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Purpose: Finite element (FE) models have emerged as a powerful method to study biomechanical complexities of velopharyngeal (VP) function. However, existing models have overlooked the active contributions of the lateral pharyngeal wall (LPW) in VP closure. This study aimed to develop and validate a more comprehensive FE model of VP closure to include the superior pharyngeal constrictor (SPC) muscle within the LPW as an active component of VP closure. Method: The geometry of the velum and the lateral and posterior pharyngeal walls with biomechanical activation governed by the levator veli palatini (LVP) and SPC muscles were incorporated into an FE model of VP closure. Differing muscle activations were employed to identify the impact of anatomic contributions from the SPC muscle, LVP muscle, and/or velum for achieving VP closure. The model was validated against normative magnetic resonance imaging data at rest and during speech production. Results: A highly accurate and validated biomechanical model of VP function was developed. Differing combinations and activation of muscles within the LPW and velum provided insight into the relationship between muscle activation and closure patterns, with objective quantification of anatomic change necessary to achieve VP closure. Conclusions: This model is the first to include the anatomic properties and active contributions of the LPW and SPC muscle for achieving VP closure. Now validated, this method can be utilized to build robust, comprehensive models to understand VP dysfunction. This represents an important advancement in patient-specific modeling of VP function and provides a foundation to support development of computational tools to meet clinical demand. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to pilot the efficacy of rapid syllable transition (ReST) treatment when provided once per week for a 50-min treatment session for 12 weeks with five children with childhood apraxia of speech. Of central importance was the children's retention and generalization of gains from treatment as indicators of speech motor learning. Method: A multiple-baseline across-participant design was employed to investigate (a) treatment effect on the 20 treated pseudowords, (b) generalization to 40 untreated real words and 10 untreated polysyllabic word sentences, and (c) maintenance of any treatment and generalization goals to up to 4 months posttreatment. To investigate any difference between in-session performance and retention, a comparison was made between data collected during treatment and probe sessions. Results: Treatment data collected during therapy showed all children improving across their 12 treatment sessions. Three of the five children showed a treatment effect on treated pseudowords in the probe sessions, but only one child showed generalization to untreated real words, and no children showed generalization to sentences. Conclusions: ReST treatment delivered at a dose frequency of once per week was efficacious for only one of the five children. In-session treatment data were not a reliable indicator of children's learning. One session per week of ReST therapy is therefore not recommended. Supplemental Material: https://doi.org/10.23641/asha.23751018 [ABSTRACT FROM AUTHOR]

Purpose: Speech-Music Therapy for Aphasia (SMTA), a method that combines speech therapy and music therapy, is introduced as a treatment method for childhood apraxia of speech (CAS). SMTA will be evaluated in a proof-of-principle study. The first case study is presented herein. Method: SMTA was evaluated in a study with a single-subject experimental design comparing 10 weeks of treatment with 2 months of no treatment. The research protocol included a pretest, baseline phase, treatment phase, posttest, no-treatment phase, and follow-up test. The participant was a boy with CAS aged 5;8 (years;months). Outcome measures were selected to reflect both intelligibility in daily communication as well as features of CAS and speech motor planning and programming. Results: Results on the Intelligibility in Context Scale-Dutch (ICS-Dutch) and in the analysis of a spontaneous speech sample suggest generalization of treatment effects. Improvements were found in measures that reflect complex speech motor skills, that is, the production of consonant clusters and consistency. Conclusions: This case study showed that speech production of the participant improved after treatment with SMTA. Although intelligibility as measured with the ICS-Dutch improved over the study period, objectifying changes at the level of intelligibility in daily communication proved to be difficult. Additional measures may be necessary to gain more insight into treatment effects at this level. Overall, the results of this first case study provide sufficient support and important leads for further evaluation of SMTA in the treatment of CAS in a proof-of-principle study. [ABSTRACT FROM AUTHOR]

Purpose: Developmental language disorder (DLD) and autism sometimes appear as overlapping conditions in behavioral tests. There is much literature on the visual scanning pattern (VSP) of faces in autistic children, but this is scarce regarding those with DLD. The purpose of this study was to compare the VSP of faces in young children with DLD, those with autism, and typically developing peers, assessing the effect of three variables. Method: Two eye-tracking experiments were designed to assess the effect of the emotion and the poser's gender (Experiment 1) and the poser's age (Experiment 2) on the VSP of participants (Experiment 1: N = 59, age range: 32-74 months; Experiment 2: N = 58, age range: 32-74 months). We operationalized the VSP in terms of attentional orientation, visual preference, and depth of processing of each sort of face. We developed two paired preference tasks in which pairs of images of faces showing different emotions were displayed simultaneously to compete for children's attention. Results: Data analysis revealed two VSP markers common to both disorders: (a) superficial processing of faces and (b) late orientation to angry and child faces. Moreover, one specific marker for each condition was also found: typical preference for child faces in children with DLD versus diminished preference for them in autistic children. Conclusions: Considering the similarities found between children with DLD and those with autism, difficulties of children with DLD in attention to faces have been systematically underestimated. Thus, more effort must be made to identify and respond to the needs of this population. Clinical practice may benefit from the potential of eye-tracking methodology and the analysis of the VSP to assess attention to faces in both conditions. This would also contribute to the improvement of early differential diagnosis in the long run. [ABSTRACT FROM AUTHOR]

Purpose: Developmental language disorder (DLD) is a neurodevelopmental disorder that impacts approximately 7% of the population and is characterized by unexplained deficits in expressive and/or receptive components of language. A common procedural learning task, serial reaction time (SRT), has been used to develop models of the basis of DLD. However, paradigms involve differing levels of implicit and explicit learning during this task, muddying interpretations of the data. Here, we tested adults with DLD on implicit and explicit SRT tasks to better understand implicit and explicit procedural learning in this population. We hypothesized that adults with DLD would demonstrate reduced learning on only the implicit SRT task, as alternate explicit neural mechanisms could lead to equivalent performance on the explicit task. Method: Fifty participants (25 with DLD and 25 with typical language) completed implicit and explicit SRT tasks, measuring their ability to learn visually presented 10-element sequences. Group differences were evaluated on sequence learning, error rates, and explicit recall of the sequence after learning. Results: Sequence learning was the same between the groups on both tasks. However, individuals with DLD showed increased errors and significantly worse recall of the explicitly learned sequence. Conclusions: Results suggest that sequence learning may be intact in this population, while aspects of explicit learning and motoric responses are impaired. Results are interpreted in light of a neurobiological model of DLD. [ABSTRACT FROM AUTHOR]

Purpose: This article describes DigiSpan, a new computer-controlled auditory test of forward and reverse digit span, designed to be administered by clinicians, and presents normative and test-retest reliability data for adults. Method: DigiSpan mimics conventional live-voice tests in that it commences with trials that ascend in length until a stopping criterion is met, giving rise to a conventional scaled score. It then administers five additional adaptive trials, the length of which depends on the correctness of the response to the previous trial. Each of these two segments of the measurement gives rise to a scaled score. The ascending and adaptive scores are averaged to give an overall score and subtracted to produce an internal measure of consistency, and hence reliability. Young adults with an Mage of 25 years (N = 163) were tested, of whom 65 were retested on a separate day. Results: The scaled scores from the conventional ascending trials were highly consistent with existing normative data based on live-voice tests. Combination of the conventional scaled score with a scaled score based on the adaptive trials led to 44% reduction in error variance for forward memory span and 20% reduction for reverse memory span. The average of these (32%) is similar to but (insignificantly) less than the 42% reduction in error variance that can be predicted based on adding the five adaptive trials. Conclusions: Replacing live-voice production of digits by a clinician with recorded, computer-controlled production has not affected the difficulty of the test. Adding five additional trials around the sequence length that a test participant can just remember has produced a decrease in measurement error. In addition, the availability of separate scaled scores for the ascending and adaptive phases enables the reliability of the combined score to be checked, for both forward and reverse measurements. The combination of standardized delivery, increased accuracy, internal reliability check, and fast automated scoring makes the test highly suitable for clinical use. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the psychometric functioning of a new criterionreferenced assessment of adolescent social communication, the Transition Pragmatics Interview (TPI), based on the synthesis model of pragmatics. Two ways of interpreting item difficulty were explored: (a) as a function of the synthesis model elements of social communication ability that items were designed to assess, and (b) as a function of the developmental level required for a successful response based on an adapted situational-discourse-semantics (SDS) model (Norris & Hoffman, 1993). Method: Thirty-seven participants aged 14–22 years completed the TPI. Responses were analyzed using Rasch analysis to evaluate the functioning of the scale and to determine item difficulty. Items were coded for the SDS developmental level required for an adequate response. The mean Rasch item difficulty for items at each SDS developmental level was analyzed for the five adapted SDS domains. Results: Consistent with the first approach for interpreting item difficulty, TPI items varied in difficulty as a function of the element of social communication they were designed to assess (p < .001). Interpreting item difficulty based on the adapted SDS model was not supported: Items requiring higher SDS developmental levels were not more difficult than those requiring less (p = .55). Conclusions: The TPI responses fit the Rasch model, supporting the TPI as a unidimensional measure and supporting the use of all items together to compute a single number that summarizes the level of social communication for each examinee. The item ordering from least to most difficult was consistent with prior findings on adolescent social communication development. [ABSTRACT FROM AUTHOR]

