at a -14-dB signal-to-noise ratio. There were 4 target conditions: (a) English only, (b) Spanish only, (c) mixed English, and (d) mixed Spanish. In the mixed- English condition, 75% of the words were in English, whereas 25% of the words were in Spanish. The percentages were reversed in the mixed-Spanish condition. Results: Accuracy was poorer for the majority (75%) and minority (25%) languages in both mixed-language conditions compared with the corresponding single-language conditions. Results of a follow-up experiment suggest that this finding cannot be explained in terms of an increase in the number of possible response alternatives for each picture in the mixed-language condition relative to the single-language condition. Conclusions: Results suggest a cost of language mixing on speech perception when bilingual listeners alternate between languages in noisy environments. In addition, the cost of code-switching on speech recognition in noise was similar for both languages in this group of highly proficient Spanish/English bilingual speakers. Differences in response-set size could not account for the poorer results in the mixed-language conditions. [ABSTRACT FROM AUTHOR]

Purpose: The first aim of this study was to explore differences in profiles of morphosyntax production of preschool children with hearing loss (CHL) relative to age- and language-matched comparison groups. The second aim was to explore the potential of extending 2 long-standing theoretical accounts of morphosyntax weakness in children with specific language impairment to preschool CHL. Method: This study examined conversational language samples to describe the accuracy and type of inaccurate productions of Brown's grammatical morphemes in 18 preschool CHL as compared with an age-matched group (±3 months, n = 18) and a language-matched group (±1 raw score point on an expressive language subtest, n = 18). Age ranged from 45 to 62 months. Performance across groups was compared. In addition, production accuracy of CHL on morphemes that varied by tense and duration was compared to assess the validity of extending theoretical accounts of children with specific language impairment to CHL. Results: CHL exhibited particular difficulty with morphosyntax relative to other aspects of language. In addition, differences across groups on accuracy and type of inaccurate productions were observed. Finally, a unified approach to explaining morphosyntax weakness in CHL was more appropriate than a linguisticor perceptual-only approach. Conclusions: Taken together, the findings of this study support a unified theoretical account of morphosyntax weakness in CHL in which both tense and duration of morphemes play a role in morphosyntax production accuracy, with a more robust role for tense than duration. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates how the variables of culture and hearing status might influence the amount of parent-child talk families engage in throughout an average day. Method: Seventeen Vietnamese and 8 Canadian families of children with hearing loss and 17 Vietnamese and 13 Canadian families with typically hearing children between the ages of 18 and 48 months old participated in this cross-comparison design study. Each child wore a Language ENvironment Analysis system digital language processor for 3 days. An automated vocal analysis then calculated an average conversational turn count (CTC) for each participant as the variable of investigation. The CTCs for the 4 groups were compared using a Kruskal-Wallis test and a set of planned pairwise comparisons. Results: The Canadian families participated in significantly more conversational turns than the Vietnamese families. No significant difference was found between the Vietnamese or the Canadian cohorts as a function of hearing status. Conclusions: Culture, but not hearing status, influences CTCs as derived by the Language ENvironment Analysis system. Clinicians should consider how cultural communication practices might influence their suggestions for language stimulation. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to analyze the changes in temporal synchrony between gesture and speech of multimodal communicative behaviors in the transition from babbling to two-word productions. Method: Ten Spanish-speaking children were observed at 9, 12, 15, and 18 months of age in a semistructured play situation. We longitudinally analyzed the synchrony between gestures and vocal productions and between their prominent parts. We also explored the relationship between gestural-vocal synchrony and independent measures of language development. Results: Results showed that multimodal communicative behaviors tend to be shorter with age, with an increasing overlap of its constituting elements. The same pattern is found when considering the synchrony between the prominent parts. The proportion of overlap between gestural and vocal elements at 15 months of age as well as the proportion of the stroke overlapped with vocalization appear to be related to lexical development 3 months later. Conclusions: These results suggest that children produce gestures and vocalizations as coordinated elements of a single communication system before the transition to the two-word stage. This coordination is related to subsequent lexical development in this period. [ABSTRACT FROM AUTHOR]

