Positive correlation of CTG expansion and pharyngoesophageal alterations in myotonic dystrophy patients

from the Italian Journal of Neurological Sciences

Abstract  Alteration of the pharyngoesophageal musculature is a common finding in patients with myotonic dystrophy (MD), regardless of the presence of dysphagia. The aim of the present study was to determine whether a specific pattern of swallowing abnormalities could be identified in MD patients, and the possible correlation with the size of CTG repeats. Fifteen MD patients, 8 of whom were asymptomatic for dysphagia, underwent a videofluoroscopic study of swallowing. Alterations of the pharyngoesophageal phase of swallowing were detected in 12 of 15 patients, 6 without clinical evidence of dysphagia. Incomplete relaxation of the upper esophageal sphincter (UES) and esophageal hypotonia were the most common alterations. We found a significant correlation between the number of radiological alterations and the size of CTG repeats. A typical radiological pattern of swallowing has also been identified. The role of videofluoroscopy in evaluation of MD patients is briefly discussed.

Maximum Hyoid Displacement in Normal Swallowing

from Dysphagia

Abstract  Vertical and anterior displacement of the hyoid bone is a critical biomechanical component of normal swallowing function. The purpose of this study was to evaluate the maximal vertical and anterior displacement of the hyoid bone during oropharyngeal swallowing. A retrospective review of video-fluoroscopic swallowing exams in 40 normal subjects varying by age and gender was performed. Means and standard deviations for both vertical and anterior displacement were analyzed on both 5-ml and 10-ml thin liquids using an ImageJ program. Age and gender differences were submitted to a repeated-measures one-way analysis of variance. There was a significant difference between younger and older subjects for anterior displacement of the hyoid bone during the swallow but not for vertical displacement. No significant differences between male and female subjects were observed. Anterior displacement of the hyoid bone decreased with increasing age. This reduction may be related to muscle weakness. However, older people may adapt to preserve airway protection.

A Scintigraphic Study of Oral, Pharyngeal, and Esophageal Transit in Patients with Stroke

from Dysphagia

Abstract  Although stroke affects mainly the oral and pharyngeal phases of swallowing, it may also impair esophageal contractions. Our hypothesis is that stroke may affect esophageal transit. The oral, pharyngeal, and esophageal transit was studied by the scintigraphic method in 26 patients (age range = 26–83 years), eight of whom had mild dysphagia but all were able to feed orally and who had suffered an acute first-ever ischemic stroke 10–56 days (median = 43 days) before transit evaluation. The control group included 15 healthy volunteers (age range = 27–86 years). All subjects swallowed a 5-ml liquid bolus and a 5-ml paste bolus labeled with technetium-99m phytate while sitting in front of the collimator of a gamma camara. The oral, pharyngeal, and proximal, middle, and distal esophageal transit was measured for 20 s. Three patients did not swallow the bolus during the scintigraphic evaluation. There was no difference between patients and controls with respect to oral and pharyngeal transit or clearance of liquid. For paste, the pharyngeal transit time was shorter for patients (0.48 ± 0.17 s) than for controls (0.61 ± 0.18 s, p = 0.027). Also for the paste bolus, the residue in the mouth was greater in patients (18.4 ± 13.6%) than in controls (10.2 ± 4.9%, p = 0.031). The liquid transit duration in the distal esophagus was shorter in patients with stroke (1.74 ± 0.84 s) than in controls (2.68 ± 1.65 s, p = 0.028). There was no difference between patients and controls in esophageal residue. In conclusion, patients with stroke and able to feed orally may have alterations in the esophageal transit of a liquid bolus.