Purpose: Verbal working memory is poorer for children with hearing loss than for peers with normal hearing (NH), even with cochlear implantation and early intervention. Poor verbal working memory can affect academic performance, especially in higher grades, making this deficit a significant problem. This study examined the stability of verbal working memory across middle childhood, tested working memory in adolescents with NH or cochlear implants (CIs), explored whether signal enhancement can improve verbal working memory, and tested two hypotheses proposed to explain the poor verbal working memory of children with hearing loss: (a) Diminished auditory experience directly affects executive functions, including working memory; (b) degraded auditory inputs inhibit children’s abilities to recover the phonological structure needed for encoding verbal material into storage. Design: Fourteen-year-olds served as subjects: 55 with NH; 52 with CIs. Immediate serial recall tasks were used to assess working memory. Stimuli consisted of nonverbal, spatial stimuli and four kinds of verbal, acoustic stimuli: nonrhyming and rhyming words, and nonrhyming words with two kinds of signal enhancement: audiovisual and indexical. Analyses examined (a) stability of verbal working memory across middle childhood, (b) differences in verbal and nonverbal working memory, (c) effects of signal enhancement on recall, (d) phonological processing abilities, and (e) source of the diminished verbal working memory in adolescents with cochlear implants. Results: Verbal working memory remained stable across middle childhood. Adolescents across groups performed similarly for nonverbal stimuli, but those with CIs displayed poorer recall accuracy for verbal stimuli; signal enhancement did not improve recall. Poor phonological sensitivity largely accounted for the group effect. Conclusions: The central executive for working memory is not affected by hearing loss or cochlear implantation. Instead, the phonological deficit faced by adolescents with CIs denigrates the representation in storage and augmenting the signal does not help. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this research note is to introduce a new appraisal form, the Classroom Communication and Collaboration (C3) Appraisal, designed to evaluate communication and collaboration within classroom settings. Method: A comprehensive synthesis of the key skills from a broad range of publications on successful communication and collaboration in the classroom was conducted. The resulting appraisal comprises 39 items across six scales: crafting clear messages, appropriateness of communication exchange, active listening, pragmatics and discourse, communication breakdown, and collaboration. To demonstrate its application, an exemplar usage of the C3 Appraisal involving a hearing child and a child with hearing loss engaged in a collaborative learning task is presented. Results: The C3 Appraisal allowed for the quality and successfulness of the collaborative learning task between the two children to be assessed and quantified across the six scales. Conclusions: These findings highlight the utility of the C3 Appraisal as a valuable tool for evaluating communication and collaboration in classroom environments. Next steps are to test the reliability and validity of the C3 Appraisal on a large data set. [ABSTRACT FROM AUTHOR]

Purpose: We explore a new approach to the study of cognitive effort involved in listening to speech by measuring the brain activity in a listener in relation to the brain activity in a speaker. We hypothesize that the strength of this brain-to-brain synchrony (coupling) reflects the magnitude of cognitive effort involved in verbal communication and includes both listening effort and speaking effort. We investigate whether interbrain synchrony is greater in native-to-native versus native-tononnative communication using functional near-infrared spectroscopy (fNIRS). Method: Two speakers participated, a native speaker of American English and a native speaker of Korean who spoke English as a second language. Each speaker was fitted with the fNIRS cap and told short stories. The native English speaker provided the English narratives, and the Korean speaker provided both the nonnative (accented) English and Korean narratives. In separate sessions, fNIRS data were obtained from seven English monolingual participants ages 20–24 years who listened to each speaker’s stories. After listening to each story in native and nonnative English, they retold the content, and their transcripts and audio recordings were analyzed for comprehension and discourse fluency, measured in the number of hesitations and articulation rate. No story retellings were obtained for narratives in Korean (an incomprehensible language for English listeners). Utilizing fNIRS technique termed sequential scanning, we quantified the brain-to-brain synchronization in each speaker–listener dyad. Results: For native-to-native dyads, multiple brain regions associated with various linguistic and executive functions were activated. There was a weaker coupling for native-to-nonnative dyads, and only the brain regions associated with higher order cognitive processes and functions were synchronized. All listeners understood the content of all stories, but they hesitated significantly more when retelling stories told in accented English. The nonnative speaker hesitated significantly more often than the native speaker and had a significantly slower articulation rate. There was no brain-to-brain coupling during listening to Korean, indicating a break in communication when listeners failed to comprehend the speaker. Conclusions: We found that effortful speech processing decreased interbrain synchrony and delayed comprehension processes. The obtained brain-based and behavioral patterns are consistent with our proposal that cognitive effort in verbal communication pertains to both the listener and the speaker and that brain-to-brain synchrony can be an indicator of differences in their cumulative communicative effort [ABSTRACT FROM AUTHOR]

Purpose: The American Speech-Language-Hearing Association (ASHA) has committed to advancing diversity, equity, and inclusion (DEI) in the profession of speech and hearing sciences. However, there exist significant discrepancies between the demographics of our members and the populations served. These discrepancies extend to the participants included within our research publications. This article addresses participant selection when conducting research investigations. First, we draw attention to standards of conduct that are present within and outside the field. Second, we highlight inequities that exist. We explore a case study as an example. Finally, we offer suggestions to help rectify the problem. Conclusions: Inequities at the level of participants’ selection result in discrepant access to clinical services and evidence-based research for multilingual individuals; neurodiverse individuals; and Black, Indigenous, and people of color communities. ASHA and researchers alike can show commitment to DEI by addressing this problem from multiple approaches. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to systematically identify items that measure communicative participation from measurement instruments that measure (aspects of) communication and/or participation in children and adolescents (5–18 years old) with communication disorders, for developing an item bank. Method: A systematic literature search was performed in MEDLINE and Embase to search for patient-reported outcome measures (PROMs) or parent reports measuring aspects of communication and/or participation in children and adolescents. The individual items of the included measurement instruments were reviewed on whether they measure communicative participation. The items were then classified into one of the International Classification of Functioning, Disability and Health (ICF) for Children and Youth (World Health Organization, 2007) domains of activities and participation. Results: A total of 29 instruments were found, nine PROMs and 20 parent reports. One hundred forty-five items were identified that measure communicative participation. From these 145 items, 74 were retrieved from PROMs (51%), and 71 were retrieved from parent reports (49%). The majority of items were classified in ICF Domain 7, interpersonal interactions and relationships (73.8%), followed by Domain 8, major life areas (13.8%), and Domain 9, community, social, and civic life (8.3%). Only a few items were found in Domains 5 and 6, and none was found in Domains 1, 2, and 4. Conclusions: We identified 145 items potentially useful for developing an item bank addressing communicative participation in children and adolescents with communication disorders. However, item development in collaboration with the target population is needed to ensure that these items fully reflect the construct. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to develop a valid and reliable bilingual version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) for the auditory-perceptual evaluation of voice in Catalan and Spanish speakers. Method: The development of this CAPE-V adaptation included Delphi methodology with 20 voice and speech experts reaching consensus on the optimal adapted terminology of the perceptual vocal attributes, considering also input from the original instrument authors. The adaptation and validation of vocal tasks followed a sequential validation procedure, with input from phoneticians and speech-language pathologists. Following pilot testing with a large sample of speech-language pathology students, a refined adapted version was empirically tested for validity and reliability. Concurrent validity was assessed by comparing the adapted CAPE-V with the reference Grade, Roughness, Breathiness, Asthenia, Strain scale. Construct validity was assessed through convergent and discriminant validity analysis. Intrarater and interrater reliability were assessed via intraclass correlation coefficient calculations. User experience was evaluated through a questionnaire. Scale properties were validated using a confusion matrix, and cutoff values were calculated to achieve the optimal balance between sensitivity and specificity. Results: Through a formalized consensus process, optimal Catalan/Spanish terminology was determined for the perceptual attributes of voice present in the CAPE-V. An adapted protocol of tasks was obtained that preserves the objectives of the original instrument and the relevance of the phonetic criteria in the target languages. The results demonstrated concurrent validity, construct validity, and intrarater reliability. Interrater reliability was found to depend on the extent to which evaluators shared their internal standards. The raters identified CAPE-V as an effective and preferred instrument. Conclusion: An adapted, validated version of the CAPE-V is made available to clinical professionals for the evaluation of voice in Catalan and Spanish speakers. [ABSTRACT FROM AUTHOR]