Purpose: The study aims to explore whether finite verbal morphology is affected in children/adolescents with Down syndrome (DS), whether observed deficits in this domain are indicative of a delayed or deviant development, and whether they are due to phonetic/phonological problems or deficits in phonological short-term memory. Method: An elicitation task on subject-verb agreement, a picture-naming task targeting stem-final consonants that also express verbal agreement, a nonword repetition task, and a test on grammar comprehension were conducted with 2 groups of monolingual German children: 32 children/adolescents with DS (chronological age M = 11;01 [years; months]) and a group of 16 typically developing children (chronological age M = 4;00) matched on nonverbal mental age. Results: Analyses reveal that a substantial number of children/adolescents with DS are impaired in marking verbal agreement and fail to reach an acquisition criterion. The production of word-final consonants succeeds, however, when these consonants do not express verbal agreement. Performance with verbal agreement and nonword repetition are related. Conclusions: Data indicate that a substantial number of children/adolescents with DS display a deficit in verbal agreement inflection that cannot be attributed to phonetic/phonological problems. The influence of phonological short-term memory on the acquisition of subject-verb agreement has to be further explored. [ABSTRACT FROM AUTHOR]

Purpose: This study describes a phonetic complexitybased approach for speech intelligibility and articulatory precision testing using preliminary data from talkers with amyotrophic lateral sclerosis. Method: Eight talkers with amyotrophic lateral sclerosis and 8 healthy controls produced a list of 16 low and high complexity words. Sixty-four listeners judged the samples for intelligibility, and 2 trained listeners completed phonemelevel analysis to determine articulatory precision. To estimate percent intelligibility, listeners orthographically transcribed each word, and the transcriptions were scored as being either accurate or inaccurate. Percent articulatory precision was calculated based on the experienced listeners' judgments of phoneme distortions, deletions, additions, and/or substitutions for each word. Articulation errors were weighted based on the perceived impact on intelligibility to determine word-level precision. Results: Between-groups differences in word intelligibility and articulatory precision were significant at lower levels of phonetic complexity as dysarthria severity increased. Specifically, more severely impaired talkers showed significant reductions in word intelligibility and precision at both complexity levels, whereas those with milder speech impairments displayed intelligibility reductions only for more complex words. Articulatory precision was less sensitive to mild dysarthria compared to speech intelligibility for the proposed complexity-based approach. Conclusions: Considering phonetic complexity for dysarthria tests could result in more sensitive assessments for detecting and monitoring dysarthria progression. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the impact of metaphoric actions--head nods and hand gestures--in producing Mandarin tones for first language (L1) and second language (L2) speakers. Method: In 2 experiments, participants imitated videos of Mandarin tones produced under 3 conditions: (a) speech alone, (b) speech + head nods, and (c) speech + hand gestures. Fundamental frequency was recorded for both L1 (Experiment 1) and L2 (Experiment 2a) speakers, and the output of the L2 speakers was rated for tonal accuracy by 7 native Mandarin judges (Experiment 2b). Results: Experiment 1 showed that 12 L1 speakers' fundamental frequency spectral data did not differ among the 3 conditions. In Experiment 2a, the conditions did not affect the production of 24 English speakers for the most part, but there was some evidence that hand gestures helped Tone 4. In Experiment 2b, native Mandarin judges found limited conditional differences in L2 productions, with Tone 3 showing a slight head nods benefit in a subset of "correct" L2 tokens. Conclusion: Results suggest that metaphoric bodily actions do not influence the lowest levels of L1 speech production in a tonal language and may play a very modest role during preliminary L2 learning. [ABSTRACT FROM AUTHOR]

