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

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

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

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

The purpose of the study was to examine neurophysiological, cognitive and linguistic development in deaf and hearing-impaired children (5–7 years of age) with CI and/or hearingaids and how a phonological intervention programme may influence this development. The deaf and hearing-impaired children were compared with age-matched hearing children. The results reveal that deaf and hearing-impaired children had equivalent or close to equivalent performance levels compared to hearing children for cognitive and linguistic tasks with relatively low demands on phonological processing, whereas there was a substantial and significant difference between the groups for cognitive tasks involving explicit phonological processing. The results indicate that there is a relationship between age at implant and neurophysiological, cognitive and linguistic development, where early implantation promotes faster development. The childrens´ cognitive performance increased as a function of phonological intervention.

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

Thirty-two children with hearing impairment (HI) using cochlear implants (CI) and/or hearing aids (HA), and sixteen with normal hearing (NH) participated in a computer-assisted intervention study that focused on perceiving and memorizing phonemic sounds. The first purpose was to study cognitive abilities in NH and HI children, how they related to phonological processing skills (PhPS) pre intervention and to phonological growth post intervention. The second purpose was to analyze children’s performance at different fine-grained levels of phonological processing, i.e. how they manipulated, stored and produced phonological entities of different size with or without semantic content. This was put in relation to children’s type of auditory stimulation (electrical; bilateral CI, bimodal: CI + HA and acoustical; bilateral HA). Results showed significant correlations between complex working memory and PhPS in children with HI but not in children with NH. This suggests different cognitive strategies in the children when dealing with phonological processing tasks. Poor phoneme discrimination was the strongest predictor of phonological growth in the children with HI as a function of training. Thus, the computer-assisted program was beneficial for HI children with weak initial phoneme discrimination skills. Children with CI showed reduced performance at fine-grained levels of receptive phonological processing but not on expressive phonological lexical tasks.

Aim: Study cognitive abilities; specifically working memory and lexical access in NH and DHH children, and their correlations to phonological processing skills (PhPS) pre intervention. Analyze how cognitive abilities related to phonological change post intervention. Material and Method: Tasks for lexical access, complex and visual working memory and Phpr were assessed pre and post intervention. Conclusion: DHH children performed at a lower level than NH children on lexical access but equally on complex and visual working memory. Significant correlations between complex working memory and PhPS were evident in DHH children but not in NH. This suggests that DHH children recruit more cognitive resources when performing PhPr tasks. Weak initial performance on a task for phonological representations (Phrep) was the only significant predictor of phonological change in DHH children. Weak PhRep was associated with a higher age at diagnosis, higher age at implant, and shorter usage-time with CI.

Children with mild to profound hearing impairment 5, 6 and 7 years of age, thirty-two using cochlear implants and/or hearing aids, and sixteen normal hearing children participated in a computer based phonological intervention study.The main design was a quasi-experimental design with three test sessions separated in time with four weeks. Each test session included tasks for phonological skills and letter knowledge. All children were asked to practice 10 minutes per day.Results showed that children with HI displayed a heterogeneous pattern of results with respect to phonological skills. Only 20 percent performed within the range of NH children; these were children with HA, except one child with CI/HA.Group comparisons at the first and last test session revealed that children with CI displayed difficulty with phonological working memory whereas children with HA showed less letter knowledge. Intervention revealed positive effects on accuracy of phoneme-grapheme correspondence for all children and a significant positive change on phonological processing skills for children with weak initial phonological skills., Barn med mild, måttlig och grav hörselnedsättning (HNS), i åldrarna 5, 6 och 7 år deltog i en datorbaserad fonologisk interventionsstudie. Trettiotvå barn använde cochleaimplantat (CI) och/eller hörapparat (HA). Sexton barn med normal hörsel utgjorde kontrollgrupp. Studien hade en kvasi-experimentell design med tre testtillfällen. Varje testtillfälle ägde rum med fyra veckors mellanrum och omfattade prövning av fonologiska färdigheter och bokstavskännedom. Alla deltagare informerades om att öva hemma 10 minuter per dag. Resultaten visade att barn med HNS uppvisade stor variation avseende fonologisk förmåga. Endast 20 procent presterade inom normalvariationen för normalhörande barn. Dessa var barn med HA, undantaget ett barn med CI/HA. Gruppjämförelser vid första och sista testtillfället visade att barn med CI uppvisade svårigheter med fonologiskt arbetsminne, medan barn med HA hade svagare bokstavskännedom. Interventionen visade generell effekt på säkerheten i fonem-grafemkorrespondens, och en signifikant positiv förändring avseende fonologisk bearbetningsförmåga hos barn med svagt initialt fonologiskt utgångsläge, Neurofysiologiska förutsättningar för hörande