Purpose: Speech and language disorders can negatively affect preschool children’s communicative participation skills. Focus on the Outcomes of Communication Under Six-34 (FOCUS-34) is a valid and reliable scale that evaluates communicative participation in preschool children with speech and language disorders. This study aimed to establish the Turkish version of FOCUS-34 (FOCUS-34-TR) and investigate its validity and reliability. Method: A total of 175 children with language disorders, speech sound disorders, and fluency disorders (aged 20-72 months) and their parents were included in the study. Parents were asked to complete the demographic information form, the FOCUS-34-TR scale, and the Ages and Stages Questionnaires: Social-Emotional (ASQ-SE) Turkish version. The construct validity, convergent and divergent validity, internal consistency, and test-retest reliability of the scale were investigated. Results: The FOCUS-34-TR had high values for internal consistency (α = .97) and test-retest reliability (r = .95). The correlations between the FOCUS-34-TR total score and its subscales were between .77 and .90. A moderately significant negative correlation was found between the FOCUS-34-TR scale and the ASQ-SE. Conclusion: The Turkish version of FOCUS-34 is a valid and reliable scale that can be used in clinics and for research purposes to evaluate the communicative participation skills of Turkish-speaking preschool children with speech and language disorders. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the effectiveness of a self-administered naming treatment for one individual, B.N., presenting with semantic variant primary progressive aphasia (svPPA) and a history of traumatic brain injury (TBI). Method: Naming treatment included components of Lexical Retrieval Cascade Treatment and was self-administered using an adaptive spaced retrieval software, Anki. Using a multiple-baseline, single-case experimental design, naming accuracy probes were taken during pretreatment, treatment, posttreatment, and follow-up (through 12 months) for 60 trained words and 10 untrained words. Item-level Bayesian generalized mixed-effects models were used to estimate (a) the treatment effect for trained words, (b) change in untrained words, and (c) maintenance of treatment effects from posttreatment to each subsequent follow-up. Results: Statistical analyses revealed that a gain of 35 out of 60 trained words (35.3; 90% CI [30.6, 39.5]) was directly attributable to treatment. Following treatment, evidence of generalization to untrained words was not observed. During the follow-up period, there was gradual decline in naming accuracy of trained items. Conclusions: The positive treatment results reported here support the use of self-administered naming treatments for those with svPPA and a history of TBI. Although the utility of this treatment approach is constrained by patient factors including motivation, self-administered naming treatments represent a unique opportunity to expand access to speech-language intervention for people with svPPA, including those with concomitant diagnoses. [ABSTRACT FROM AUTHOR]

Purpose: According to most models of spoken word recognition, listeners probabilistically activate a set of lexical candidates, which is incrementally updated as the speech signal unfolds. Speech carries segmental (speech sound) as well as suprasegmental (prosodic) information. The role of the latter in spoken word recognition is less clear. We investigated how suprasegments (tone and voice quality) in three North Germanic language varieties affected lexical access by scrutinizing temporally fine-grained neurophysiological effects of lexical uncertainty and information gain. Method: Three event-related potential (ERP) studies were reanalyzed. In all varieties investigated, suprasegments are associated with specific word endings. Swedish has two lexical “word accents” realized as pitch falls with different timings across dialects. In Danish, the distinction is in voice quality. We combined pronunciation lexica and frequency lists to calculate estimates of lexical uncertainty about an unfolding word and information gain upon hearing a suprasegmental cue and the segment upon which it manifests. We used single-trial mixed-effects regression models run every 4 ms. Results: Only lexical uncertainty showed solid results: a frontal effect at 150-400 ms after suprasegmental cue onset and a later posterior effect after 200 ms. While a model including only segmental information mostly performed better, it was outperformed by the suprasegmental model at 200-330 ms at frontal sites. Conclusions: The study points to suprasegmental cues contributing to lexical access over and beyond segments after around 200 ms in the North Germanic varieties investigated. Furthermore, the findings indicate that a previously reported “pre-activation negativity” predominantly reflects forward-looking processing. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine the effects of residual hearing slopes and cochlear implant frequency map settings on bimodal and electric– acoustic stimulation (EAS) benefits in speech perception. Method: Adults with normal hearing were recruited for simulated bimodal and EAS hearing. Sentence perception was measured unilaterally and bilaterally. For the acoustic stimulation, three slopes of high-frequency hearing loss were created using low-pass filters with a cutoff frequency of 500 Hz: steep (96 dB/ octave), medium (48 dB/octave), and shallow (24 dB/octave). For the electric stimulation, an eight-channel sinewave vocoder was used with an output frequency range (1000–7938 Hz) with three input frequency ranges to create frequency maps, overlap (188–7938 Hz), meet (500–7938 Hz), and gap (750– 7938 Hz), relative to the cutoff frequency in the acoustic stimulation. Results: The largest bimodal/EAS benefit occurred with the shallow slope, and the smallest occurred with the steep slope. The effects of the slopes on bimodal/EAS benefit were greatest with the meet or gap map and the least with the overlap map. EAS benefit was greater than bimodal benefit at higher signalto-noise ratios regardless of frequency map. Conclusions: The results indicate that correlation between bimodal/EAS benefit and residual hearing could potentially improve if slopes were considered. The optimal frequency map differed with different slopes, suggesting that the slopes of residual hearing should be carefully considered in fitting bimodal and EAS hearing. EAS hearing provided greater benefit over bimodal hearing, suggesting that spectrotemporal integration was better within one ear (i.e., EAS) than across ears (i.e., bimodal). [ABSTRACT FROM AUTHOR]

Purpose: Talkers adapt their speech according to the demands of their listeners and the communicative context, enhancing the properties of the signal (pitch, intensity) and/or properties of the code (enhancement of phonemic contrasts). This study asked how mothers adapt their child-directed speech (CDS) in ways that might serve the immediate goals of increasing intelligibility, as well as longterm goals of supporting speech and language development in their children. Method: Mothers (N = 28) participated in a real-time interactive speech production/perception paradigm, in which mothers instructed their young (3- to 5-year-old) children, or an adult listener, to select the picture corresponding to a target word. The task was performed at low and high levels (56 vs. 75 dB SPL) of background noise to examine the Lombard effects of decreased audibility on speech production. Results: Acoustic–phonetic analyses of CDS and adult-directed speech (ADS) productions of target words and carrier phrase (e.g., “Find pig”) revealed that mothers significantly enhanced the mean pitch, pitch variability, and intensity of target words in CDS, particularly at higher background noise levels and for younger children. Mothers produce CDS with a higher signal-to-noise ratio than ADS. However, limited evidence was found for phonetic enhancement of the segmental properties of speech. Although increased category separation was found in the voice onset time of stop consonants, decreased vowel category separation (an anti-enhancement effect) was observed in CDS. Conclusions: Mothers readily enhance the suprasegmental signal properties of their speech in CDS, but not the acoustic–phonetic properties of phonemes. This study fails to provide evidence of phonetic enhancement in preschool children in a dyadic communication task under noisy listening conditions. [ABSTRACT FROM AUTHOR]

