Relationship between self-reported listening and communication difficulties and executive function: a protocol for a systematic review and meta-analysis

Introduction Listening and communication difficulties can limit people’s participation in activity and adversely affect their quality of life. Hearing, as well as listening and communication difficulties, can be measured either by using behavioural tests or self-report measures, and the outcomes are not always closely linked. The association between behaviourally measured and self-reported hearing is strong, whereas the association between behavioural and self-reported measures of listening and communication difficulties is much weaker, suggesting they assess different aspects of listening. While behavioural measures of listening and communication difficulties have been associated with poorer cognitive performance including executive functions, the same association has not always been shown for self-report measures. The objective of this systematic review and meta-analysis is to understand the relationship between executive function and self-reported listening and communication difficulties in adults with hearing loss, and where possible, potential covariates of age and pure-tone audiometric thresholds.Methods and analysis Studies will be eligible for inclusion if they report data from both a self-report measure of listening difficulties and a behavioural measure of executive function. Eight databases are to be searched: MEDLINE (via Ovid SP), EMBASE (via Ovid SP), PsycINFO (via Ovid SP), ASSIA (via ProQuest), Cumulative Index to Nursing and Allied Health Literature or CINAHL (via EBSCO Host), Scopus, PubMed and Web of Science (Science and Social Science Citation Index). The JBI critical appraisal tool will be used to assess risk of bias for included studies. Results will be synthesised primarily using a meta-analysis, and where sufficient quantitative data are not available, a narrative synthesis will be carried out to describe key results

Tecken på läsutveckling : Teckenspråk och läsutveckling hos döva och hörselskadade barn

Reading development is supported by strong language skills, not least in deaf and hard-of-hearing (DHH) children. The work in the present thesis investigates reading development in DHH children who use sign language, attend Regional Special Needs Schools (RSNS) in Sweden and are learning to read. The primary aim of the present work was to investigate whether the reading skills of these children can be improved via computerized sign language based literacy training. Another aim was to investigate concurrent and longitudinal associations between skills in reading, sign language, and cognition in this population. The results suggest that sign language based literacy training may support development of word reading. In addition, awareness and manipulation of the sub-lexical structure of sign language seem to assist word reading, and imitation of familiar signs (i.e., vocabulary) may be associated with developing reading comprehension. The associations revealed between sign language skills and reading development support the notion that sign language skills provide a foundation for emerging reading skills in DHH signing children. In addition, the results also suggest that working memory and Theory of Mind (ToM) are related to reading comprehension in this population. Furthermore, the results indicate that sign language experience enhances the establishment of representations of manual gestures, and that progression in ToM seems to be typical, although delayed, in RSNS pupils. Working memory has a central role in integrating environmental stimuli and language-mediated representations, and thereby provides a platform for cross-modal language processing and multimodal language development.En god språklig förmåga bidrar till god läsutveckling, inte minst hos döva och hörselskadade (D/H) barn. Studierna som ingår i avhandlingen undersöker läsutveckling hos D/H elever som går på teckenspråkiga specialskolor och som håller på att lära sig att läsa. Arbetets huvudsakliga syfte var att undersöka om deras läsförmåga kan förbättras via datoriserad teckenspråksbaserad lästräning. Ett annat syfte var att undersöka samtida och longitudinella samband mellan läsförmåga, teckenspråk, och kognition i samma population. Resultaten indikerar att teckenspråksbaserad lästräning kan bidra till ordläsningsutveckling. Vidare pekar resultaten på att medvetenhet om och manipulation av teckenspråkets sublexikala struktur stöttar läsförmågan och dessutom att imitation av kända tecken (i.e., vokabulär) var associerat med utvecklingen av barnens läsförståelse. Dessa fynd visar att teckenspråkskunskaper kan utgöra en grund för läsutveckling hos teckenspråkiga D/H elever. Resultaten indikerade även att arbetsminne och Theory of Mind (ToM) är relaterade till läsförståelse i denna grupp. Vid sidan av resultaten rörande läsutveckling, framkom också att teckenspråkserfarenhet leder till starkare etablering av representationer av manuella gester och vidare att barnens mentaliseringsförmåga (Theory of Mind) uppvisade en förväntad progression, om än försenad. En implikation av detta är att insatser som stöttar utveckling av teckenbaserade representationer och deras användning vid bearbetning av skrivet språk kan främja läsutveckling hos teckenspråkiga D/H elever. Arbetsminne föreslås genom sin roll i integration mellan inkommande stimuli och språkmedierade representationer fungera som en plattform för modalitetsöverskridande språkbearbetning och multimodal språkutveckling

Reorganization of large-scale brain networks in deaf signing adults: The role of auditory cortex in functional reorganization following deafness

