Listening to children with communication impairment talking through their drawings

Including children as research participants is an important new direction in early childhood research. However, it is rare for such studies to include the voices of children with significant communication impairment. This article suggests that drawing may be an appropriate non-verbal method for ‘listening’ to these children’s ideas and recording their perspectives. Three areas of inquiry are reviewed: (1) the use of drawings as a method of listening respectfully to children; (2) approaches to the analysis of children’s drawings; and (3) the analysis of drawings completed by children with communication impairment. We identify six aspects of children’s drawings — facial expressions, accentuation of body features (e.g. mouth and ears), portrayal of talking/listening, colours used, conversational partners, and sense of self — that are potentially pertinent for children with communication impairment.

from the Journal of Early Childhood Research

Unintended imitation in nonword repetition

Verbal repetition is conventionally considered to require motor-reproduction of only the phonologically relevant content of a perceived linguistic stimulus, while imitation of incidental acoustic properties of the stimulus is not an explicit part of this task. Exemplar-based theories of speech processing, however, would predict that imitation beyond linguistic reproduction may occur in word repetition. Five experiments were conducted in which verbal audio-motor translations had to be performed under different conditions. Nonwords varying in phonemic content, in vocal pitch (F0), and in speaking style (schwa-syllable expression) were presented. We experimentally varied the factors response delay (repetition vs. shadowing), intention-to-repeat (repetition vs. pseudo-naming), and phonological load (repetition vs. transformation). The responses of ten healthy participants were examined for phonemic accuracy and for traces of para-phonological imitation. Two aphasic patients with phonological impairments were also included, to find out if lesions to left anterior or posterior perisylvian cortex interfere with imitation.

In the healthy participants, significant imitation of both F0 and phonetic style was observed, with markedly stronger effects for the latter. Strong imitation was also found in an aphasic patient with a lesion to left anterior perisylvian cortex, whereas almost no imitation occurred in a patient with a lesion to the posterior language area. The degree of unintended imitation was modulated by each of the three independent factors introduced here. The results are discussed on the background of cognitive and neurolinguistic theories of imitation.

from the Journal of Voice

The Northwestern Anagram Test: Measuring Sentence Production in Primary Progressive Aphasia

Primary progressive aphasia (PPA) is a clinical dementia syndrome with early symptoms of language dysfunction. Postmortem findings are varied and include Alzheimer disease and frontotemporal lobar degeneration (FTLD), both tauopathies and TAR DNA binding protein (TDP-43) proteinopathies. Clinical-pathological correlations in PPA are complex but the presence in the clinical profile of agrammatism has a high association with tauopathy. Grammatical competence is difficult to assess in the clinical setting with available methods. This article describes the Northwestern Anagram Test (NAT), a new clinical measure of sentence production. A total of 16 patients with PPA and their controls assembled single printed words to create sentences describing pictures. Northwestern Anagram Test performance was significantly correlated with a measure of sentence production and with aphasia severity but not with measures of naming, single word comprehension, object recognition, or motor speech. The NAT can be used to assess syntax competence when patients cannot be tested with measures that require intact speech production.

from the American Journal of Alzheimer’s Disease and Other Dementias

Age-related changes in the functional neuroanatomy of overt speech production

Alterations of existing neural networks during healthy aging, resulting in behavioral deficits and changes in brain activity, have been described for cognitive, motor, and sensory functions. To investigate age-related changes in the neural circuitry underlying overt non-lexical speech production, functional MRI was performed in 14 healthy younger (21–32 years) and 14 healthy older individuals (62–84 years). The experimental task involved the acoustically cued overt production of the vowel /a/ and the polysyllabic utterance /pataka/. In younger and older individuals, overt speech production was associated with the activation of a widespread articulo-phonological network, including the primary motor cortex, the supplementary motor area, the cingulate motor areas, and the posterior superior temporal cortex, similar in the /a/ and /pataka/ condition. An analysis of variance with the factors age and condition revealed a significant main effect of age. Irrespective of the experimental condition, significantly greater activation was found in the bilateral posterior superior temporal cortex, the posterior temporal plane, and the transverse temporal gyri in younger compared to older individuals. Significantly greater activation was found in the bilateral middle temporal gyri, medial frontal gyri, middle frontal gyri, and inferior frontal gyri in older vs. younger individuals. The analysis of variance did not reveal a significant main effect of condition and no significant interaction of age and condition. These results suggest a complex reorganization of neural networks dedicated to the production of speech during healthy aging.

from Neurobiology of Aging

Epidemiology of Speech and Language Impairment in a Nationally Representative Sample of 4- to 5-Year-Old Children