Background: Understanding the different factors that determine vocabulary development in young children is essential for the diagnosis and rehabilitation of language disorders in children. Language development is closely related to other cognitive processes such as auditory verbal learning and memory. This research focuses on the development of a novel auditory verbal learning test (AVLT) for 4- and 5-year-old children within the Dutch population. This new test is an adaptation of the common AVLT for both older children and adults, usually including a list of 15 words. Considering the lower attention span and limited executive functioning in young children, the word list of this new instrument is reduced to 10 words. Besides, a second recognition form has been developed to improve the ability to distinguish between possible underlying learning and memory deficits. Method: Ninety-five preschool children (ages 4;0–5;12 [years;months]) were tested with this new AVLT 10-word test for kids (10WT-K), yielding different measures of verbal auditory memory. Forty-eight of 95 children received a recognition task with semantically unrelated items, and 47 of 95 received a recognition task with semantically related items. Three additional language skills were assessed to establish test validation: receptive and expressive vocabulary performance and nonword repetition. Outcome of the 10WT-K was related to scores on the language measures. Results: Positive correlations were found between the total score of the 10WT-K and all three aforementioned language skills. We found no correlations between frequency of error types (intrusions and repetitions) and language measures. Furthermore, children who were administered the recognition list with semantically related items showed fewer correct answers and more false-positive and falsenegative responses than children who received a recognition list with semantically unrelated items. Conclusions: The 10WT-K for young children can be used to (a) measure different aspects of auditory verbal learning and memory, (b) clarify the nature of possible verbal learning difficulties, and (c) identify a possible nature of language disorders. The word recognition task tested with semantically related items provides a more accurate measurement of individual differences, namely, in distinguishing retrieval and storage abilities. The significant relation found between auditory verbal short-term memory capacity and vocabulary performance in preschool children is a first step toward establishing test validity. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the effectiveness of the stuttering modification intervention Kinder Dürfen Stottern (KIDS) in school-age children who stutter. Method: Seventy-three children who stutter were included in this multicenter, two-group parallel, randomized, wait-list controlled trial with a follow-up of 12 months. Children aged 7–11 years were recruited from 34 centers for speech therapy and randomized to either the immediate-treatment group or the 3 months delayed-treatment group. KIDS was provided by 26 clinicians who followed a treatment manual. Although the primary outcome measure was the impact of stuttering (Overall Assessment of the Speaker’s Experience of Stuttering–School-Age [OASES-S]), the secondary outcomes included objective and subjective data on stuttering severity. Results: At 3 months postrandomization, the mean score changes of the OASESS differed significantly between the experimental (n = 33) and control group (n = 29; p = .026). Furthermore, treatment outcomes up to 12 months were analyzed (n = 59), indicating large effects of time on the OASES-S score (p < .001, partial η² = .324). This was paralleled by significant improvements in parental ratings and objective ratings (stuttering severity, frequency, and physical concomitants). Conclusions: The significant short-term treatment effects in the OASES-S are in line with the (initial) focus of KIDS on cognitive and affective aspects of stuttering. Over 12 months, these changes were maintained and accompanied by behavioral improvements. The results suggest that individual treatment with KIDS is an adequate treatment option for this age group. [ABSTRACT FROM AUTHOR]

Purpose: This study examines the effects of an auditory training program on the auditory and cognitive abilities of older adults. Auditory rehabilitation programs are generally designed for hearing aid users, and studies have demonstrated benefits for them. In this study, we seek to understand whether such a training program can also benefit older adults who do not wear hearing aids. We also examined if cognitive benefits can indeed be observed as a result of the training. Method: Sixty-four older adults were recruited and assigned into three groups: the experimental group (n = 20), the active control group (n = 21), and the notraining control group (n = 23). The experimental group underwent an auditory training program (Listening and Communication Enhancement [LACE]) during the training phase. Meanwhile, the active control group listened to short audio clips and the no-training control group did not participate in any program. An auditory test (Quick Speech-in-Noise [QuickSIN]) and a battery of cognitive tests were conducted before and after the training to examine the participants' performance on auditory ability, short-term memory, and attention. Results: The results showed improvements in auditory and cognitive abilities during the training period. When assessing the training effects by comparing the pre- and the posttraining performances, a significant improvement on the QuickSIN task was found in the training group but not in the other two groups. However, other cognitive tests did not show any significant improvement. That is, the LACE training did not benefit short-term memory and attention. The improved performance on short-term memory during the training was not maintained in the posttraining session. Conclusion: Overall, the study has extended the auditory benefit from the LACE training to the typical aging population in terms of improved communication ability, but the effect of training on auditory abilities did not transfer to gains in cognitive abilities. [ABSTRACT FROM AUTHOR]

Purpose: Many models of language comprehension assume that listeners predict the continuation of an incoming linguistic stimulus immediately after its onset, based on only partial linguistic and contextual information. Their related developmental models try to determine which cues (e.g., semantic or morphosyntactic) trigger such prediction, and to which extent, during different periods of language acquisition. One morphosyntactic cue utilized predictively in many languages, inter alia German, is grammatical gender. However, studies of the developmental trajectories of the acquisition of predictive gender processing in German remain a few. Method: This study attempts to shed light on such processing strategies used in noun phrase decoding among children acquiring German as their first language by examining their eye movements during a language--picture matching task (N = 78, 5--10 years old). Its aim was to confirm whether the eye movements indicated the presence of age-specific differences in the processing of a gender cue, provided either in isolation or in combination with a semantic cue. Results: The results revealed that German children made use of predictive gender processing strategies from the age of 5 years onward; however, the pace of online gender processing, as well as confidence in the predicted continuation, increased up to the age of 10 years. Conclusion: Predictive processing of gender cues plays a role in German language comprehension even in children younger than 8 years. [ABSTRACT FROM AUTHOR]

Purpose: Communication is as much persuasion as it is the transfer of information. This creates a tension between the interests of the speaker and those of the listener, as dishonest speakers naturally attempt to hide deceptive speech and listeners are faced with the challenge of sorting truths from lies. Listeners with hearing impairment in particular may have differing levels of access to the acoustical cues that give away deceptive speech. A greater tendency toward speech pauses has been hypothesized to result from the cognitive demands of lying convincingly. Higher vocal pitch has also been hypothesized to mark the increased anxiety of a dishonest speaker. Method: Listeners with or without hearing impairments heard short utterances from natural conversations, some of which had been digitally manipulated to contain either increased pausing or raised vocal pitch. Listeners were asked to guess whether each statement was a lie in a two-alternative forced-choice task. Participants were also asked explicitly which cues they believed had influenced their decisions. Results: Statements were more likely to be perceived as a lie when they contained pauses, but not when vocal pitch was raised. This pattern held regardless of hearing ability. In contrast, both groups of listeners self-reported using vocal pitch cues to identify deceptive statements, though at lower rates than pauses. Conclusions: Listeners may have only partial awareness of the cues that influence their impression of dishonesty. Listeners with hearing impairment may place greater weight on acoustical cues according to the differing degrees of access provided by hearing aids. [ABSTRACT FROM AUTHOR]

Purpose: This study assesses how spectrotemporal degradations that can occur in the sound transmission of a cochlear implant (CI) may influence the ability of non-native listeners to recognize the intended meaning of utterances based on the position of the prosodically focused word. Previous research suggests that perceptual accuracy and listening effort are negatively affected by CI processing (or CI simulations) or when the speech is presented in a non-native language, in a number of tasks and circumstances. How these two factors interact to affect prosodic focus interpretation, however, remains unclear. Method: In an online experiment, normal-hearing (NH) adolescent and adult native Dutch learners of English and a small control group of NH native English adolescents listened to CI-simulated (eight-channel noise-band vocoded) and non-CI-simulated English sentences differing in prosodically marked focus. For assessing perceptual accuracy, listeners had to indicate which of four possible context questions the speaker answered. For assessing listening effort, a dualtask paradigm was used with a secondary free recall task. Results: The results indicated that prosodic focus interpretation was significantly less accurate in the CI-simulated condition compared with the non-CIsimulated condition but that listening effort was not increased. Moreover, there was no interaction between the influence of the degraded CI-simulated speech signal and listening groups in either their perceptual accuracy or listening effort. Conclusion: Non-native listeners are not more strongly affected by spectrotemporal degradations than native listeners, and less proficient non-native listeners are not more strongly affected by these degradations than more proficient nonnative listeners. [ABSTRACT FROM AUTHOR]

Purpose: For voice perception, two voice cues, the fundamental frequency (fo) and/or vocal tract length (VTL), seem to largely contribute to identification of voices and speaker characteristics. Acoustic content related to these voice cues is altered in cochlear implant transmitted speech, rendering voice perception difficult for the implant user. In everyday listening, there could be some facilitation from top-down compensatory mechanisms such as from use of linguistic content. Recently, we have shown a lexical content benefit on just-noticeable differences (JNDs) in VTL perception, which was not affected by vocoding. Whether this observed benefit relates to lexicality or phonemic content and whether additional sentence information can affect voice cue perception as well were investigated in this study. Method: This study examined lexical benefit on VTL perception, by comparing words, time-reversed words, and nonwords, to investigate the contribution of lexical (words vs. nonwords) or phonetic (nonwords vs. reversed words) information. In addition, we investigated the effect of amount of speech (auditory) information on fo and VTL voice cue perception, by comparing words to sentences. In both experiments, nonvocoded and vocoded auditory stimuli were presented. Results: The outcomes showed a replication of the detrimental effect reversed words have on VTL perception. Smaller JNDs were shown for stimuli containing lexical and/or phonemic information. Experiment 2 showed a benefit in processing full sentences compared to single words in both fo and VTL perception. In both experiments, there was an effect of vocoding, which only interacted with sentence information for fo. Conclusions: In addition to previous findings suggesting a lexical benefit, the current results show, more specifically, that lexical and phonemic information improves VTL perception. fo and VTL perception benefits from more sentence information compared to words. These results indicate that cochlear implant users may be able to partially compensate for voice cue perception difficulties by relying on the linguistic content and rich acoustic cues of everyday speech. Supplemental Material: https://doi.org/10.23641/asha.23796405 [ABSTRACT FROM AUTHOR]