The auditory system helps regulate phonation. A speaker's perception of their own voice is likely to be of both emotional and functional significance. Although many investigations have observed deviating voice qualities in individuals who are prelingually deaf or profoundly hearing impaired, less is known regarding how older adults with acquired hearing impairments perceive their own voice and potential voice problems. Purpose: The purpose of this study was to investigate problems relating to phonation and self-perceived voice sound quality in older adults based on hearing ability and the use of hearing aids. Method: This was a cross-sectional study, with 290 participants divided into 3 groups (matched by age and gender): (a) individuals with hearing impairments who did not use hearing aids (n = 110), (b) individuals with hearing impairments who did use hearing aids (n = 110), and (c) individuals with no hearing impairments (n = 70). All participants underwent a pure-tone audiometry exam; completed standardized questionnaires regarding their hearing, voice, and general health; and were recorded speaking in a soundproof room. Results: The hearing aid users surpassed the benchmarks for having a voice disorder on the Voice Handicap Index (VHI; Jacobson et al., 1997) at almost double the rate predicted by the Swedish normative values for their age range, although there was no significant difference in acoustical measures between any of the groups. Both groups with hearing impairments scored significantly higher on the VHI than the control group, indicating more impairment. It remains inconclusive how much hearing loss versus hearing aids separately contribute to the difference in voice problems. The total scores on the Hearing Handicap Inventory for the Elderly (Ventry & Weinstein, 1982), in combination with the variables gender and age, explained 21.9% of the variance on the VHI. Perceiving one's own voice as being distorted, dull, or hollow had a strong negative association with a general satisfaction about the sound quality of one's own voice. In addition, groupwise differences in own-voice descriptions suggest that a negative perception of one's voice could be influenced by alterations caused by hearing aid processing. Conclusions: The results indicate that hearing impairments and hearing aids affect several aspects of vocal satisfaction in older adults. A greater understanding of how hearing impairments and hearing aids relate to voice problems may contribute to better voice and hearing care. [ABSTRACT FROM AUTHOR]

Purpose: Early childhood stuttering is associated with atypical speech motor development. Compared with children who do not stutter (CWNS), the speech motor systems of school-age children who stutter (CWS) may also be particularly susceptible to breakdown under increased processing demands. The effects of increased syntactic complexity and sentence length on articulatory coordination were investigated. Method: Kinematic, temporal, and behavioral indices of articulatory coordination were quantified for school-age CWS (n = 19) and CWNS (n = 18). Participants produced 4 sentences varying in syntactic complexity (simple declarative/complex declarative with a relative clause) and sentence length (short/long). Lip aperture variability (LAVar) served as a kinematic measure of interarticulatory consistency over repeated productions. Articulation rate (syllables per second) was also calculated as a related temporal measure. Finally, we computed accuracy and stuttering frequency percentages for each sentence to assess task performance. Results: Increased sentence length, but not syntactic complexity, increased LAVar in both groups. This effect was disproportionately greater for CWS compared with CWNS. No group differences were observed for articulation rate. CWS were also less accurate in their sentence productions than fluent peers and exhibited more instances of stuttering when processing demands associated with length and syntactic complexity increases. Conclusions: The speech motor systems of school-age CWS appear to be particularly vulnerable to processing demands associated with increased sentence length, as evidenced by increased LAVar. Increasing the length and complexity of the sentence stimuli also resulted in reduced production accuracy and increased stuttering frequency. We discuss these findings within a motor control framework of speech production. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify contributors to communicative participation in adults who stutter. Specifically, it was of interest to determine whether psychosocial variables of self-esteem, self-efficacy, and social support were predictive of communicative participation beyond contributions of demographic and speech-related variables. Method: Adults who stutter (N = 339) completed an online survey that included measures of communicative participation, self-esteem, self-efficacy, social support, self-reported speech-related variables (speech usage, number of years stuttering, history of treatment and selfhelp support group participation for stuttering, and physical speech disruption severity), and demographics (age, sex, living situation, education, and employment status). Hierarchical regression was performed for prediction of communicative participation, in addition to calculating Spearman correlations between social roles variables, communicative participation, and physical speech disruption severity. Results: After controlling for demographic and speech-related variables, self-esteem, self-efficacy, and social support each significantly predicted communicative participation in adults who stutter. Large correlations were observed between communicative participation and measures of social roles, whereas medium correlations were observed between physical speech disruption severity and measures of social roles. Conclusions: Communicative participation in adults who stutter is associated with a variety of demographic, speech-related, and psychosocial variables. Speech-language pathologists should be aware of predictors of communicative participation such as self-esteem, self-efficacy, and social support, in addition to severity of physical speech disruptions. They should consider and evaluate these factors in clients who stutter and target them in treatment if necessary. