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Two prototype voice output communication aids were implemented to compare methods of graphic symbol message formulation; one emulated current devices that require syntactical ordering of icons (Default) and the other used semantic frames (iconCHAT). Message constructions of eight typically developing children (7-10 years of age) using both prototypes were compared in terms of accuracy, speed, complexity, and preference. Although there were slight differences in speed, all participants formulated equally complex and grammatically accurate sentences using both prototypes. These findings demonstrate that semantic frame-based message formulation may be a viable alternative to conventional methods based on syntax. Future research to assess whether these findings extend to children who use AAC is warranted. Outcomes and benefits of semantic composition are particularly relevant for children with emerging grammatical skills since semantic schemas provide scaffolding for constructing complete utterances that may in turn foster increased self-confidence and improved perceptions of communicative competence. (Contains 2 tables and 5 figures.)

Purpose: Acquisition of prosodic control appears to evolve across development with younger children relying on durational cues and older children utilizing a broader spectrum of cues including fundamental frequency, intensity, and duration. This study aimed to determine whether unfamiliar listeners could identify prosodic contrasts produced by 4-, 7-, and 11-year-olds despite differences in acoustic cues used by each age group. Method: Thirty-six adult monolingual speakers of American English participated as listeners. A previous study yielded speech recordings from 12 children (2 male, 2 female from each age group) producing 2 linguistic contrasts, question-statement and contrastive stress, which served as listening stimuli. Results: In both tasks, listener accuracy ranged from 39.7% to 100% with significant differences between 4-year-olds and both older age groups. Listeners had difficulty deciphering the 4-year-olds' questions compared with statements and were more accurate in identifying contrastive stress placed on sentence-initial words compared with sentence-final words across all age groups. Conclusion: Although listeners identified prosodic contrasts produced by all 3 age groups, accuracy was significantly higher for 7- and 11-year-old productions. Findings are consistent with production studies that suggest relative stabilization of prosodic control between ages 4 and 7. Parallels between prosodic and segmental acquisition are discussed.

Familiarity is thought to aid listeners in decoding disordered speech; however, as the speech signal degrades, the "familiarity advantage" becomes less beneficial. Despite highly unintelligible speech sound production, many children with dysarthria vocalize when interacting with familiar caregivers. Perhaps listeners can understand these vocalizations by cuing into prosodic consistencies in their child's productions. This paper examined whether familiarity influenced the identification of sustained vowels that varied in pitch, duration, and pitch-duration combinations, produced by 3 children with severe dysarthria due to cerebral palsy. Thirty-six listeners participated in the study. For each speaker, there were 2 familiar listeners (FAM), 5 experienced listeners (EXP), and 5 unfamiliar/inexperienced listeners (INX). Results indicated that familiarity did not impact identification of prosodic contrasts. In fact, all 3 listener groups were highly accurate in identifying duration, somewhat less successful at identifying pitch, and least accurate in identifying combinations of pitch and duration. Influences of speaker-listener variables on familiarity are discussed. (Contains 4 tables and 5 figures.)

This study explored the relationship between articulator movement and prosody in children at different developmental ages. Jaw, lower lip, and upper lip kinematics were examined in 4-, 7-, and 11-year-old children as they produced the declarative and interrogative forms of utterances "Show Bob a bot" and "Show Pop a pot." Articulator movement differences were found between declaratives and interrogatives during the production of vowel and consonant targets. The 7- and 11-year-olds differentiated the duration and displacement of their articulator movements to distinguish between declaratives and interrogatives. Several age-related differences in movement duration between the 4-year-olds and the older participants were associated with the production of these targets. Productions of declaratives and interrogatives were not associated with any significant differences in articulator movement variability, although variability did decrease significantly with maturation. The results suggest that children modify their articulator movements to meet the prosodic and linguistic demands of the task. While 4-year-olds appear to be able to modify lip and jaw movement to mark the declarative-interrogative contrast, refinement of these movements continues throughout childhood.

Introduction: Rapid diagnostic testing (RDT) in combination with antimicrobial stewardship programs (ASPs) has been associated with improved outcomes in adults with Staphylococcus aureus bacteremia (SAB); however, pediatric data are limited. Objectives: The primary objective of this study was to assess the clinical impact of concomitant implementation of an ASP and RDT in children with SAB. Methods: This pre‐post quasi‐experimental study compared time to optimal antibiotic in children with SAB in 2015/2016 (pre‐intervention [PRE]) and 2017/2018 (post‐intervention [POST]). During the PRE period there was no RDT or ASP available. However, in the POST period, RDT was performed on all positive blood cultures, followed by feedback from an ASP. Secondary outcomes included time to effective antibiotic, antibiotic exposure, duration of bacteremia, hospital length of stay (LOS), transfer to the intensive care unit (ICU), SAB recurrence, and inpatient mortality. Results: Sixty‐eight patients were included in the study (PRE: n = 32, POST: n = 36). Median time to optimal antibiotic therapy decreased by 23 hours (PRE: 44.3 hours vs POST: 21.3 hours; P =.008). Duration of bacteremia (PRE: 65 hours vs POST: 40.9 hours; P =.03) and inpatient mortality (PRE: 12.5% vs POST: 0%; P =.04) were also reduced. However, further review revealed that only one death was related to SAB. Differences in time to effective therapy, antibiotic exposure, and hospital LOS were not significantly different between the groups. There were similar rates of infectious disease (ID) consultation (PRE: 78% vs POST: 89%, P =.23), but a shorter time to central line removal in the POST group (PRE: 68.2 hours vs POST: 19.8 hours; P =.04). Throughout the study period, recurrence of SAB only occurred in one patient (PRE). Conclusion: ASP interventions, facilitated by RDT, resulted in a shorter time to optimal antibiotic therapy in children with SAB. Although these interventions may have led to improved overall SAB management, further studies are needed to confirm clinical benefits. [ABSTRACT FROM AUTHOR]