Purpose: Previous studies have shown that individuals who stutter exhibit abnormal speech perception in addition to disfluent production as compared with their nonstuttering peers. This study investigated whether adult Chinese-speaking stutterers are still able to use knowledge of statistical regularities embedded in their native language to recognize spoken words and, if so, how much acoustic information is needed to trigger this information. Method: Seventeen stutterers and 20 typical, nonstuttering controls participated in a gating experiment. All participants listened to monosyllabic words that consisted of syllables and lexical tones and were segmented into eight successive gates. These words differed in syllable token frequency and syllable-tone cooccurrence probability in line with a Chinese spoken word corpus. The correct syllable-only, correct tone-only, correct syllable-tone word, and correct syllable-incorrect tone responses were analyzed between the two groups using mixed-effects models. Results: Stutterers were less accurate overall than controls, with fewer correct syllables, tones, and their combination as words. However, stutterers showed consistent and reliable perceptual patterns triggered by statistical information of speech, as reflected by more accurate responses to high-frequency syllables, high-probability tones, and tone errors all in manners similar to those of nonstuttering controls. Conclusions: Stutterers' atypical speech perception is not due to a lack of statistical learning. Stutterers were able to perceive spoken words with phonological tones based on statistical regularities embedded in their native speech. This finding echoes previous production studies of stuttering and lends some support for a link between perception and production. Implications of pathological, diagnostic, and therapeutic conditions of stuttering are discussed. [ABSTRACT FROM AUTHOR]

Purpose: The spatiotemporal index (STI) is a standard metric for quantifying the stability and patterning of speech movements. The STI has often been applied to individual speech articulators, but an STI derived from the acoustic signal offers a composite and easily obtained measure that incorporates multiple components of the speech production complex. In this work, we examine the relationship between kinematic and acoustic STIs in children with and without developmental language disorder (DLD), with the aim of determining whether the acoustic and kinematic STIs reflect similar degrees of production variability. Method: A total of 85 children with DLD and with typical language development (or typically developing [TD] children), aged 4-8 years, were studied. In this methodological article, two experiments were conducted: one deliberately selected because group differences were observed in the kinematic STI (i.e., sentence production) and one in which there were no group differences in the kinematic STI (i.e., nonword production). These two experiments are representative of speech stability studies. The aim was to determine whether the acoustic STI (i.e., amplitude envelope) results aligned with those obtained via the kinematic STI (i.e., lip motion). Results: In sentence production, most group differences aligned across kinematic and acoustic STI measures. The acoustic, but not the kinematic, STI showed higher variability in children with DLD compared with the 6-year-old TD group. In nonword production, neither the kinematic STI nor the acoustic STI differentiated children with DLD from TD children. In each experiment, the kinematic and acoustic STIs showed a moderate-to-strong correlation. Conclusions: The kinematic and acoustic STIs assess different components of speech movement patterning. However, the relationship between acoustic and kinematic spatiotemporal stability is strong in two tasks of varying linguistic complexity in children with and without DLD. These findings are promising for future experimental work in this area. [ABSTRACT FROM AUTHOR]

Purpose: Emotional voice conveys important social cues that demand listeners' attention and timely processing. This event-related potential study investigated the feasibility of a multifeature oddball paradigm to examine adult listeners' neural responses to detecting emotional prosody changes in nonrepeating naturally spoken words. Method: Thirty-three adult listeners completed the experiment by passively listening to the words in neutral and three alternating emotions while watching a silent movie. Previous research documented preattentive change-detection electrophysiological responses (e.g., mismatch negativity [MMN], P3a) to emotions carried by fixed syllables or words. Given that the MMN and P3a have also been shown to reflect extraction of abstract regularities over repetitive acoustic patterns, this study employed a multifeature oddball paradigm to compare listeners' MMN and P3a to emotional prosody change from neutral to angry, happy, and sad emotions delivered with hundreds of nonrepeating words in a single recording session. Results: Both MMN and P3a were successfully elicited by the emotional prosodic change over the varying linguistic context. Angry prosody elicited the strongest MMN compared with happy and sad prosodies. Happy prosody elicited the strongest P3a in the centro-frontal electrodes, and angry prosody elicited the smallest P3a. Conclusions: The results demonstrated that listeners were able to extract the acoustic patterns for each emotional prosody category over constantly changing spoken words. The findings confirm the feasibility of the multifeature oddball paradigm in investigating emotional speech processing beyond simple acoustic change detection, which may potentially be applied to pediatric and clinical populations. [ABSTRACT FROM AUTHOR]

Purpose: Early language and communication interventions for children with language impairments have been shown to be effective in assessments administered immediately after treatment. The purpose of the current systematic review and meta-analysis was to assess the overall durability of those effects over time and whether durability was related to outcome type, etiology of child language impairments, implementer of intervention, magnitude of posttest effects, time between intervention and follow-up, and study risk of bias. Method: We conducted a systematic search of online databases and reference lists to identify experimental and quasi-experimental group design studies. All studies tested the effects of early communication interventions at least 3 months post-intervention. Participants were children 0–5 years old with language impairments. Coders identified study features and rated methodological quality indicators for all studies. Effect sizes at long-term timepoints and associations with potential moderators were estimated using multilevel meta-analysis with robust variance estimation. Results: Twenty studies with 129 long-term outcome effect sizes met inclusion criteria. Studies included children with developmental language disorders or language impairment associated with autism. The overall average effect size was small and significant (g = .22, p = .002). Effect size estimates were larger for prelinguistic outcomes (g = .36, p < .001) than for linguistic outcomes (g = .14, p = .101). Significant factors were the posttest effect sizes, the risk of bias for randomized trials, and etiology of language impairment for linguistic outcomes. Time post-intervention did not significantly predict long-term effect sizes. Conclusions: Outcomes of early language and communication interventions appear to persist for at least several months post-intervention. More research is needed with collection and evaluation of long-term outcomes, a focus on measurement, and consistency of primary study reporting. [ABSTRACT FROM AUTHOR]

Purpose: Our study addresses three main questions: (a) Do autistics and neurotypicals produce different patterns of disfluencies, depending on the experimenter's direct versus averted gaze? (b) Are these patterns correlated to gender, skin conductance responses, fixations on the experimenter's face, alexithymia, or social anxiety scores? Lastly, (c) can eye-tracking and electrodermal activity data be used in distinguishing listener- versus speaker-oriented disfluencies? Method: Within a live face-to-face paradigm combining a wearable eye-tracker with electrodermal activity sensors, 80 adults (40 autistics, 40 neurotypicals) defined words in front of an experimenter who was either staring at their eyes (direct gaze condition) or looking elsewhere (averted gaze condition). Results: Autistics produce less listener-oriented (uh, um) and more speaker-oriented (prolongations, breath) disfluencies than neurotypicals. In both groups, men produce less um than women. Both autistics' and neurotypicals' speech are influenced by whether their interlocutor systematically looks at them in the eyes or not, but their reactions go in opposite directions. Disfluencies seem to primarily be linguistic phenomena as experienced stress, social attention, alexithymia, and social anxiety scores do not influence any of the reported results. Finally, eye-tracking and electrodermal activity data suggest that laughter could be a listener-oriented disfluency. Conclusions: This article studies disfluencies in a fine-grained way in autistic and neurotypical adults while controlling for social attention, experienced stress, and experimental condition (direct vs. averted gaze). It adds to current literature by (a) enlightening our knowledge of speech in autism, (b) opening new perspectives on disfluency patterns as important signals in social interaction, (c) addressing theoretical issues on the dichotomy between listener- and speaker-oriented disfluencies, and (d) considering understudied phenomena as potential disfluencies (e.g., laughter, breath). [ABSTRACT FROM AUTHOR]

Purpose: This article reviews 43 adaptations of the MacArthur–Bates Communicative Development Inventories (MB-CDIs), a tool used for measuring children’s communicative and language skills. The aim is to provide an overview of different approaches to develop local versions of the instrument (reflecting linguistic and cultural specifics) and to formulate recommendations and suggestions that expand the current guidelines of the MB-CDI Advisory Board. The article also discusses cross-linguistic differences in the structure of this tool, as well as the availability of sources for the language-specific MB-CDI adaptations. Conclusions: Strategies differ in the construction of the inventory contents and in the norming phase, as well as in documenting reliability and validity. The most frequent strategies in developing the item lists are translations of existing CDIs and pilot administrations; relatively recent strategies include consultations with child development experts. The norming approach varies in, for example, the number of participants and techniques of administrations. When establishing age-related norms, different methods of growth curve construction are used. We recommend methods that consider the complete data set and provide a code example. We suggest that the reliability of the tool should be documented not only as internal consistency but also using test–retest measures, ideally combined with interrater agreement. It is desirable that adaptations establish criterion validity against other measures of language development, such as structured tests, spontaneous language samples, or experimental methods. In summary, by critically reviewing the different adaptation strategies, the present review article provides guidance for teams that adapt the MB-CDI into new languages. [ABSTRACT FROM AUTHOR]