If the brain is deprived of input from one or more senses during development, functional and structural reorganization of the deprived regions takes place. However, little is known about how sensory deprivation affects large-scale brain networks. In the present study, we use data-driven independent component analysis (ICA) to characterize large-scale brain networks in 15 deaf early signers and 24 hearing non-signers based on resting-state functional MRI data. We found differences between the groups in independent components representing the left lateralized control network, the default network, the ventral somatomotor network, and the attention network. In addition, we showed stronger functional connectivity for deaf compared to hearing individuals from the middle and superior temporal cortices to the cingulate cortex, insular cortex, cuneus and precuneus, supramarginal gyrus, supplementary motor area, and cerebellum crus 1, and stronger connectivity for hearing non-signers to hippocampus, middle and superior frontal gyri, pre- and postcentral gyri, and cerebellum crus 8. These results show that deafness induces large-scale network reorganization, with the middle/superior temporal cortex as a central node of plasticity. Cross-modal reorganization may be associated with behavioral adaptations to the environment, including superior ability in some visual functions such as visual working memory and visual attention, in deaf signers

Editorial Material: Working Memory in Deaf Children Is Explained by the Developmental Ease of Language Understanding (D-ELU) Model in FRONTIERS IN PSYCHOLOGY, vol 7, issue 1047, pp

n/aFunding Agencies|Swedish Research Council for Health, Working Life and Welfare [2008-0846]</p

Neonatal Imitation, Intersubjectivity, and Children With Atypical Development : Do Observations on Autism and Down Syndrome Change Our Understanding?

Almost all studies on neonatal imitation to date seem to have focused on typically developing children, and we thus lack information on the early imitative abilities of children who follow atypical developmental trajectories. From both practical and theoretical perspectives, these abilities might be relevant to study in children who develop a neuropsychiatric diagnosis later on or in infants who later show impaired ability to imitate. Theoretical in the sense that it will provide insight into the earliest signs of intersubjectivity—i.e., primary intersubjectivity—and how this knowledge might influence our understanding of children following atypical trajectories of development. Practical in the sense that it might lead to earlier detection of certain disabilities. In the present work, we screen the literature for empirical studies on neonatal imitation in children with an Autism spectrum disorder (ASD) or Down syndrome (DS) as well as present an observation of neonatal imitation in an infant that later was diagnosed with autism and a re-interpretation of previously published data on the phenomenon in a small group of infants with DS. Our findings suggest that the empirical observations to date are too few to draw any definite conclusions but that the existing data suggests that neonatal imitation can be observed both in children with ASD and in children with DS. Thus, neonatal imitation might not represent a useful predictor of a developmental deficit. Based on current theoretical perspectives advocating that neonatal imitation is a marker of primary intersubjectivity, we propose tentatively that an ability to engage in purposeful exchanges with another human being exists in these populations from birth.Funding: Sven Jerring Foundation; Claes Groschinskys Foundation, Sweden; Swedish Council for Working Life and Social ResearchSwedish Research CouncilSwedish Research Council for Health Working Life &amp; Welfare (Forte) [2008-0875]; Swedish Research CouncilSwedish Research CouncilEuropean Commission [2011-1913]; Swedish Research Council for Health, Working Life and WelfareSwedish Research CouncilSwedish Research Council for Health Working Life &amp; Welfare (Forte) [2018-01840]; Marcus and Amalia Wallenberg Foundation (MAW) [2018.0084]</p

Computerized Sign Language-Based Literacy Trainingfor Deaf and Hard-of-Hearing Children

Strengthening the connections between sign language and written language may improve reading skills in deaf and hard-of-hearing (DHH) signing children. The main aim of the present study was to investigate whether computerized sign language-based literacy training improves reading skills in DHH signing children who are learning to read. Further, longitudinal associations between sign language skills and developing reading skills were investigated. Participants were recruited from Swedish state special schools for DHH children, where pupils are taught in both sign language and spoken language. Reading skills were assessed at five occasions and the intervention was implemented in a cross-over design. Results indicated that reading skills improved over time and that development of word reading was predicted by the ability to imitate unfamiliar lexical signs, but there was only weak evidence that it was supported by the intervention. These results demonstrate for the first time a longitudinal link between sign-based abilities and word reading in DHH signing children who are learning to read. We suggest that the active construction of novel lexical forms may be a supramodal mechanism underlying word reading development.Funding agencies: Swedish Research Council for Health, Working Life and Welfare [2008-0846]; Swedish Hearing Foundation [B2015/480]</p