Reading fluency has traditionally focused on speed and accuracy yet recent reports suggest that expressive oral reading is an important component that has been largely overlooked. The current study assessed the impact of augmenting text with visual prosodic cues to improve expressive reading in beginning readers. Customized reading software was developed to present text augmented with prosodic cues to convey changes in pitch, duration and/or intensity. Prosodic modulation was derived from the recordings of a fluent adult model and rendered as a set of visual cues that could be presented in isolation or in combination. To establish baseline measures, eight children aged 7–8 first read a five-chapter story in standard text format. In the subsequent three sessions, participants were trained to use each augmented text cue with the guidance of an auditory model. They also had the opportunity to practice reading aloud in each cue condition. At the post-training session, participants re-recorded the baseline story with each chapter read in one of the different cue conditions (standard, pitch, duration, intensity and combination). Post-training and baseline recordings were acoustically analyzed to assess changes in reading expressivity. Despite large individual differences in how each participant implemented the prosodic cues, as a group, there were notable improvements in marking pitch accents and elongating word duration to convey linguistic contrasts. In fact, even after only three training sessions, participants appeared to have generalized implementation of pitch and word duration cues when reading standard text at post-training. In contrast, while participants manipulated pause duration when provided with explicit visual cues, they did not transfer these cues to standard text at post-training. These findings suggest that beginning readers could benefit from explicit visual prosodic cues and that even limited exposure may be sufficient to learn and generalize skills. Further discussion focuses on the implications of this work on struggling readers and second language learners. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop a picture description task for eliciting connected speech from children with motor speech disorders. The Park Play scene is a child-friendly picture description task aimed at augmenting current assessment protocols for childhood motor speech disorders. The design process included a literature review to: (1) establish optimal design features for child assessment, (2) identify a set of evidence-based speech targets specifically tailored to tax the motor speech system, and (3) enhance current assessment tools. To establish proof of concept, five children (ages 4;3-11;1) with dysarthria or childhood apraxia of speech were audio-recorded while describing the Park Play scene. Feedback from the feasibility test informed iterative design modifications. Descriptive, segmental, and prosodic analyses revealed the task was effective in eliciting desired targets in a connected speech sample, thereby yielding additional information beyond the syllables, words, and sentences generally elicited through imitation during the traditional motor speech examination. Further discussion includes approaches to adapt the task for a variety of clinical needs. [ABSTRACT FROM AUTHOR]

Abstract: This study assessed the effectiveness of software designed to facilitate expressive oral reading through text manipulations that convey prosody. The software presented stories in standard (S) and manipulated formats corresponding to variations in fundamental frequency (F), intensity (I), duration (D), and combined cues (C) indicating modulation of pitch, loudness and length, respectively. Ten early readers (mean age=7.6years) attended three sessions. During the first session, children read two stories in standard format to establish a baseline. The second session provided training and practice in the manipulated formats. In the third, post-training session, sections of each story were read in each condition (S, F, I, D, C in random order). Recordings were acoustically examined for changes in word duration, peak intensity and peak F0 from baseline to post-training. When provided with pitch cues (F), children increased utterance-wide peak F0 range (mean=34.5Hz) and absolute peak F0 for accented words. Pitch cues were more effective in isolation (F) than in combination (C). Although Condition I elicited increased intensity of salient words, Conditions S and D had minimal impact on prosodic variation. Findings suggest that textual manipulations conveying prosody can be readily learned by children to improve reading expressivity. [Copyright &y& Elsevier]