Rehabilitative Management of Oropharyngeal Dysphagia in Acute Care Settings: Data from a Large Italian Teaching Hospital

from Dysphagia

Abstract  A high incidence of oropharyngeal dysphagia (OD) in acute-care settings has been reported; however, no data on its management are found in the literature. Here we report the experience with rehabilitative management of OD in a large Italian hospital. The characteristics of inpatients with OD during 2004 have been studied prospectively. For each patient, demographic data, the department referring the patient, the disease causing OD, and the presence of a communication disorder were registered. The swallowing level at the beginning and at the end of rehabilitation were recorded. Of the 35,590 inpatients admitted to San Giovanni Battista Hospital of Turin during 2004, 222 of them were referred for the assessment and rehabilitation of OD. The inpatients with OD came from different departments and mainly had a neurologic disease. In 110 patients a communication disorder was present. The swallowing impairment was moderate to severe at the moment of referral, while on average patients were able to eat by mouth after swallowing therapy. Dysphagia rehabilitation in an acute care setting is requested from different departments because of its prevalence and severity; skilled specialists are needed for early assessment and the best management.

Fluency remediation in dyslexic children: does age make a difference?

from Dyslexia

This study tested the hypothesis whether older dyslexic children may obtain fewer gains on fluency and accuracy with respect to their younger peers after specific remediation.
Changes in accuracy and fluency of a group of children with a diagnosis of dyslexia attending third and fourth grades were compared with those obtained by a group of children attending the sixth, seventh or eighth grade in two different treatments, one based on the Balance model (Bakker) and the second based on the automatization of syllable recognition (sublexical).
Among all comparisons between the gains in accuracy and fluency obtained by the two groups, only the younger group in the sublexical treatment obtained a statistically significant gain with respect to their older peers’ accuracy in reading words.
These outcomes suggest that, at least for the chronological ages and types of treatments considered in this study, older children with dyslexia may obtain comparable gains to their younger peers, suggesting that it is never too late to remediate reading fluency and accuracy. Copyright © 2007 John Wiley & Sons, Ltd.

Acetylcysteine [N-acetylcysteine] may prevent gentamicin-induced deafness among haemodialysis patients

from Reactions

No abstract available.

Audiovisual temporal adaptation of speech: temporal order versus simultaneity judgments

from Experimental Brain Research

Abstract  The temporal perception of simple auditory and visual stimuli can be modulated by exposure to asynchronous audiovisual speech. For instance, research using the temporal order judgment (TOJ) task has shown that exposure to temporally misaligned audiovisual speech signals can induce temporal adaptation that will influence the TOJs of other (simpler) audiovisual events (Navarra et al. (2005) Cognit Brain Res 25:499–507). Given that TOJ and simultaneity judgment (SJ) tasks appear to reflect different underlying mechanisms, we investigated whether adaptation to asynchronous speech inputs would also influence SJ task performance. Participants judged whether a light flash and a noise burst, presented at varying stimulus onset asynchronies, were simultaneous or not, or else they discriminated which of the two sensory events appeared to have occurred first. While performing these tasks, participants monitored a continuous speech stream for target words that were either presented in synchrony, or with the audio channel lagging 300 ms behind the video channel. We found that the sensitivity of participant’s TOJ and SJ responses was reduced when the background speech stream was desynchronized. A significant modulation of the point of subjective simultaneity (PSS) was also observed in the SJ task but, interestingly, not in the TOJ task, thus supporting previous claims that TOJ and SJ tasks may tap somewhat different aspects of temporal perception.

Word juncture behaviours in young children’s spontaneous speech production

from Clinical Linguistics and Phonetics

The present study explores word boundary behaviours in the spontaneous speech of a group of 6 preschool children. Speech collected in play settings is examined for the presence of normal and atypical connected speech behaviours, and to identify specific instances of open and close word juncture behaviours. The findings suggest that developmental and adult-like features co-exist in the speech of typically-developing children and that developmental changes occur in connected speech behaviours between the ages of 2-3 years. In particular, a shift from equal numbers of close and open junctures, to a preference for close junctures is noted. Individual differences are also apparent between speakers, and these are discussed.

