Phonemic discrimination and reproduction in 4-5-year-old children : Relations to hearing

Objective: The long-term objective of this research is to highlight the importance of speech perception assessment in children with developmental language disorder (DLD), and to investigate how hearing contributes to speech and language skills. As a first step in fulfilling this aim, the present study explored relations between phonemic discrimination and reproduction, and sensitive measures of hearing in young healthy children. Methods: The American Listen-Say test was developed and served as speech perception tool. This test reports speech discrimination of phonemic contrasts quantitatively for both quiet and in noise conditions, along with reproduction scores, all measured within one session. Speech tokens were perceptually homogenized in noise. Forty-one 4-5-year-old American children participated. Phonemic discrimination (quiet and speech shaped noise) and phonemic reproduction, audiometric thresholds in the conventional (1-8 kHz) and extended high frequency (EHF; 10-16 kHz) range, and distortion product otoacoustic emissions (DPOAEs) were examined. Results: All children had normal hearing thresholds within the conventional range (mean PTA bilaterally 8.6 dB HL). Ten (24.3%) of the children had elevated EHF thresholds (> 20 dB HL) for one or more frequencies or ears, and six (14.6%) had DPOAE signal to noise ratios (SNR) < 6 dB. EHF thresholds and DPOAE SNRs were significantly associated. Children's phonemic discrimination was impaired in noise, relative to quiet. There was a moderate, significant correlation between overall phonemic discrimination in noise and EHF audiometric thresholds. Conclusions: Overall, the present study showed that sensitive hearing measures enabled the detection of subtle hearing difficulties in young healthy children. In particular, phonemic discrimination in noise showed associations with hearing. Implications of including sensitive hearing measures in children with DLD are discussed

Rethinking Sound : Computer-assisted reading intervention with a phonics approach for deaf and hard of hearing children using cochlear implants or hearing aids

In the present thesis, computer-assisted reading intervention with a phonics approach was examined in deaf and hard of hearing children (DHH) aged 5, 6 or 7 years old using cochlear implants, hearing aids or a combination of both. Children with normal hearing (NH), matched for non-verbal intelligence and age, served as a reference group. Deaf and hard of hearing children constitute a heterogenetic population regarding cognitive and academic achievement. Many of them do not reach age appropriate levels in language and reading ability during their school years, with negative consequences for later training facilities and job opportunities. Finding relevant intervention methods to promote early language learning and literacy development that are easy to implement is therefore of great importance. In this thesis three aspects of cognitive ability (phonological processing skills, lexical access and working memory capacity), and reading ability was examined at three points in time; baseline 1, pre intervention and post intervention. Additionally, computer-assisted training delivered by  means of the Internet in the children’s homes was explored in order to determine whether it would be a useful and efficient method for the DHH population. Overall, the results from the present thesis support the notion that offering a computer-assisted intervention program delivered at home, is an alternative way to support not only NH children with reading difficulties but also to support DHH children’s phonological development and decoding proficiency.I denna avhandling undersöktes fonologisk lästräning vid datorn för döva och hörselskadade barn 5, 6 och 7 år gamla som använde cochleaimplantat, hörapparat eller en kombination av båda. Barn med normal hörsel som var matchade avseende icke-verbal intelligens och ålder utgjorde jämförelsegrupp. Döva och hörselskadade barn utgör en heterogen grupp avseende kognitiv förmåga och skolframgång. Många av dem når inte kraven för åldern avseende språk och läsförmåga under skoltiden vilket får negativa konsekvenser för senare utbildning och arbete. Att hitta relevanta interventionsmetoder för att främja tidig språkinlärning och läsutveckling som är lätta att genomföra, är därför av stor betydelse. I avhandlingen undersöktes tre aspekter av kognitiv förmåga (fonologisk bearbetningsförmåga, lexikal åtkomst och arbetsminneskapacitet) och läsförmåga vid tre tidpunkter; förtest 1, före intervention och efter intervention. Dessutom undersöktes om datorbaserad intervention som genomförs via Internet i hemmet, skulle vara en användbar och effektiv metod för döva och hörselskadade barn. Resultaten i stort visar att fonologisk lästräning vid datorn i barnens hem är en alternativ metod att stödja inte bara barn i risk att utveckla lässvårigheter, utan även döva och hörselskadade barns fonologi och avkodningsförmåga