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the effects of 2nd language proficiency and linguistic uncertainty on performance and listening effort in mixed language contexts. Method: Thirteen native speakers of Dutch with varying degrees of fluency in English listened to and repeated sentences produced in both Dutch and English and presented in the presence of single-talker competing speech in both Dutch and English. Target and masker language combinations were presented in both blocked and mixed (unpredictable) conditions. In the blocked condition, in each block of trials the target--masker language combination remained constant, and the listeners were informed of both prior to beginning the block. In the mixed condition, target and masker language varied randomly from trial to trial. All listeners participated in all conditions. Performance was assessed in terms of speech reception thresholds, whereas listening effort was quantified in terms of pupil dilation. Results: Performance (speech reception thresholds) and listening effort (pupil dilation) were both affected by 2nd language proficiency (English test score) and target and masker language: Performance was better in blocked as compared to mixed conditions, with Dutch as compared to English targets, and with English as compared to Dutch maskers. English proficiency was correlated with listening performance. Listeners also exhibited greater peak pupil dilation in mixed as compared to blocked conditions for trials with Dutch maskers, whereas pupil dilation during preparation for speaking was higher for English targets as compared to Dutch ones in almost all conditions. Conclusions: Both listener's proficiency in a 2nd language and uncertainty about the target language on a given trial play a significant role in how bilingual listeners attend to speech in the presence of competing speech in different languages, but precise effects also depend on which language is serving as target and which as masker. [ABSTRACT FROM AUTHOR]

Purpose: Distortion product otoacoustic emissions (DPOAEs) are a by-product of active cochlear processes that lead to the compressive nonlinearity of healthy ears. The most commonly studied emission is at the frequency 2f1--f2, but there has been recent interest in using the quadratic distortion product at the frequency f2--f1 to detect cochleopathies including endolymphatic hydrops. Before the DPOAE at f2--f1 can be applied clinically in any capacity, optimal stimulus parameters for its elicitation must be established. Method: We investigated stimulus parameters for the DPOAEs at f2--f1 and 2f1--f2 in 23 adults with normal hearing. Logarithmically swept tones between approximately 0.6 and 20 kHz (L1 = L2 = 70 dB SPL) served as the higher frequency stimulus (f2). DPOAEs were measured for 6 f2/f1 ratios: 1.14, 1.18, 1.22, 1.30, 1.32, and 1.36. Results: Both DPOAEs were consistently measurable. In line with previous investigations, the highest levels of the DPOAE at 2f1--f2 were generated between f2/f1 ratios of 1.14--1.22, with a peak in the level ratio function at 1.22. In contrast, f2--f1 was less influenced by ratio, although the narrowest ratio (1.14) produced slightly higher levels across frequency. Conclusion: The DPOAE at f2--f1 is measurable in individuals with normal hearing up to f2 of 20 kHz at narrow f2/f1 ratios. Measurements at additional stimulus levels and in subjects with hearing impairment will be needed before clinical implementation. [ABSTRACT FROM AUTHOR]

Purpose: The aims of the study were to examine the acoustic reflex screening and threshold in healthy neonates and those at risk of hearing loss and to determine the effect of birth weight and gestational age on acoustic stapedial reflex (ASR). Method: We assessed 18 healthy neonates (Group I) and 16 with at least 1 risk factor for hearing loss (Group II); all of them passed the transient evoked otoacoustic emission test that assessed neonatal hearing. The test battery included an acoustic reflex screening with activators of 0.5, 1, 2, and 4 kHz and broadband noise and an acoustic reflex threshold test with all of them, except for the broadband noise activator. Results: In the evaluated neonates, the main risk factors were the gestational age at birth and a low birth weight; hence, these were further analyzed. The lower the gestational age at birth and birth weight, the less likely that an acoustic reflex would be elicited by pure-tone activators. This effect was significant at the frequencies of 0.5, 1, and 2 kHz for gestational age at birth and at the frequencies of 1 and 2 kHz for birth weight. When the broadband noise stimulus was used, a response was elicited in all neonates in both groups. When the pure-tone stimulus was used, the Group II showed the highest acoustic reflex thresholds and the highest percentage of cases with an absent ASR. The ASR threshold varied from 50 to 100 dB HL in both groups. Group II presented higher mean ASR thresholds than Group I, this difference being significant at frequencies of 1, 2, and 4 kHz. Conclusions: Birth weight and gestational age at birth were related to the elicitation of the acoustic reflex. Neonates with these risk factors for hearing impairment were less likely to exhibit the acoustic reflex and had higher thresholds. [ABSTRACT FROM AUTHOR]