Voice onset time production in speakers with Alzheimer’s disease

from Clinical Linguistics and Phonetics

In the present study, voice onset time (VOT) measurements were compared between a group of individuals with moderate Alzheimer’s disease (AD) and a group of healthy age- and gender-matched peers. Participants read a list of consonant-vowel-consonant (CVC) words, which included the six stop consonants. The VOT measurements were made from oscillographic displays obtained from the Brown Laboratory Interactive Speech System (BLISS) implemented on an IBM-compatible computer. VOT measures for the participants’ six stop consonant productions were subjected to statistical analysis. The results indicated that VOT values in speakers with Alzheimer’s disease were not statistically different from those for the normal control speakers.

Verb and sentence processing in Norwegian aphasic speakers compared to Dutch and English aphasic speakers: experimental evidence

from Clinical Linguistics and Phonetics

The article reports on a comparative study of the abilities of aphasic speakers and normal control subjects to comprehend and produce verbs and sentences. The analysis is based on test results obtained as part of the standardization procedure for a test battery originally developed for Dutch and since translated and adapted for English and Norwegian. With a few exceptions, there is extensive similarity in the test results between the different languages. The exceptions can be accounted for with reference both to structural differences between the languages and to coincidental aspects of informant selection and scoring procedures. The Norwegian version contains an additional sub-test on past tense inflection, which correlates significantly with at least two other sub-tests in the test battery.

Variability in cortical representations of speech sound perception

from Clinical Linguistics and Phonetics

Recent brain mapping studies have provided new insights into the cortical systems that mediate human speech perception. Electrocortical stimulation mapping (ESM) is a brain mapping method that is used clinically to localize cortical functions in neurosurgical patients. Recent ESM studies have yielded new insights into the cortical systems that mediate speech perception and how these systems vary as a function of individual differences. ESM methods are described and findings from recent ESM studies of speech perception are reviewed. The clinical implications of these findings are discussed as they relate to current understanding of how individual differences in listening abilities are reflected in the underlying cortical representations.

Relation of melody complexity in infants’ cries to language outcome in the second year of life: A longitudinal study

from Clinical Linguistics and Phonetics

This study is part of the German Language Development Study’s prospective longitudinal research programme on infants from birth until the age of 3 years. Thirty-four infants were retrospectively classified into two groups (normal/delayed) by their language skills at 2.5 years of age. Frequency spectrograms and melodies of about 11,000 cries from the first 16 weeks of life were analysed using a CSL 4400. A Melody Complexity Index was calculated at monthly intervals. Infants with less than 45% complex melodies in their cries during the second month were found to be almost five times more likely to develop a language delay as infants with a higher proportion. For infants above the cut-off of .45, development of a language delay condition could be ruled out with a probability of 89%. Although the results need to be interpreted cautiously, the data indicate a possible relation between early melody development and later language outcome.

Production of consonants by prelinguistically deaf children with cochlear implants

from Clinical Linguistics and Phonetics

Consonant production following the sensory restoration of audition was investigated in 22 prelinguistically deaf French children who received cochlear implants. Spontaneous speech productions were recorded at 6, 12, and 18 months post-surgery and consonant inventories were derived from both glossable and non-glossable phones using two acquisition criteria. The results showed that children initiated appropriate production of consonants after six months of implant use. Stops and labials were the most frequently produced speech sounds, whereas glides and palatals were still infrequent after 18 months. Speech accuracy also improved throughout the study. Consonant visibility appeared to influence the order of acquisition in the first months following the implantation and, as experience with auditory information increased, patterns of development tended to resemble those seen in children with normal hearing. Finally, a signed mode of communication and oral rehabilitation programs prior to implantation were better outcome predictors than age at implantation.