Purpose: Small-N studies are the dominant study design supporting evidencebased interventions in communication science and disorders, including treatments for aphasia and related disorders. However, there is little guidance for conducting reproducible analyses or selecting appropriate effect sizes in small-N studies, which has implications for scientific review, rigor, and replication. This tutorial aims to (a) demonstrate how to conduct reproducible analyses using effect sizes common to research in aphasia and related disorders and (b) provide a conceptual discussion to improve the reader’s understanding of these effect sizes. Method: We provide a tutorial on reproducible analyses of small-N designs in the statistical programming language R using published data from Wambaugh et al. (2017). In addition, we discuss the strengths, weaknesses, reporting requirements, and impact of experimental design decisions on effect sizes common to this body of research. Results: Reproducible code demonstrates implementation and comparison of within-case standardized mean difference, proportion of maximal gain, tau-U, and frequentist and Bayesian mixed-effects models. Data, code, and an interactive web application are available as a resource for researchers, clinicians, and students. Conclusions: Pursuing reproducible research is key to promoting transparency in small-N treatment research. Researchers and clinicians must understand the properties of common effect size measures to make informed decisions in order to select ideal effect size measures and act as informed consumers of small-N studies. Together, a commitment to reproducibility and a keen understanding of effect sizes can improve the scientific rigor and synthesis of the evidence supporting clinical services in aphasiology and in communication sciences and disorders more broadly. [ABSTRACT FROM AUTHOR]

Purpose: General language abilities of children with cochlear implants have been thoroughly investigated, especially at young ages, but far less is known about how well they process language in real-world settings, especially in higher grades. This study addressed this gap in knowledge by examining recognition of sentences with complex syntactic structures in backgrounds of speech babble by adolescents with cochlear implants, and peers with normal hearing. Design: Two experiments were conducted. First, new materials were developed using young adults with normal hearing as the normative sample, creating a corpus of sentences with controlled, but complex syntactic structures presented in three kinds of babble that varied in voice gender and number of talkers. Second, recognition by adolescents with normal hearing or cochlear implants was examined for these new materials and for sentence materials used with these adolescents at younger ages. Analyses addressed three objectives: (1) to assess the stability of speech recognition across a multiyear age range, (2) to evaluate speech recognition of sentences with complex syntax in babble, and (3) to explore how bottom-up and top-down mechanisms account for performance under these conditions. Results: Results showed: (1) Recognition was stable across the ages of 10-14 years for both groups. (2) Adolescents with normal hearing performed similarly to young adults with normal hearing, showing effects of syntactic complexity and background babble; adolescents with cochlear implants showed poorer recognition overall, and diminished effects of both factors. (3) Top-down language and working memory primarily explained recognition for adolescents with normal hearing, but the bottom-up process of perceptual organization primarily explained recognition for adolescents with cochlear implants. Conclusions: Comprehension of language in real-world settings relies on different mechanisms for adolescents with cochlear implants than for adolescents with normal hearing. A novel finding was that perceptual organization is a critical factor. [ABSTRACT FROM AUTHOR]

Purpose: In skilled speech production, sets of articulators, such as the jaw, tongue, and lips, work cooperatively to achieve task-specific movement goals, despite rampant contextual variation. Efforts to understand these functional units, termed coordinative structures, have focused on identifying the essential control parameters responsible for allowing articulators to achieve these goals, with some research focusing on temporal parameters (relative timing of movements) and other research focusing on spatiotemporal parameters (phase angle of movement onset for one articulator, relative to another). Here, both types of parameters were investigated and compared in detail. Method: Ten talkers recorded nonsense, disyllabic/tV#Cat/utterances using electromagnetic articulography, with alternative V and C across variation in rate (fast-slow) and stress (first syllable stressed-unstressed). Two measures were obtained: (a) the timing of tongue-tip raising onset for medial C, relative to jaw opening-closing cycles and (b) the angle of tongue-tip raising onset, relative to the jaw phase plane. Results: Results showed that any manipulation that shortened the jaw openingclosing cycle reduced both the relative timing and phase angle of the tonguetip movement onset, but relative timing of tongue-tip movement onset scaled more consistently with jaw opening-closing across rate and stress variation. Conclusion: These findings suggest the existence of an intrinsic timing mechanism (or "central clock") that is the primary control parameter for coordinative structures, with online compensation then allowing these structures to achieve their goals spatially. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was twofold: (a) to determine whether there are speech rhythm differences between preschool-age children who stutter that were eventually diagnosed as persisting (CWS-Per) or recovered (CWS-Rec) and children who do not stutter (CWNS), using empirical spectral analysis and empirical mode decomposition of the speech amplitude envelope, and (b) to determine whether speech rhythm characteristics close to onset are predictive of later persistence. Method: Fifty children (3-4 years of age) participated in the study. Approximately 2-2.5 years after the experimental testing took place, children were assigned to the following groups: CWS-Per (nine boys, one girl), CWS-Rec (18 boys, two girls), and CWNS (18 boys, two girls). All children produced a narrative based on a text-free storybook. From the audio recordings of these narratives, fluent utterances were selected for each child from which seven envelope-based measures were extracted. Group-based differences on each measure as well as predictive analyses were conducted to identify measures that discriminate CWS-Per versus CWS-Rec. Results: CWS-Per were found to have a relatively higher degree of power in suprasyllabic oscillations and greater variability in the timing of syllabic rhythms especially for longer utterances. A logistic regression model using two speech rhythm measures was able to discriminate the eventual outcome of recovery versus persistence, with 80% sensitivity and 75% specificity. Conclusion: Findings suggest that envelope-based speech rhythm measures are a promising approach to assess speech rhythm differences in developmental stuttering, and its potential for identification of children at risk of developing persistent stuttering should be investigated further. [ABSTRACT FROM AUTHOR]

Purpose: The present brain-behavior study examined whether sensory registration or neural inhibition processes explained variability in the behavioral most comfortable level (MCL) and background noise level (BNL) components of the acceptable noise level (ANL) measure. Method: A traditional auditory gating paradigm was used to evoke neural responses to pairs of pure-tone stimuli in 32 adult listeners with normal hearing. Relationships between behavioral ANL, MCL, and BNL components and cortical responses to each of the paired stimuli were analyzed using linear mixedeffects regression analyses. Results: Neural responses elicited by Stimulus 2 in the gating paradigm significantly predicted the computed ANL response. The MCL component was significantly associated with responses elicited by Stimulus 1 of the pair. The BNL component of the ANL was significantly associated with neural responses to both Stimulus 1 and Stimulus 2. Conclusions: The results suggest neural processes related to neural inhibition support the ANL and BNL component while neural stimulus registration properties are associated with the MCL a listener chooses. These findings suggest that differential neural mechanisms underlie the separate MCL and BNL components of the ANL response. [ABSTRACT FROM AUTHOR]

Purpose: Acoustic and perceptual quantification of vocal strain has been a vexing problem for years. To increase measurement rigor, a suitable single-variable matching stimulus for strain was developed and validated, based on the matching stimulus used previously for breathy and rough voice qualities. Method: A set of 21 comparison stimuli for a single-variable matching task (SVMT) was synthesized based on a speech-shaped sawtooth waveform mixed with speech-shaped noise. Variable bandpass filter gain in mid-to-high frequencies achieved a wide range of computed sharpness (in constant sharpness steps) and served as the independent variable for the SVMT. Ten natural /ɑ/ stimuli with a wide range of the primary voice quality of strain and a minimum of breathiness or roughness were selected and assessed using the SVMT. Natural voice samples and synthetic comparison stimuli were also assessed using a perceptual magnitude estimation (ME) task. Results: ME data validated the correspondence of the set of comparison stimuli to varying perceived strain. Perceived strain magnitudes of the comparison stimuli increased significantly and linearly with computed sharpness (r² = .99). A linear regression revealed that strain matching values were significantly predicted by computed sharpness (r² = .96) and perceived strain magnitudes (r² = .95) of the natural voice stimuli. Conclusion: The perception of vocal strain is strongly associated with computed sharpness and is captured accurately and precisely using an SVMT, in which the independent variable is the bandpass filter gain (in steps of equal sharpness) applied to the comparison stimuli. [ABSTRACT FROM AUTHOR]