Results: Parent-reported prevalence: 25.2% had concerns about how their child talked and made speech sounds (11.8% “concerned”; 13.4% “a little concerned”), and 9.5% had concerns about how their child understood language (4.4% “concerned”; 5.1% “a little concerned”). Parents who reported concerns identified “speech not clear to others” as the most frequent area of difficulty (12.0%). Teacher-reported prevalence: 22.3% of children were considered to be less competent than others in their expressive language ability (6.7% “much less competent”; 15.6% “less competent”); 16.9% were considered to be less competent than others in their receptive language ability (4.0% “much less competent”; 12.9% “less competent”). The match between parent and teacher identification was higher for expressive speech and language concern than for receptive language. Direct assessment: 13.0% of children were 1–2 SDs below the mean on the Adapted Peabody Picture Vocabulary Test–III (S. Rothman, 2003), and a further 1.7% were > 2 SDs below the mean. Parent and teacher reports were significantly correlated with scores obtained via direct assessment. Period prevalence: Parents and teachers reported that 14.5% of children had accessed speech-language pathologist (SLP) services. 2.2% indicated that they needed but could not access an SLP.

Conclusion: Multiple indicators of speech and language impairment in diverse contexts confirmed the high prevalence of this condition in early childhood and a concomitant need for SLP services.

from the Journal of Speech, Language, and Hearing Research

Speech and swallowing after surgical treatment of advanced oral and oropharyngeal carcinoma: a systematic review of the literature

Purpose of this review is the evaluation of speech and swallowing function after surgical treatment for advanced oral and oropharyngeal carcinoma. A systematic literature search (1993–2009), yielding 1,220 hits. The predefined criteria for inclusion in this systematic review were oral or oropharyngeal cancer, surgical treatment, speech and/or swallow function outcome, T-stage ≥ 2, patient cohort > 20, adequate description of the patient cohort in terms of tumor (sub) site, and low risk of bias (Cochrane criteria). Twelve studies fulfilled the predefined criteria. The results for speech more than 1 year after resection of oral or oropharyngeal cancer are reported to be moderate to good; although in the majority of patients speech is experienced as deviant. Overall sentence intelligibility scores are normal (92–98%). Swallowing is reported to be often already disturbed before treatment and is even more severely compromised after treatment. Aspiration rates of liquids vary from 12 to 50% and especially after oropharyngeal resection, pharyngeal transit times are delayed. Postoperative radiotherapy further increases function disturbances significantly. Critical subsites with regard to speech are the mobile tongue, and the soft palate and for swallowing, the floor of the mouth, the posterior base of tongue and the hard and soft palate.

from ORL -Journal for Oto-Rhino-Laryngology and Its Related Specialties

Fundamental frequency and speech intelligibility in background noise

Speech reception in noise is an especially difficult problem for listeners with hearing impairment as well as for users of cochlear implants (CIs). One likely cause of this is an inability to ‘glimpse’ a target talker in a fluctuating background, which has been linked to deficits in temporal fine-structure processing. A fine-structure cue that has the potential to be beneficial for speech reception in noise is fundamental frequency (F0). A challenging problem, however, is delivering the cue to these individuals. The benefits to speech intelligibility of F0 for both listeners with hearing impairment and users of CIs are reviewed, as well as various methods of delivering F0 to these listeners.

from Hearing Research

Fundamental frequency and speech intelligibility in background noise

Speech reception in noise is an especially difficult problem for listeners with hearing impairment as well as for users of cochlear implants (CIs). One likely cause of this is an inability to ‘glimpse’ a target talker in a fluctuating background, which has been linked to deficits in temporal fine-structure processing. A fine-structure cue that has the potential to be beneficial for speech reception in noise is fundamental frequency (F0). A challenging problem, however, is delivering the cue to these individuals. The benefits to speech intelligibility of F0 for both listeners with hearing impairment and users of CIs are reviewed, as well as various methods of delivering F0 to these listeners.

from Hearing Research

Not all disfluencies are are equal: The effects of disfluent repetitions on language comprehension