Purpose: Acquisition of prosodic control appears to evolve across development with younger children relying on durational cues and older children utilizing a broader spectrum of cues including fundamental frequency, intensity, and duration. This study aimed to determine whether unfamiliar listeners could identify prosodic contrasts produced by 4-, 7-, and 11-year-olds despite differences in acoustic cues used by each age group. Method: Thirty-six adult monolingual speakers of American English participated as listeners. A previous study yielded speech recordings from 12 children (2 male, 2 female from each age group) producing 2 linguistic contrasts, question-statement and contrastive stress, which served as listening stimuli. Results: In both tasks, listener accuracy ranged from 39.7% to 100% with significant differences between 4-year-olds and both older age groups. Listeners had difficulty deciphering the 4-year-olds' questions compared with statements and were more accurate in identifying contrastive stress placed on sentence-initial words compared with sentence-final words across all age groups. Conclusion: Although listeners identified prosodic contrasts produced by all 3 age groups, accuracy was significantly higher for 7- and 11-year-old productions. Findings are consistent with production studies that suggest relative stabilization of prosodic control between ages 4 and 7. Parallels between prosodic and segmental acquisition are discussed. [ABSTRACT FROM AUTHOR]

Familiarity is thought to aid listeners in decoding disordered speech; however, as the speech signal degrades, the "familiarity advantage" becomes less beneficial. Despite highly unintelligible speech sound production, many children with dysarthria vocalize when interacting with familiar caregivers. Perhaps listeners can understand these vocalizations by cuing into prosodic consistencies in their child's productions. This paper examined whether familiarity influenced the identification of sustained vowels that varied in pitch, duration, and pitch-duration combinations, produced by 3 children with severe dysarthria due to cerebral palsy. Thirty-six listeners participated in the study. For each speaker, there were 2 familiar listeners (FAM), 5 experienced listeners (EXP), and 5 unfamiliar/inexperienced listeners (INX). Results indicated that familiarity did not impact identification of prosodic contrasts. In fact, all 3 listener groups were highly accurate in identifying duration, somewhat less successful at identifying pitch, and least accurate in identifying combinations of pitch and duration. Influences of speaker-listener variables on familiarity are discussed. [ABSTRACT FROM AUTHOR]

This study explored the relationship between articulator movement and prosody in children at different developmental ages. Jaw, lower lip, and upper lip kinematics were examined in 4-, 7-, and 11-year-old children as they produced the declarative and interrogative forms of utterances "Show Bob a bot" and "Show Pop a pot." Articulator movement differences were found between declaratives and interrogatives during the production of vowel and consonant targets. The 7- and 11-year-olds differentiated the duration and displacement of their articulator movements to distinguish between declaratives and interrogatives. Several age-related differences in movement duration between the 4-year-olds and the older participants were associated with the production of these targets. Productions of declaratives and interrogatives were not associated with any significant differences in articulator movement variability, although variability did decrease significantly with maturation. The results suggest that children modify their articulator movements to meet the prosodic and linguistic demands of the task. While 4-year-olds appear to be able to modify lip and jaw movement to mark the declarative-interrogative contrast, refinement of these movements continues throughout childhood. [ABSTRACT FROM AUTHOR]

Abstract: Prosodic features of the speech signal include fundamental frequency (F0), intensity and duration. In order to study the development of prosody independent from segmental aspects of speech, we considered the question–statement contrast. In English, adults mark the contrast using changes in fundamental frequency, duration and intensity, with F0 being the most prominent cue. Declarative questions are marked by rising intonation whereas statements are marked by falling intonation. While previous studies have noted that young children can signal this contrast in imitative paradigms, little is known about the acoustic cues children use at different stages in development. The present study sought to provide an acoustic characterization of prosodic cues used by 12 children from three age groups, 4-year-olds, 7-year-olds and 11-year-olds, for elicited productions of declarative statements and questions. Results indicated that 4-year-olds were unable to reliably signal questions using rising fundamental frequency contour. Instead, they used increased final syllable duration to mark questions. Children in the 7-year-old group used all three cues, fundamental frequency, intensity and syllable duration, to contrast questions from statements. The oldest group relied primarily on changes in fundamental frequency and less so on intensity and duration cues. An age-related pattern is evident in that children employ different combinations of acoustic cues to mark the question–statement contrast across development. The impact of motor and cognitive-linguistic complexity on the development of prosodic control is discussed. [Copyright &y& Elsevier]

Empirical data on the acoustics of prosodic control in children is limited, particularly for linguistically contrastive tasks. Twelve children aged 4, 7, and 11 years were asked to produce two utterances ‘‘Show Bob a bot’’ (voiced consonants) and ‘‘Show Pop a pot’’ (voiceless consonants) 10 times each with emphasis placed on the second word (Bob/Pop) and 10 times with emphasis placed on the last word (bot/pot). A total of 40 utterances were analyzed per child. The following acoustic measures were obtained for each word within each utterance: average fundamental frequency (f0), peak f0, average intensity, peak intensity, and duration. Preliminary results suggest that 4 year olds are unable to modulate prosodic cues to signal the linguistic contrast. The 7 year olds, however, not only signaled the appropriate stress location, but did so with the most contrastive differences in f0, intensity, and duration, of all age groups. Prosodic differences between stressed and unstressed words were more pronounced for the utterance with voiced consonants. These findings suggest that the acoustics of linguistic prosody begin to differentiate between age 4 and 7 and may be highly influenced by changes in physiological control and flexibility that may also affect segmental features. [ABSTRACT FROM AUTHOR]