Purpose: Pitch plays an important role in auditory perception of music and language. This study provides a systematic review with meta-analysis to investigate whether individuals with autism spectrum disorder (ASD) have enhanced pitch processing ability and to identify the potential factors associated with processing differences between ASD and neurotypicals. Method: We conducted a systematic search through six major electronic databases focusing on the studies that used nonspeech stimuli to provide a qualitative and quantitative assessment across existing studies on pitch perception in autism. We identified potential participant- and methodology-related moderators and conducted metaregression analyses using mixed-effects models. Results: On the basis of 22 studies with a total of 464 participants with ASD, we obtained a small-to-medium positive effect size (g = 0.26) in support of enhanced pitch perception in ASD. Moreover, the mean age and nonverbal IQ of participants were found to significantly moderate the between-studies heterogeneity. Conclusions: Our study provides the first meta-analysis on auditory pitch perception in ASD and demonstrates the existence of different developmental trajectories between autistic individuals and neurotypicals. In addition to age, nonverbal ability is found to be a significant contributor to the lower level/local processing bias in ASD. We highlight the need for further investigation of pitch perception in ASD under challenging listening conditions. Future neurophysiological and brain imaging studies with a longitudinal design are also needed to better understand the underlying neural mechanisms of atypical pitch processing in ASD and to help guide auditory-based interventions for improving language and social functioning. [ABSTRACT FROM AUTHOR]

Purpose: The graphic symbol is the foundation of augmentative and alternative communication (AAC) for many preliterate individuals; however, research has focused primarily on static graphic symbol sequences despite mainstream commercial technologies such as animation. The goal of this study was to compare static and animated symbol sequences across receptive communication outcome measures and psycholinguistic features (e.g., word frequency). Method: A counterbalanced, 2 × 2 × 2 mixed design was used to investigate the effects of symbol format (animated and static), first condition (animated or static), and first experimental task (identification or labeling) on identification accuracy and labeling accuracy of graphic symbol sequences (five symbols) in 24 children with typical development ages 7 and 8 years old. Additionally, three 2 × 2 repeated-measures analyses of variance were conducted using symbol format (animated and static) and (a) word frequency (low, high), (b) imageability (low, high), and (c) concreteness (low, high). Results: In addition to superior identification and labeling accuracy of animated sequences, a significant interaction between symbol format and the first condition was observed for both experimental tasks. When the animation format was the first condition, then the children's performance improved in the subsequent static condition. Finally, word frequency, imageability, and concreteness ratings for all verbs and prepositions had significant effects on labeling accuracy of verbs and prepositions. Significant interactions between symbol format and psycholinguistic features were also found. For example, highly imageable, animated verbs were labeled with greater accuracy when compared with all other variables. Conclusions: Animation technology appears to alleviate some of the burden associated with word- and sentence-level outcomes in children with typical development. Moreover, animation appears to reduce the effects of psycholinguistic features such as word frequency and imageability by increasing the transparency of the symbol. Given the increase in research in this area, speech-language pathologists may consider adopting animated graphic symbols on a case-by-case basis as a tool to augment the learning of word classes in which movement is integral to comprehension. [ABSTRACT FROM AUTHOR]

Purpose: This study reports the development, refinement, and exploration of the psychometric properties of the Vanderbilt Responses to Your Child's Speech (VRYCS) rating scale, a novel measure designed to assess parents' self-perceived responses to the speech of their children who stutter (CWS). Method: Parents of 214 young (ages 2;4[years;months]–5;11) CWS completed the original 40-item version of the VRYCS. Content analyses and an exploratory factor analysis determined the scale's factors and identified specific items corresponding to each. Items that did not load onto the factors were removed and internal consistency was assessed. Results: The final 18-item VRYCS rating scale includes five factors relating to parents' responses to the speech of their CWS including (a) Requesting Change, (b) Speaking for the Child, (c) Supporting Communication, (d) Slowing and Simplifying, and (e) Responding Emotionally. Reliability was demonstrated, responses by parents of CWS were described, and a revised scoring form developed. Conclusions: The VRYCS is a valid and reliable tool for assessing and exploring parents' perceptions of their own responses to the speech of their CWS for clinical and research purposes. Clinical applications of the VRYCS for assessment and treatment of childhood stuttering are discussed. [ABSTRACT FROM AUTHOR]

Purpose: The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) is a standardized instrument used in voice assessment to assess voice quality. It has been translated and culturally adapted in several languages. This study aimed at developing and validating a Tamil version of CAPE-V through auditory perceptual evaluation of remotely recorded voice samples. Method: The Tamil version was adapted with permission from the American Speech-Language-Hearing Association to match the rationale in English CAPE-V. The sentences were constructed by the first author and validated for content by two panels of experts. Forty-five participants (15 cases and 30 controls) were included in the study. Data recording was conducted online (Zoom Video Communications, Inc., app) for all samples. Three raters participated in the auditory evaluation and scored all samples using Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale followed by CAPE-V with a week gap in between. Twenty percent of samples were repeated to assess intrarater reliability. The intrarater and interrater reliability measures for Tamil CAPE-V were established using intraclass coefficients (ICCs). To ensure construct validity, group differences were determined between the cases and controls. The concurrent validity was established by correlating Tamil CAPE-V with the GRBAS scale. Results: The intrarater reliability for Tamil CAPE-V ranged from moderate to excellent (ICC: .610–.998). The Tamil CAPE-V obtained moderate to good interrater reliability for all parameters (ICC: .525–.790) except pitch (ICC: .405). The differences between the cases and controls were statistically significant (p < .01). The correlation between CAPE-V and GRBAS was strong for overall severity, breathiness, and strain (rs = .725–.861) and moderate for roughness (rs = .678). Conclusion: The Tamil CAPE-V is a reliable and valid tool for auditory perceptual evaluation in Tamil-speaking populations. [ABSTRACT FROM AUTHOR]

Purpose: Effects related to literacy acquisition have been observed at different levels of speech processing. This study investigated the link between orthographic knowledge and children's perception and production of specific speech sounds. Method: Sixty Spanish-speaking second graders, differing in their phonological decoding skills, completed a speech perception and a production task. In the perception task, a behavioral adaptation of the oddball paradigm was used. Children had to detect orthographically consistent /t/, which has a unique orthographic representation (〈t〉), and inconsistent /k/, which maps onto three different graphemes (〈c〉, 〈qu〉, and 〈k〉), both appearing infrequently within a repetitive auditory sequence. In the production task, children produced these same sounds in meaningless syllables. Results: Perception results show that all children were faster at detecting consistent than inconsistent sounds regardless of their decoding skills. In the production task, however, the same facilitation for consistent sounds was linked to better decoding skills. Conclusions: These findings demonstrate differences in speech sound processing related to literacy acquisition. Literacy acquisition may therefore affect already-formed speech sound representations. Crucially, the strength of this link in production is modulated by individual decoding skills. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to develop a child self-report questionnaire measuring bilingual experience and self-perceptions of Spanish and English proficiency and establish preliminary evidence of validity and reliability for the questionnaire. Method: Participants included 113 Spanish-English bilingual children with and without developmental language disorders ranging in age from 4 to 8 years. All children completed the questionnaire in Spanish and participated in behavioral assessment of their language skills in both Spanish and English. Results: Using confirmatory factor analysis, a model with three correlated factors (self-perception of proficiency in Spanish, self-perception of proficiency in English, and bilingual experience) emerged with the best global fit, reasonableness, consistency with theory, and model parsimony, suggesting that the questionnaire has good internal reliability. The scaled results of the questionnaires significantly correlated with behavioral measures of both Spanish and English, supporting the convergent validity of the measure. Conclusions: The Houston Questionnaire is an assessment tool for the assessment of bilingual experience and self-perception of proficiency in Spanish and English bilingual children between the ages of 4 and 8 years. The results provide foundational evidence supporting the reliability and convergent validity of this tool. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to advance the use of structured, monologic discourse analysis by validating an automated scoring procedure for core lexicon (CoreLex) using transcripts. Method: Forty-nine transcripts from persons with aphasia and 48 transcripts from persons with no brain injury were retrieved from the AphasiaBank database. Five structured monologic discourse tasks were scored manually by trained scorers and via automation using a newly developed CLAN command based upon previously published lists for CoreLex. Point-to-point (or word-by-word) accuracy and reliability of the two methods were calculated. Scoring discrepancies were examined to identify errors. Time estimates for each method were calculated to determine if automated scoring improved efficiency. Results: Intraclass correlation coefficients for the tasks ranged from .998 to .978, indicating excellent intermethod reliability. Automated scoring using CLAN represented a significant time savings for an experienced CLAN user and for inexperienced CLAN users following step-by-step instructions. Conclusions: Automated scoring of CoreLex is a valid and reliable alternative to the current gold standard of manually scoring CoreLex from transcribed monologic discourse samples. The downstream time saving of this automated analysis may allow for more efficient and broader utilization of this discourse measure in aphasia research. To further encourage the use of this method, go to https://aphasia.talkbank.org/discourse/CoreLexicon/for materials and the step-by-step instructions utilized in this project. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this study was to experimentally evaluate how compensating for the adverse acoustic effects of a posterior glottal opening (PGO) by increasing subglottal pressure and changing supraglottal compression, as have been associated with vocal hyperfunction, influences the risk of vocal fold (VF) trauma. Method: A self-oscillating synthetic silicone model of the VFs with an airflow bypass that modeled a PGO was investigated in a hemilaryngeal flow facility. The influence of compensatory mechanisms on collision pressure and dissipated collision power was investigated for different PGO areas and supraglottal compression. Compensatory behaviors were mimicked by increasing the subglottal pressure to achieve a target sound pressure level (SPL). Results: Increasing the subglottal pressure to compensate for decreased SPL due to a PGO produced higher values for both collision pressure and dissipated collision power. Whereas a 10-mm² PGO area produced a 12% increase in the peak collision pressure, the dissipated collision power increased by 122%, mainly due to an increase in the magnitude of the collision velocity. This suggests that the value of peak collision pressure may not fully capture the mechanisms by which phonotrauma occurs. It was also found that an optimal value of supraglottal compression exists that maximizes the radiated SPL, indicating the potential utility of supraglottal compression as a compensatory mechanism. Conclusions: Larger PGO areas are expected to increase the risk of phonotrauma due to the concomitant increase in dissipated collision power associated with maintaining SPL. Furthermore, the risk of VF damage may not be fully characterized by only the peak collision pressure. [ABSTRACT FROM AUTHOR]