Disfluencies can affect language comprehension, but to date, most studies have focused on disfluent pauses such as er. We investigated whether disfluent repetitions in speech have discernible effects on listeners during language comprehension, and whether repetitions affect the linguistic processing of subsequent words in speech in ways which have been previously observed with ers. We used event-related potentials (ERPs) to measure participants’ neural responses to disfluent repetitions of words relative to acoustically identical words in fluent contexts, as well as to unpredictable and predictable words that occurred immediately post-disfluency and in fluent utterances. We additionally measured participants’ recognition memories for the predictable and unpredictable words. Repetitions elicited an early onsetting relative positivity (100–400 ms post-stimulus), clearly demonstrating listeners’ sensitivity to the presence of disfluent repetitions. Unpredictable words elicited an N400 effect. Importantly, there was no evidence that this effect, thought to reflect the difficulty of semantically integrating unpredictable compared to predictable words, differed quantitatively between fluent and disfluent utterances. Furthermore there was no evidence that the memorability of words was affected by the presence of a preceding repetition. These findings contrast with previous research which demonstrated an N400 attenuation of, and an increase in memorability for, words that were preceded by an er. However, in a later (600–900 ms) time window, unpredictable words following a repetition elicited a relative positivity. Reanalysis of previous data confirmed the presence of a similar effect following an er. The effect may reflect difficulties in resuming linguistic processing following any disruption to speech.

from Brain and Language

Not all disfluencies are are equal: The effects of disfluent repetitions on language comprehension

Disfluencies can affect language comprehension, but to date, most studies have focused on disfluent pauses such as er. We investigated whether disfluent repetitions in speech have discernible effects on listeners during language comprehension, and whether repetitions affect the linguistic processing of subsequent words in speech in ways which have been previously observed with ers. We used event-related potentials (ERPs) to measure participants’ neural responses to disfluent repetitions of words relative to acoustically identical words in fluent contexts, as well as to unpredictable and predictable words that occurred immediately post-disfluency and in fluent utterances. We additionally measured participants’ recognition memories for the predictable and unpredictable words. Repetitions elicited an early onsetting relative positivity (100–400 ms post-stimulus), clearly demonstrating listeners’ sensitivity to the presence of disfluent repetitions. Unpredictable words elicited an N400 effect. Importantly, there was no evidence that this effect, thought to reflect the difficulty of semantically integrating unpredictable compared to predictable words, differed quantitatively between fluent and disfluent utterances. Furthermore there was no evidence that the memorability of words was affected by the presence of a preceding repetition. These findings contrast with previous research which demonstrated an N400 attenuation of, and an increase in memorability for, words that were preceded by an er. However, in a later (600–900 ms) time window, unpredictable words following a repetition elicited a relative positivity. Reanalysis of previous data confirmed the presence of a similar effect following an er. The effect may reflect difficulties in resuming linguistic processing following any disruption to speech.

from Brain and Language

Understanding in an instant: Neurophysiological evidence for mechanistic language circuits in the brain

Abstract
How long does it take the human mind to grasp the idea when hearing or reading a sentence? Neurophysiological methods looking directly at the time course of brain activity indexes of comprehension are critical for finding the answer to this question. As the dominant cognitive approaches, models of serial/cascaded and parallel processing, make conflicting predictions on the time course of psycholinguistic information access, they can be tested using neurophysiological brain activation recorded in MEG and EEG experiments. Seriality and cascading of lexical, semantic and syntactic processes receives support from late (latency 1/2 s) sequential neurophysiological responses, especially N400 and P600. However, parallelism is substantiated by early near-simultaneous brain indexes of a range of psycholinguistic processes, up to the level of semantic access and context integration, emerging already 100–250 ms after critical stimulus information is present. Crucially, however, there are reliable latency differences of 20–50 ms between early cortical area activations reflecting lexical, semantic and syntactic processes, which are left unexplained by current serial and parallel brain models of language. We here offer a mechanistic model grounded in cortical nerve cell circuits that builds upon neuroanatomical and neurophysiological knowledge and explains both near-simultaneous activations and fine-grained delays. A key concept is that of discrete distributed cortical circuits with specific inter-area topographies. The full activation, or ignition, of specifically distributed binding circuits explains the near-simultaneity of early neurophysiological indexes of lexical, syntactic and semantic processing. Activity spreading within circuits determined by between-area conduction delays accounts for comprehension-related regional activation differences in the millisecond range.

from Brain and Language

Cleft Audit Protocol for Speech (CAPS-A): a comprehensive training package for speech analysis

Methods & Procedures: Thirty-six specialist speech and language therapists undertook the training programme over four days. This consisted of two days’ training on the CAPS-A tool followed by a third day, making independent ratings and transcriptions on ten new cases which had been previously recorded during routine audit data collection. This task was repeated on day 4, a minimum of one month later. Ratings were made using the CAPS-A record form with the CAPS-A definition table. An analysis was made of the speech and language therapists’ CAPS-A ratings at occasion 1 and occasion 2 and the intra- and inter-rater reliability calculated.