Purpose: It has been widely reported that a proportion of healthy, community-dwelling seniors will develop dysphagia in the absence of a known neurological, neuromuscular, or structural cause. Our objective was to test whether various feasible, noninvasive measures of swallowing could differentiate safe versus unsafe and efficient versus inefficient swallowing on videofluoroscopy (VF) in a sample of healthy seniors. Method: VFs from 44 (21 male, 23 female) healthy community-dwelling seniors (> 65 years old) were compared with a series of feasible, noninvasive swallowing metrics: maximal tongue strength (anterior and posterior), hand grip strength, pharyngeal volume, age, body mass index, 3-oz water swallow challenge, the 10-item Eating Assessment Tool questionnaire, and the Frailty Index. The VF protocol included 9 liquid barium boluses (3 x 5 ml thin, 3 x 20 ml thin, and 3 x 5 ml nectar). Each swallow was rated (randomized and blind) for safety using the Penetration--Aspiration Scale score and for efficiency using the Normalized Residue Ratio Scale (NRRS). Participants were deemed "unsafe" if they had any single Penetration--Aspiration Scale scores ≥ 3 and "inefficient" if they had any NRRS valleculae score > 0.082 or NRRS pyriform sinus score > 0.067. Univariate analyses of variance were run for each continuous swallowing measure by swallowing safety and swallowing efficiency status. Pearson's chisquare analyses were used to compare binary outcomes by swallow safety and efficiency status. Bonferroni corrections were applied to control for multiple comparisons. Results: None of the swallowing measures significantly differentiated safe from unsafe swallows. Although several variables trended to distinguishing efficient from inefficient swallows (age, 10-item Eating Assessment Tool, 3-oz water swallow challenge), only one variable, pharyngeal volume, was significantly different between efficient and inefficient swallows (p = .002). Conclusion: Our findings support the notion that larger pharyngeal volumes (measured using acoustic pharyngometry) are associated with worse swallowing efficiency, a finding we attribute to atrophy of the pharyngeal musculature in healthy aging. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to give an integrative answer on which speech stereotypes exist toward German gay and straight men, whether and how acoustic correlates of actual and perceived sexual orientation are connected, and how this relates to masculinity/femininity. Hence, it tests speech stereotype accuracy in the context of sexual orientation. Method: Twenty-five gay and 26 straight German speakers provided data for a fine-grained psychological selfassessment (e.g., masculinity/femininity) and explicit speech stereotypes. They were recorded for an extensive set of read and spontaneous speech samples using microphones and nasometry. Recordings were analyzed for a variety of acoustic parameters (e.g., fundamental frequency and nasalance). Seventy-four listeners categorized speakers as gay or straight on the basis of the same sentence. Results: Most relevant explicitly expressed speech stereotypes encompass voice pitch, nasality, chromaticity, and smoothness. Demonstrating implicit stereotypes, speakers were perceived as sounding straighter, the lower their median f0, center of gravity in /s/, and mean F2. However, based on actual sexual orientation, straight men only showed lower mean F1 than gay men. Additionally, we found evidence that actual masculinity/femininity and the degree of sexual orientation were reflected in gay and straight men's speech. Conclusion: Implicit and explicit speech stereotypes about gay and straight men do not contain a kernel of truth, and differences within groups are more important than differences between them. Supplemental Material: https://doi.org/10.23641/asha.6484001 [ABSTRACT FROM AUTHOR]