Non-word repetition in Dutch children with (a risk of) dyslexia and SLI

from Clinical Linguistics and Phonetics

It has been proposed that poor non-word repetition is a marker of specific language impairment (SLI), and a precursor and marker of dyslexia. This study investigated whether a non-word repetition deficit underlies both disorders. A group of Dutch preschool SLI children and children at familial risk of dyslexia, as well as school-going groups of SLI and dyslexic children were presented with a non-word repetition task. The results showed that the SLI and the (at-risk of) dyslexia groups performed more poorly than the control children. Furthermore, with the exception of one child, all preschool SLI children scored significantly below the mean of the preschool control group, suggesting that non-word repetition performance is a marker of SLI. Approximately half of the at-risk group were poor performers, which was expected on the basis of the familial risk factor of the at-risk group. The results show that a non-word repetition deficit is attested early in life and underlies both dyslexia and SLI.

Non-pulmonic-egressive speech in clinical data: A brief review

from Clinical Linguistics and Phonetics

This review examines the literature on the use of non-pulmonic egressive sounds in disordered speech. Studies are described that report the use of pulmonic ingressive speech, clicks, ejectives, and implosives. Broad trends are identified linking the use of each type of non-pulmonic-egressive airstream use with particular disorders. The importance of including these airstream types in both phonetic theory and practice classes in the training of speech-language pathologists is stressed.

Informativeness of the spoken narratives of younger and older adolescents with specific language impairment and their counterparts with normal language

from Clinical Linguistics and Phonetics

A large body of literature describing the narrative skills of young children with and without language impairments exists. However, there has been only limited study of the informativeness of narratives of adolescents with normally developing language (NL) and those of adolescents with specific language impairment (SLI), even though narratives play an important role in adolescents’ complex social and academic lives and there is emerging evidence that narrative abilities in young children portend their later language proficiency. This study examined the informativeness of oral narratives produced by four groups of adolescents: younger adolescents with NL (mean age = 13years:2 months), older adolescents with NL (15:10), younger adolescents with SLI (13:2) and older adolescents with SLI (15:9). The results indicated that the narratives produced by the SLI adolescents consisted of fewer informative and more irrelevant/inaccurate responses than the narratives of their peers with NL. The SLI adolescents also tended to give more vague responses in their narratives than their NL counterparts, as well tending not to provide any responses to the pictures representing the story. Taken together, these results painted a picture of SLI adolescents producing less satisfying, complete, and cohesive narratives, findings consistent with those of the research on children with SLI. Language status more than age appeared to be the factor that affected the likelihood of the adolescents providing or not providing informative responses. These results suggested that the performance of adolescents with SLI may not catch up to the level of performance of their NL counterparts during adolescence.

Information status and word order in Croatian Sign Language

from Clinical Linguistics and Phonetics

This paper presents the results of research on information structure and word order in narrative sentences taken from signed short stories in Croatian Sign Language (HZJ). The basic word order in HZJ is SVO. Factors that result in other word orders include: reversible arguments, verb categories, locative constructions, contrastive focus, and prior context. Word order in context depends on communication rules, based on the relationship between old (theme) and new (rheme) information, which is predicated of the theme. In accordance with Grice’s Maxim of Quantity, HZJ has a tendency to omit old information, or to reduce it to pronominal status. If old information is overtly signed in non-pronominal form, it precedes the rheme. We have observed a variety of sign language mechanisms that are used to show items of reduced contextual significance: use of assigned spatial location for previously introduced referents; eyegaze to indicate spatial location of previously introduced referents; use of the non-dominant hand for backgrounded information; use of a special category of signs known as classifiers as pronominal indicators of previously introduced referents; and complex noun phrases that allow a single occurrence of a noun to simultaneously serve multiple functions. These devices permit information to be conveyed without the need for separate signs for every referent, which would create longer constructions that could be taxing to both production and perception. The results of this research are compatible with well-known word order generalizations - HZJ has its own grammar, independent of spoken language, like any other sign language.