Outcomes & Results: Trained therapists showed consistency in individual judgements on specific sections of the tool. Intraclass correlation coefficients were calculated for each section with good agreement on eight of 13 sections. There were only fair levels of agreement on anterior oral cleft speech characteristics, non-cleft errors/immaturities and voice. This was explained, at least in part, by their low prevalence which affects the calculation of the intraclass correlation coefficient statistic.

Conclusions & Implications: Speech and language therapists benefited from training on the CAPS-A, focusing on specific aspects of speech using definitions of parameters and scalar points, in order to apply the tool systematically and reliably. Ratings are enhanced by ensuring a high degree of attention to the nature of the data, standardizing the speech sample, data acquisition, the listening process together with the use of high-quality recording and playback equipment. In addition, a method is proposed for maintaining listening skills following training as part of an individual’s continuing education.

from the International Journal of Language and Communication Disorders

Electrophysiological (EEG, sEEG, MEG) evidence for multiple audiovisual interactions in the human auditory cortex

Abstract
In this review, we examine the contribution of human electrophysiological studies (EEG, sEEG and MEG) to the study of visual influence on processing in the auditory cortex. Focusing mainly on studies performed by our group, we critically review the evidence showing (1) that visual information can both activate and modulate the activity of the auditory cortex at relatively early stages (mainly at the processing stage of the auditory N1 wave) in response to both speech and non-speech sounds and (2) that visual information can be included in the representation of both speech and non-speech sounds in auditory sensory memory. We describe an important conceptual tool in the study of audiovisual interaction (the additive model) and show the importance of considering the spatial distribution of electrophysiological data when interpreting EEG results. Review of these studies points to the probable role of sensory, attentional and task-related factors in modulating audiovisual interactions in the auditory cortex.

from Language and Cognitive Processes

Teacher identification of speech and language impairment in kindergarten students using the Kindergarten Development Check

The purpose of this paper was to profile the extent and accuracy of teacher identification of speech and language impairment within a kindergarten student population in Tasmania, Australia, using the Kindergarten Development Check (KDC). A total of 286 kindergarten students (aged 4-5 years and in their first year of formal schooling) were screened by teachers with the KDC on two separate occasions over their kindergarten year. In the following academic year, each of the same 286 students were assessed by a speech-language pathologist, and diagnosed with either typically developing or impaired speech and/or language skills. Review of KDC data determined the number of students identified by teachers with speech and language impairment at each occasion during their kindergarten year. Comparison of data from the later KDC administration and speech-language pathology assessment then determined the correspondence between identification of speech and language impairment by teachers and speech-language pathologists. Upon initial administration of the KDC, 51 (17.8%) students were identified by teachers with language impairment and 47 (16.4%) students with speech impairment. Following the second administration of the KDC 3 months later, 20 (7.0%) students continued to be identified with language impairment, and 39 (13.6%) with speech impairment. Comparison of speech-language pathology testing results and KDC data from the second administration found the overall validity of teacher identification was 86.4% and 71% for speech and language impairment respectively. Specificity rates were high, with 93% and 97% of students with typically developing speech and language skills respectively, correctly classified on the KDC. However, the sensitivity was only 50% for speech impairment and 15% for language impairment, indicating that 50% of students presenting with speech impairment and 85% of students with language impairment in their subsequent academic year were not recorded by teachers as having such a difficulty on the later KDC administration during their kindergarten year. The KDC appears to be ineffective in supporting kindergarten teachers to identify students with ongoing speech and to a greater extent, language impairment. Measures to improve the sensitivity of the KDC in particular need to be considered by speech-language pathologists and educational professionals in Tasmania.

from the International Journal of Speech-Language Pathology

Interaction of speech and script in human auditory cortex: Insights from neuro-imaging and effective connectivity

In addition to visual information from the face of the speaker, a less natural, but nowadays extremely important visual component of speech is its representation in script. In this review, neuro-imaging studies are examined which were aimed to understand how speech and script are associated in the adult “literate” brain. The reviewed studies focused on the role of different stimulus and task factors and effective connectivity between different brain regions. The studies will be summarized in a neural mechanism for the integration of speech and script that can serve as a basis for future studies addressing (the failure of) literacy acquisition. In this proposed mechanism, speech sound processing in auditory cortex is modulated by co-presented visual letters, depending on the congruency of the letter–sound pairs. Other factors of influence are temporal correspondence, input quality and task instruction. We present results showing that the modulation of auditory cortex is most likely mediated by feedback from heteromodal areas in the superior temporal cortex, but direct influences from visual cortex are not excluded. The influence of script on speech sound processing occurs automatically and shows extended development during reading acquisition. This review concludes with suggestions to answer currently still open questions to get closer to understanding the neural basis of normal and impaired literacy.

from Hearing Research