Purpose: Individual-randomized trials are the gold standard for testing the efficacy and effectiveness of drugs, devices, and behavioral interventions. Health care delivery, educational, and programmatic interventions are often complex, involving multiple levels of change and measurement precluding individual randomization for testing. Cluster-randomized trials and cluster-randomized stepped-wedge trials are alternatives where the intervention is allocated at the group level, such as a clinic or a school, and the outcomes are measured at the person level. These designs are introduced along with the statistical implications of similarities among individuals within the same cluster. We also illustrate the parameters that have the most impact on the likelihood of detecting intervention effects, which must be considered when planning these trials. Conclusion: Cluster-randomized and stepped-wedge designs should be considered by researchers as experimental alternatives to individual-randomized trials when testing speech, language, and hearing care interventions in real-world settings. [ABSTRACT FROM AUTHOR]

Purpose: Growing evidence suggests that fatigue associated with listening difficulties is particularly problematic for children with hearing loss (CHL). However, sensitive, reliable, and valid measures of listening-related fatigue do not exist. To address this gap, this article describes the development, psychometric evaluation, and preliminary validation of a suite of scales designed to assess listening-related fatigue in CHL: the pediatric versions of the Vanderbilt Fatigue Scale (VFS-Peds). Method: Test development employed best practices, including operationalizing the construct of listening-related fatigue from the perspective of target respondents (i.e., children, their parents, and teachers). Test items were developed based on input from these groups. Dimensionality was evaluated using exploratory factor analyses (EFAs). Item response theory (IRT) and differential item functioning (DIF) analyses were used to identify high-quality items, which were further evaluated and refined to create the final versions of the VFS-Peds. Results: The VFS-Peds is appropriate for use with children aged 6-17 years and consists of child self-report (VFS-C), parent proxy-report (VFS-P), and teacher proxy-report (VFS-T) scales. EFA of child self-report and teacher proxy data suggested that listening-related fatigue was unidimensional in nature. In contrast, parent data suggested a multidimensional construct, composed of mental (cognitive, social, and emotional) and physical domains. IRT analyses suggested that items were of good quality, with high information and good discriminability. DIF analyses revealed the scales provided a comparable measure of fatigue regardless of the child's gender, age, or hearing status. Test information was acceptable over a wide range of fatigue severities and all scales yielded acceptable reliability and validity. Conclusions: This article describes the development, psychometric evaluation, and validation of the VFS-Peds. Results suggest that the VFS-Peds provide a sensitive, reliable, and valid measure of listening-related fatigue in children that may be appropriate for clinical use. Such scales could be used to identify those children most affected by listening-related fatigue, and given their apparent sensitivity, the scales may also be useful for examining the effectiveness of potential interventions targeting listening-related fatigue in children. [ABSTRACT FROM AUTHOR]

Purpose: The spatiotemporal index (STI) is a widely used approach for measuring speech pattern stability across multiple repetitions of a stimulus. In this study, we examine how methodological choices in the implementation of the STI (including the number of repetitions, length of stimuli, and parsing procedure) can affect its value. Method: To evaluate how each methodological decision affects the STI, we use a synthetic data framework that allows for the generation of random productions of the template phrase “Buy Bobby a Puppy” at different stability levels. Within this framework, we conduct three experiments: Experiment 1 investigates the effects of the number of repetitions, Experiment 2 investigates the effects of stimulus length, and Experiment 3 investigates the effects of parsing errors. Results: In Experiment 1, we observed that STI values based on fewer repetitions will systematically underestimate larger repetition estimates. Experiment 2 showed that STI values will tend to be higher when calculated on longer (multimovement) stimuli independent of any differences in the stability of the underlying speech patterns. Finally, in Experiment 3, we showed that even minor parsing errors (≈ 10 ms) increase the value of the STI. Conclusions: The results of this study illustrate that even minor choices in the implementation of the STI can have a noticeable impact on the resulting value. These findings highlight the care that needs to be taken when designing studies and comparing STI values across studies to ensure that different STI values are capturing real differences in motion pattern stability rather than trivial methodological variation. [ABSTRACT FROM AUTHOR]

Purpose: Physically active adults have experienced training benefits from fish oil-derived omega-3 fatty acid (FO n3), which may also be of benefit to singers. The purpose of this research study was to determine if self-reported vocal adaptations and body composition changes occur in singers following FO n3 supplementation in conjunction with a singer's normal training regimen. Method: Twenty college students, currently enrolled in vocal lessons at a university, were randomized to receive either 3.0 g of FO n3 or placebo, which they took during a 10-week study period. Participants were blinded to group assignment. Participants completed the Reflux Symptom Index (RSI), Singing Voice Handicap Index-10 (SVHI-10), and the Evaluation of Ability to Sing Easily (EASE) and submitted to body composition measures (weight, skeletal mass, and body fat mass) before and after the study period. Results: Sixteen participants completed all parts of the study protocol. Mean compliance for the placebo group (83.9%) and the supplement group (75.2%) was similar. There were no significant differences in body composition measures, RSI scores, and EASE scores between groups. Scores on the SVHI-10 decreased significantly over time for all participants. Conclusions: Improvements seen in the SVHI-10 were not meaningfully different between the supplement and placebo group, pointing to the benefit of weekly lessons. The lack of changes in the questionnaire scores in the supplement group are partially attributed to the low compliance rate and low sample size, which is supported by the lack of change in the body composition measures. [ABSTRACT FROM AUTHOR]

Purpose: Auditory-perceptual evaluation is essential for the assessment of voice quality. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) provides a standardized protocol and assessment form for clinicians to analyze the voice quality and has been adapted into several different languages. The aims of this study were to develop the Japanese version of the CAPE-V and to investigate its reliability and validity. Method: The Japanese CAPE-V consisted of the same three speech contexts (vowels, sentences, and conversation) as developed in the original English version. The sentences were designed according to the concepts of the original version and reviewed by Japanese phoneticians. To validate the usefulness of the Japanese CAPE-V, voices of 173 Japanese-speaking subjects (76 subjects with dysphonia and 97 without voice complaints) were evaluated by five experienced judges, according to the Japanese CAPE-V as well as the GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) scale. Results: The Japanese CAPE-V provided a high interrater reliability (intraclass correlation coefficients [ICCs] > .85 for all the parameters) as well as a high intrarater reliability (ICCs > .85 for all the parameters). In addition, overall severity, roughness, and breathiness in the Japanese CAPE-V were highly correlated with the corresponding dimensions in the GRBAS scale, having Spearman correlation coefficients greater than .8. Conclusion: This study demonstrated the reliability and validity of the newly developed Japanese CAPE-V as an auditory-perceptual evaluation instrument. [ABSTRACT FROM AUTHOR]