Fluency remediation in dyslexic children: does age make a difference?

from Dyslexia

This study tested the hypothesis whether older dyslexic children may obtain fewer gains on fluency and accuracy with respect to their younger peers after specific remediation.
Changes in accuracy and fluency of a group of children with a diagnosis of dyslexia attending third and fourth grades were compared with those obtained by a group of children attending the sixth, seventh or eighth grade in two different treatments, one based on the Balance model (Bakker) and the second based on the automatization of syllable recognition (sublexical).
Among all comparisons between the gains in accuracy and fluency obtained by the two groups, only the younger group in the sublexical treatment obtained a statistically significant gain with respect to their older peers’ accuracy in reading words.
These outcomes suggest that, at least for the chronological ages and types of treatments considered in this study, older children with dyslexia may obtain comparable gains to their younger peers, suggesting that it is never too late to remediate reading fluency and accuracy. Copyright © 2007 John Wiley & Sons, Ltd.

Effect of intensive voice treatment on tone-language speakers with Parkinson’s disease

from Clinical Linguistics and Phonetics

The aim of this study was to investigate the effect of intensive voice therapy on Cantonese speakers with Parkinson’s disease. The effect of the treatment on lexical tone was of particular interest. Four Cantonese speakers with idiopathic Parkinson’s disease received treatment based on the principles of Lee Silverman Voice Treatment (LSVT). Outcome measures included perceptual measures and acoustic correlates of loudness, pitch, intonation, and tone (only intonation and tone are detailed in this study). All four participants demonstrated an increase in loudness, an increase in pitch and pitch range, and improved intonation during connected speech, as measured perceptually and acoustically. However, there were no obvious changes in the accuracy of lexical tone production, based on either phonetic transcription or acoustic analysis. The lack of improvement in lexical tones may support previous claims of a dissociation in fundamental frequency control for intonation and lexical tone production.

Alternative organization of speech perception deficits in children

from Clinical Linguistics and Phonetics

Children’s first-language perception base takes shape gradually from birth onwards. Empirical research has confirmed that children may continue to fall short of age-based expectations in their speech perception. The purpose of this study was to assess the contribution of various perception processes in both reading and learning disabled children. A series of experiments was carried out with 450 Hungarian-speaking schoolchildren: learning disabled, reading disabled and typically developing control first-, second-, and third-graders. Data from seven perception tasks - focusing on acoustic, phonetic and phonological perception processes - were analysed. Results revealed that (i) there is no linear development in all groups across ages, (ii) correct performance is characteristic of both the perception process and the type of disability, and (iii) a specific pattern of organization can be drawn up as a factor in development.

Acoustic and perceptual analysis of speech adaptation to an artificial palate

from Clinical Linguistics and Phonetics

The study investigated adaptation to a standard electropalatographic (EPG) practise palate in a group of eight adults (mean age = 24 years). The participants read the phrase “a CVC” over four sampling conditions: prior to inserting the palate, immediately following insertion of the palate, 45 minutes after palate insertion, and 3 hours after insertion of the palate. Perceptual and acoustic analyses were conducted on the initial CV portion of the stimuli. Consonants examined included: /t/, /k/, /s/, and // followed by the /i/, /a/, and /u/ vowels. Results revealed that individuals within the group were able to adapt their speech articulation to compensate for the presence of the artificial palate. Perceptually, mild consonant imprecision was observed upon insertion of the palate; however, this resolved following 45 minutes to 3 hours of adaptation. Acoustic findings indicated that the palate did not affect segment durations or vowel formant frequencies. However, a significant reduction in M1 for /s/ persisted across the sampling periods. Overall, the results suggest that a period of between 45 minutes and 3 hours of adaptation is generally suitable for participation in EPG studies.