Children with mild to profound hearing impairment (HI) using cochlear implants (CI) and/or hearingaids (HA), and children with normal hearing (NH) participated in a phonological intervention study, bymeans of a computer‐based intervention program (Graphogame, Lyytinen et al., 2009). Children were 5,6 and 7 years of age. Thirty‐two of the children used CI and/or HA. 16 children with NH served as thecontrol group. The main design was a quasi‐experimental 3 x 3 design. Each test session was separatedin time with four weeks. All children were asked to practice 10 minutes per day at home supported bytheir parents, with an intervention program primarily developed to enhance phonemic differentiation.Results showed that the children with HI displayed a heterogeneous pattern of results, specifically withrespect to their performance on the phonological tasks. Approximately 20 percent performed within therange of NH children; these were all children with HA except one child with CI/HA. Children with CIdisplayed considerable difficulty with phonological working memory whereas children with HAshowed less knowledge in letter tasks. Intervention revealed positive effects on accuracy of phonemegraphemecorrespondence for all children and a significant positive change on phonological processingskills for children with weak initial phonological skills. Enhanced phoneme‐grapheme connections maybuild associations between the phonological lexicon and the sub‐lexical phonological representations,thereby improving underlying skills essential for word learning and the development of literacy. Implicationsof this are discussed within theoretical models of phonological and lexical processing (Goswami,2000; Ramus, 2001).

Presentation högre seminarium Hälsouniversitetet, Linköping, avdelningen för logopedi 26 mars 2012

Presentation på Forsknings- och utvecklingsenheten, Akademiska sjukhuset 26 april 2012

Presentation Läkarsällskapet, Stockholm 12 mars 2012

Presentation på FAS-närverket Lund 7 april 2011

The purpose of the study was to examine neurophysiological, cognitive and linguistic development in deaf and hearing-impaired children (5–7 years of age) with CI and/or hearingaids and how a phonological intervention programme may influence this development. The deaf and hearing-impaired children were compared with age-matched hearing children. The results reveal that deaf and hearing-impaired children had equivalent or close to equivalent performance levels compared to hearing children for cognitive and linguistic tasks with relatively low demands on phonological processing, whereas there was a substantial and significant difference between the groups for cognitive tasks involving explicit phonological processing. The results indicate that there is a relationship between age at implant and neurophysiological, cognitive and linguistic development, where early implantation promotes faster development. The childrens´ cognitive performance increased as a function of phonological intervention.

Early in reading development, children generally read by using phonological decoding strategies where words are read letter by letter. Later in reading development, orthographic decoding strategies are generally used by most readers. This means that whole words are recognized directly through a process of comparing written words to mental orthographic representations, i.e. long-term memories of written words.This strategy is quicker and more efficient for reading familiar words.The process of building up a mental orthographic lexicon in long term memory is often referred to as orthographic learning (e.g. Share, 2004). In children with normal hearing and typical development, those who are better at phonological decoding also become better at constructing their orthographic lexicon. Children with cochlear implants (CI) have demonstrated relatively high reading skills despite less favorable cognitive prerequisites in terms of phonological representations, phonological working memory, phonological skills and lexical access (Asker-Árnason et al., 2007, Wass et al., 2010).The present study explores the acquistion orthographic representations in children who use CI and children who have moderate hearing impairments and use hearing aids (HA). The performance of each group was compared to that of hearing children matched for grade, nonverbal intelligence and gender.The results indicated that the children with CI did not have significantly different orthographic learning ability than their comparison group but had slightly poorer reading comprehension. The children with HA performed significantly poorer than their comparison group on orthographic learning but had similar reading skills as their comparison group on all measures of reading.

Presentation för professor Heikki Lyytinen, Graphogame sommarskola, Jyväskylä universitet, Finland 9 september 2011

Presentation FAS-nätverket Linköping 17 oktober 2011

Presentation på Resurs- och kunskapscentrum, Uppsala 25 januari 2011

Presentation vi högre seminarium Lunds universitet 11 februari 2011

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

and profound hearing impairment treated by cochlear implants (CI). In this study we explore this relationship in sixteen Swedish children with CI. We found that over 60% of the children with CI performed at the level of their hearing peers in a reading comprehension test. Demographic factors were not predictive of reading comprehension, but a complex working memory task was. Reading percentile was significantly correlated to the working memory test, but no other correlations between reading and cognitive/linguistic factors remained significant after age was factored out. Individual results from a comparison of the two best and the two poorest readers corroborate group results, confirming the important role of working memory for reading as measured by comprehension of words and sentences in this group of children.

The present study investigated the relationships between orthographic learning and other aspects of reading (phonological and orthographic decoding and comprehension) in Swedish children (age 7–9yrs). Cognitive correlates of orthographic learning were also studied, as well as the cognitive predictors of decoding skill and reading comprehension. The results indicated that orthographic learning was related to all the other aspects of reading. Orthographic learning and decoding skills were both related to phonological and visuospatial working memory. Reading comprehension was associated with phonological- and general working memory. The findings are discussed with reference to the component model of working memory.