Purpose: Research suggests that abnormal levels of intrinsic laryngeal muscle (ILM) contraction is a potential causal factor in stress-induced voice disorders. This study seeks to characterize the ILM stress response in a cohort of vocally healthy women. Method: The authors used an unblinded, nonrandomized, repeated-measures design. Forty vocally healthy female adults were subjected to a stressful speech preparation task. Measurements of heart rate, blood pressure, trapezius muscle (positive control) activation, and tibialis muscle (negative control) activation were obtained from 37 participants before and during stressor exposure, in a nonvoice and nonspeaking task paradigm, to confirm physiological stress response compared to baseline. Fine wire electromyography of the ILMs (posterior cricoarytenoid, thyroarytenoid/lateral cricoarytenoid muscle complex, and cricothyroid) was performed simultaneously so that the activity of these muscles could be measured prior to and during stressor exposure. Results: The protocol successfully elicited the typical and expected physiological stress responses. Findings supported the hypothesis that, in some individuals, the ILMs significantly increase in activity during stress reactions compared to baseline, as do the control muscles. Conclusions: This study characterizes ILM responses to psychological stress in vocally healthy participants. Some of the female adults in this study appeared to be "laryngeal stress responders," as evidenced by increased activity of the ILMs during a silent (i.e., nonvocal, nonspeech) speech preparation task that they considered to be stressful. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to assess Cantonese word recognition and the discrimination of Cantonese tones with manipulated contours by child and adolescent cochlear implant (CI) users and a group of peers with normal hearing (NH). It was hypothesized that the CI users would perform more poorly than their counterparts with NH in both tasks and that CI users implanted before 2 years of age would perform better than those implanted after 2 years. Method: Forty-one participants were recruited from hospitals, schools, and kindergartens in Hong Kong: Ten CI users implanted at or before 2 years of age ("early" CI group), 13 CI users implanted after 2 years of age ("late" CI group), and 18 individuals with NH. The mean age at implantation of the early CI group was 1.5 years (SD = 0.3), and for the late CI group, it was 4.3 years (SD = 2.1). Participants were a mean of 13.3 years of age (SD = 3.7) at time of testing. Participants completed a Cantonese word recognition test and a discrimination task using Cantonese tones with modified fundamental frequency trajectories. Results: Both CI user groups obtained significantly lower scores than the group with NH on the word recognition test. Mean percent correct scores for the word recognition test were 79% for the early CI group, 69% for the late CI group, and 97% for the group with NH. The group with NH consistently achieved higher scores than the CI user groups when discriminating manipulated Cantonese tones. Increasing the acoustic difference between tones improved discrimination performance for CI users for level tone contrasts only. CI users implanted at or before 2 years of age obtained higher scores than those implanted later. Conclusions: The results of this study add further evidence that children using CIs do not perform as well as peers in perceiving Cantonese tones. Modification of tones to increase pitch range did not consistently improve the ability of children with implants to perceive the difference between tones. Further research is required to fully assess potential benefits of early implantation for speakers of tonal languages. [ABSTRACT FROM AUTHOR]

Purpose: The main goal of this study was to investigate the minimum amount of sensory information required to recognize spoken words (isolation points [IPs]) in listeners with cochlear implants (CIs) and investigate facilitative effects of semantic contexts on the IPs. Method: Listeners with CIs as well as those with normal hearing (NH) participated in the study. In Experiment 1, the CI users listened to unprocessed (full-spectrum) stimuli and individuals with NH listened to full-spectrum or vocoder processed speech. IPs were determined for both groups who listened to gated consonant-nucleus-consonant words that were selected based on lexical properties. In Experiment 2, the role of semantic context on IPs was evaluated. Target stimuli were chosen from the Revised Speech Perception in Noise corpus based on the lexical properties of the final words. Results: The results indicated that spectrotemporal degradations impacted IPs for gated words adversely, and CI users as well as participants with NH listening to vocoded speech had longer IPs than participants with NH who listened to full-spectrum speech. In addition, there was a clear disadvantage due to lack of semantic context in all groups regardless of the spectral composition of the target speech (full spectrum or vocoded). Finally, we showed that CI users (and users with NH with vocoded speech) can overcome such word processing difficulties with the help of semantic context and perform as well as listeners with NH. Conclusion: Word recognition occurs even before the entire word is heard because listeners with NH associate an acoustic input with its mental representation to understand speech. The results of this study provide insight into the role of spectral degradation on the processing of spoken words in isolation and the potential benefits of semantic context. These results may also explain why CI users rely substantially on semantic context. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to determine if there is a specific association between motor delays and receptive and expressive language function, respectively, in prematurely born children. Method: Retrospective data review: 126 premature children = 1,250-g birthweight from English-speaking families were evaluated on motor development (normal, mild delay, and moderate-severe delay) and the cognitive and language scales of the Bayley Scales of Infant and Toddler Development- Third Edition (Bayley, 2006) at 18 months corrected age. Cognitive scores were categorized as normal, suspect, and abnormal. Gender, demographic, and perinatal variables were recorded and analyzed with respect to motor category. Results: Lower birthweight, chronic need for oxygen, severe intraventricular hemorrhage, and intestinal infection/inflammation were related to poorer motor development. On receptive language, the normal motor group attained significantly higher scores than the moderate-severe motor group but did not differ significantly from the mild delay motor group. On expressive language, the normal motor group had significantly higher scores than both the mild and moderate-severe groups. Girls performed better than boys on receptive and expressive language, but there was no significant interaction between gender and motor category on any of the Bayley scores. Cognitive, but not motor, category significantly contributed to variance of receptive language scores; cognitive and motor category each independently contributed to the variance in expressive language. Conclusion: Findings suggest that motor control areas of the brain may be implicated in expressive language development of premature children. Further research is needed to determine the underlying factors for the association between motor and expressive language function. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to address the reported inconsistencies in the relationship between objective acoustic measures and perceptual ratings of vocal quality. Method: This tutorial moves away from the more widely examined problems related to obtaining the perceptual ratings and the acoustic measures and centers in less scrutinized issues regarding the procedure to establish the correspondence. Expressions for the most common measure of association between perceptual and acoustic measures (Pearson's r) are derived using a multiple linear regression model. The particular case where the multiple linear regression involves only roughness and breathiness is discussed to illustrate the issues. Results: Most problems reported regarding inconsistent findings in the relationship between given acoustic measures and particular perceptual ratings could be linked to sample properties not directly related to the actual relationship. The influential sample properties are the collinearity between the regressors in the multiple linear regression and their relative variances. Recommendations on how to rule out this possible cause of inconsistency are given, varying in scope from data collection, reporting, manipulation, and results interpretation. Conclusions: The problems described can be extended to more general cases than the exemplified roughness and breathiness sample's coverage. Ruling out this possible cause of inconsistency would increase the validity of the results reported. [ABSTRACT FROM AUTHOR]

Purpose: Singers are vocal athletes having specific demands from their voice and require special consideration during voice evaluation. Presently, there is a lack of standards for acoustic evaluation in them. The aim of the present study was to systematically review the available literature on the acoustic analysis of voice in singers. Method: A systematic review of studies on acoustic analysis of voice in singers (PubMed/MEDLINE, CINAHL, Scopus, ProQuest, Cochrane, Ovid, Science Direct, and Shodhganga) was carried out. Key words based on PIO (population- investigation-outcome) were used to develop search strings. Titles and abstracts were screened independently, and appropriate studies were read in full for data extraction. Results: Of the 895 studies, 26 studies met the inclusion criteria. Great variability was noted in the instruments and task used. Different acoustic measures were employed, such as fundamental frequency, perturbation, cepstral, spectral, dysphonia severity index, singing power ratio, and so forth. Conclusion: Overall, a great heterogeneity was noted regarding population, tasks, instruments, and parameters. There is a lack of standardized criteria for the evaluation of singing voice. In order to implement acoustic analysis as a part of comprehensive voice evaluation exclusively for singers, there is a certain need for methodical sound studies. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the aging effect on the categorical perception of Mandarin Chinese tones with varied fundamental frequency (F0) contours and signal duration. Method: Both younger and older native Chinese listeners with normal hearing were recruited in 2 experiments: tone identification and tone discrimination on a series of stimuli with the F0 contour systematically varying from the flat tone to the rising-falling tones. Apart from F0 contour, tone duration was manipulated at 3 levels: 100, 200, and 400 ms. Results: Results suggested that, compared with younger listeners, older listeners performed with shallower slope inthe identification function and smaller peakedness in the discrimination function, particularly for Tones 1 and 2, whereas for Tones 1 and 4, comparable categorical perception was found between younger and older listeners. Conclusions: The current study suggested that longer duration facilitated categorical perception in the flat-rising tones for the older listeners. Such an aging effect was not found with the flat-falling tones, suggesting that the agingrelated deficit in categorical perception might relate to different tone types. Aging resulted in less categoricality of Mandarin tone perception for the flat-rising tones with short duration like 100 ms, possibly due to the aging-related decline in temporal processing. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to investigate the role of external feedback in auditory perceptual learning of school-age children as compared with that of adults. Method: Forty-eight children (7-9 years of age) and 64 adults (20-35 years of age) conducted a training session using an auditory frequency discrimination (difference limen for frequency) task, with external feedback (EF) provided for half of them. Results: Data supported the following findings: (a) Children learned the difference limen for frequency task only when EF was provided. (b) The ability of the children to benefit from EF was associated with better cognitive skills. (c) Adults showed significant learning whether EF was provided or not. (d) In children, within-session learning following training was dependent on the provision of feedback, whereas between-sessions learning occurred irrespective of feedback. Conclusions: EF was found beneficial for auditory skill learning of 7-9-year-old children but not for young adults. The data support the supervised Hebbian model for auditory skill learning, suggesting combined bottom-up internal neural feedback controlled by top-down monitoring. In the case of immature executive functions, EF enhanced auditory skill learning. This study has implications for the design of training protocols in the auditory modality for different age groups, as well as for special populations. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare the motivation to change in relation to hearing problems in adults with normal hearing thresholds but who report hearing problems and that of adults with a mild-to-moderate sensorineural hearing loss. Factors related to their motivation were also assessed. Method: The motivation to change in relation to selfreported hearing problems was measured using the University of Rhode Island Change Assessment (McConnaughy, Prochaska, & Velicer, 1983). The relationship between objective and subjective measures and an adult's motivation was examined. Results: The level of hearing handicap did not differ significantly between adults with normal hearing who reported problems hearing in background noise and adults who had a mild-to-moderate sensorineural hearing loss. Hearing handicap, personal distress, and minimization of hearing loss were factors significantly related to motivation. Age, degree of hearing loss, speech-in-noise scores, working memory, and extended high-frequency average thresholds were not significantly related to their motivation. Conclusions: Adults with normal hearing thresholds but self-reported hearing problems had the same level of hearing handicap and were equally motivated to take action for their hearing problems as age-matched adults with a mild-to-moderate sensorineural hearing loss. Hearing handicap, personal distress, and minimization of hearing loss were most strongly correlated with an individual's motivation to change. [ABSTRACT FROM AUTHOR]

Purpose: Several investigators have compared infants' detection of speech in speech and nonspeech maskers to evaluate developmental differences in masking. Such comparisons have produced contradictory results, possibly because each investigation used different stimuli. The current study examined target and masker effects on infants' and adults' detection of speech. Method: An observer-based procedure was used to compare infants' and adults' detection of the vowel /▵ / and the word "baby" in a 2-talker speech masker and matched speechspectrum noise. The measure of performance was d'. A total of 43 7-month-old infants and 41 young adults were randomly assigned to 1 target-masker combination condition, and mean performance was compared across conditions at each age. Results: Adults' detection was influenced by an interaction between the target and the masker: Adults detected the vowel better in the 2-talker masker than in speechspectrum noise but detected the word equally well in the 2 maskers. In contrast, infants detected both targets better in speech-spectrum noise than in the 2-talker masker. Conclusions: The relative effects of the masker on target detection by infants and adults depend on the target to be detected. Thus, conclusions drawn about differences between infants and adults in the mechanisms responsible for masking will depend on the stimuli. Standardization of speech stimuli in developmental research would help clarify the nature of infants' segregation difficulties. [ABSTRACT FROM AUTHOR]