The Impact of Sonority on Onset-Rime and Peak-Coda Lexical Decision and Naming of Lexical Items by Children with Different Spelling Ability

from the Journal of Psycholinguistic Research

Abstract  The present study used the lexical decision (making YES/NO decision) and the vocalization (naming) paradigms in two reaction time experiments to examine the cohesiveness of onset-rime and peak-coda in the syllable structure of English lexical items. The aim was to study the effect of sonority hierarchy of liquids, nasals and obstruents on the accurate and rapid identification and naming of CCVCC words and pseudowords in relation to the spelling performance of 222 grades 4, 5 and 6 students. In the onset-rime lexical decision and naming tasks nasals were processed faster than the liquids and the obstruents. In the peak-coda lexical decision and naming the obstruents were processed faster than the liquids and nasals. The reaction time results suggest relationship with the spelling of English words even though the significant main effects of grade, spelling performance, mode of response and lexicality of the stimulus items need to be interpreted in the context of statistical interactions.

A model for ethical practices in clinical phonetics and linguistics

from Clinical Linguistics and Phonetics

The emergence of clinical phonetics and linguistics as an area of scientific inquiry gives rise to the need for guidelines that define ethical and responsible conduct. The diverse membership of the International Clinical Phonetics and Linguistics Association (ICPLA) and the readership of this journal are uniquely suited to consider ethical issues from diverse perspectives. Accordingly, this paper introduces a multi-tiered six-factor model for ethical practices to stimulate discussion of ethical issues.

Self-esteem and Satisfaction With Life of Deaf and Hard-of-Hearing People—A Resource-Oriented Approach to Identity Work

from the Journal of Deaf Studies and Deaf Education

In the context of the current identity discussions, the interrelations between acculturations, psychological resources, and self-esteem as well as the satisfaction with life of deaf and hard-of-hearing people (N = 629) were examined by means of a questionnaire-based survey. To check these interrelations, one-factor and two-factor analyses of variance were employed. The results show that bicultural, deaf, and hearing acculturation styles have the advantage over marginal acculturation, but the results for marginal acculturation need to be discussed in depth to ensure a comprehensive understanding of them. All in all, bicultural acculturation seems to be a secure option for psychosocial well-being. The availability of psychological resources (optimism, self-efficacy) seems to be of special importance for the quality of self-esteem and satisfaction with life. On the other hand, the power of these psychological resources is closely associated with good communicative conditions in the individual biographies of the participants in this study as well as with their education level. Going beyond a methodological discussion then, the mission for educators would seem to be one of making good communicative conditions available to each deaf or hard-of-hearing child and optimizing academic achievement so as to ensure a secure, comprehensive, and differentiated opening up of the world and psychological empowerment. In this way, a good foundation can be laid for developing quality of life.

Developmental dyslexia and the dual route model of reading: Simulating individual differences and subtypes

from Cognition

Developmental dyslexia was investigated within a well-understood and fully specified computational model of reading aloud: the dual route cascaded model (DRC [Coltheart, M., Rastle, K., Perry, C., Langdon, R., & Ziegler, J.C. (2001). DRC: A dual route cascaded model of visual word recognition and reading aloud. Psychological Review, 108, 204–256.]). Four tasks were designed to assess each representational level of the DRC: letter level, orthographic lexicon, phonological lexicon, and phoneme system. The data showed no single cause of dyslexia, but rather a complex pattern of phonological, phonemic, and letter processing deficits. Importantly, most dyslexics had deficits in more than one domain. Subtyping analyses also suggested that both the phonological and surface dyslexics almost always had more than a single underlying deficit. To simulate the reading performance for each individual with the DRC, we added noise to the model at a level proportional to the underlying deficit(s) of each individual. The simulations not only accounted fairly well for individual reading patterns but also captured the different dyslexia profiles discussed in the literature (i.e., surface, phonological, mixed, and mild dyslexia). Thus, taking into account the multiplicity of underlying deficits on an individual basis provides a parsimonious and accurate description of developmental dyslexia. The present work highlights the necessity and merits of investigating dyslexia at the level of each individual rather than as a unitary disorder.

Atypical language in lesional and nonlesional complex partial epilepsy

from Neurology

Objective: We investigated the relationship between partial epilepsy, MRI findings, and atypical language representation.

Methods: A total of 102 patients (4 to 55 years) with left hemisphere epileptogenic zones were evaluated using three fMRI language tasks obtained at 1.5 or 3T with EPI BOLD techniques: verbal fluency, reading comprehension, and auditory comprehension. fMRI maps were visually interpreted at a standard threshold and rated as left or atypical language.

Results: Atypical language dominance occurred in 30 patients (29%) and varied with MRI type (p < 0.01). Atypical language representation occurred in 36% (13/36) with normal MRI, 21% (6/29) with mesial temporal sclerosis, 14% (4/28) with focal cortical lesions (dysplasia, tumor, vascular malformation), and all (6/6) with a history of stroke. Multivariate logistic regression analysis found handedness, seizure onset, and MRI type accounted for much of the variance in language activation patterns (2 = 24.09, p < 0.01). Atypical language was more prevalent in patients with early seizure onset (43.2%, p < 0.05) and atypical handedness (60%, p < 0.01). None of the three clinical factors were correlated with each other (p > 0.40). Patients with atypical language had lower verbal abilities (F = 6.96, p = 0.01) and a trend toward lower nonverbal abilities (F = 3.58, p = 0.06). There were no differences in rates of atypical language across time, age groups, or MRI scanner.

Conclusion: Early seizure onset and atypical handedness, as well as the location and nature of pathologic substrate, are important factors in language reorganization.

Sight, Sound Processed Together And Earlier Than Previously Thought

from Medical News Today.com

The area of the brain that processes sounds entering the ears also appears to process stimulus entering the eyes, providing a novel explanation for why many viewers believe that ventriloquists have thrown their voices to the mouths of their dummies.

When nominal features are marked on verbs: A transcranial magnetic stimulation study

from Brain and Language

It has been claimed that verb processing (as opposed to noun processing) is subserved by specific neural circuits in the left prefrontal cortex. In this study, we took advantage of the unusual grammatical characteristics of clitic pronouns in Italian (e.g., lo and la in portalo and portala ‘bring it [masculine]/[feminine]‘, respectively)-the fact that clitics have both nominal and verbal characteristics, to explore the neural correlates of verb and clitic processing. We used repetitive transcranial magnetic stimulation (rTMS) to suppress the excitability of the left prefrontal cortex and to assess its role in producing verb+det+noun and verb+clitic phrases. Results showed an interference effect for both kinds of phrases when stimulation was applied to the left but not to the right prefrontal cortex. However, the interference effect was significantly greater for the verb+clitic than for the verb+det+noun phrases. These findings support the view that clitics increase the morphosyntactic complexity of verbs.

Using enhanced milieu teaching and a voice-output communication aid to increase independent requesting by three children with autism

from Evidence-Based Communication Assessment and Intervention

No abstract available.

Performance after cochlear implantation in DFNB1 patients

from Otolaryngology–Head and Neck Surgery

Objective
To evaluate the speech perception and language development with cochlear implants (CI) of DFNB1 children in comparison with non-DFNB1 deaf children.

Study Design
Retrospective case series.

Setting
Academic tertiary center.

Results
Thirty-one congenitally deafened children, screened for GJB2 allele variants, were followed for an average 32 months after CI. With the use of age-appropriate testing, 75% of DFNB1 and 53% of non-DFNB1 children achieved open set word recognition (speech perception category [SPC] level 6). Multivariate analysis showed that SPC was primarily dependent on duration of CI use, but not on the cause of hearing loss. In Reynell language tests, DFNB1 children showed more consistent and quicker gains than non-DFNB1 children.

Conclusion
Although children with CI with DFNB1 show faster gains in Reynell scores, duration of CI use appears to have a greater effect on speech perception than DFNB1 status.

Significance
Identification of DFNB1 children is useful in counseling of CI outcomes.