Load and distinctness interact in working memory for lexical manual gestures

The Ease of Language Understanding model (Ronnberg et al., 2013) predicts that decreasing the distinctness of language stimuli increases working memory load; in the speech domain this notion is supported by empirical evidence. Our aim was to determine whether such an over-additive interaction can be generalized to sign processing in sign-naive individuals and whether it is modulated by experience of computer gaming. Twenty young adults with no knowledge of sign language performed an n-back working memory task based on manual gestures lexicalized in sign language; the visual resolution of the signs and working memory load were manipulated. Performance was poorer when load was high and resolution was low. These two effects interacted over-additively, demonstrating that reducing the resolution of signed stimuli increases working memory load when there is no pre-existing semantic representation. This suggests that load and distinctness are handled by a shared amodal mechanism which can be revealed empirically when stimuli are degraded and load is high, even without pre-existing semantic representation. There was some evidence that the mechanism is influenced by computer gaming experience. Future work should explore how the shared mechanism is influenced by pre-existing semantic representation and sensory factors together with computer gaming experience.Funding Agencies|Linnaeus Centre HEAD grant from the Swedish Research Council</p

Cognitive Hearing Science: Three Memory Systems, Two Approaches, and the Ease of Language Understanding Model

Purpose The purpose of this study was to conceptualize the subtle balancing act between language input and prediction (cognitive priming of future input) to achieve understanding of communicated content. When understanding fails, reconstructive postdiction is initiated. Three memory systems play important roles: working memory (WM), episodic long-term memory (ELTM), and semantic long-term memory (SLTM). The axiom of the Ease of Language Understanding (ELU) model is that explicit WM resources are invoked by a mismatch between language input—in the form of rapid automatic multimodal binding of phonology—and multimodal phonological and lexical representations in SLTM. However, if there is a match between rapid automatic multimodal binding of phonology output and SLTM/ELTM representations, language processing continues rapidly and implicitly. Method and Results In our first ELU approach, we focused on experimental manipulations of signal processing in hearing aids and background noise to cause a mismatch with LTM representations; both resulted in increased dependence on WM. Our second—and main approach relevant for this review article—focuses on the relative effects of age-related hearing loss on the three memory systems. According to the ELU, WM is predicted to be frequently occupied with reconstruction of what was actually heard, resulting in a relative disuse of phonological/lexical representations in the ELTM and SLTM systems. The prediction and results do not depend on test modality per se but rather on the particular memory system. This will be further discussed. Conclusions Related to the literature on ELTM decline as precursors of dementia and the fact that the risk for Alzheimer's disease increases substantially over time due to hearing loss, there is a possibility that lowered ELTM due to hearing loss and disuse may be part of the causal chain linking hearing loss and dementia. Future ELU research will focus on this possibility.Funding: Swedish Research CouncilSwedish Research CouncilEuropean Commission [2017-06092]; Linnaeus Centre HEAD - Swedish Research Council; FORTE: Swedish Research Council for Health, Working Life, and Welfare</p

Evidence of an association between sign language phonological awareness and word reading in deaf and hard-of-hearing children

BACKGROUND AND AIMS: Children with good phonological awareness (PA) are often good word readers. Here, we asked whether Swedish deaf and hard-of-hearing (DHH) children who are more aware of the phonology of Swedish Sign Language, a language with no orthography, are better at reading words in Swedish. METHODS AND PROCEDURES: We developed the Cross-modal Phonological Awareness Test (C-PhAT) that can be used to assess PA in both Swedish Sign Language (C-PhAT-SSL) and Swedish (C-PhAT-Swed), and investigated how C-PhAT performance was related to word reading as well as linguistic and cognitive skills. We validated C-PhAT-Swed and administered C-PhAT-Swed and C-PhAT-SSL to DHH children who attended Swedish deaf schools with a bilingual curriculum and were at an early stage of reading. OUTCOMES AND RESULTS: C-PhAT-SSL correlated significantly with word reading for DHH children. They performed poorly on C-PhAT-Swed and their scores did not correlate significantly either with C-PhAT-SSL or word reading, although they did correlate significantly with cognitive measures. CONCLUSIONS AND IMPLICATIONS: These results provide preliminary evidence that DHH children with good sign language PA are better at reading words and show that measures of spoken language PA in DHH children may be confounded by individual differences in cognitive skills.Funding agencies: Swedish Research Council for Health, Working Life and Welfare [2008-0846]</p

Cognitive hearing science and ease of language understanding

Objective: The current update of the Ease of Language Understanding (ELU) model evaluates the predictive and postdictive aspects of speech understanding and communication.Design: The aspects scrutinised concern: (1) Signal distortion and working memory capacity (WMC), (2) WMC and early attention mechanisms, (3) WMC and use of phonological and semantic information, (4) hearing loss, WMC and long-term memory (LTM), (5) WMC and effort, and (6) the ELU model and sign language.Study Samples: Relevant literature based on own or others data was used.Results: Expectations 1-4 are supported whereas 5-6 are constrained by conceptual issues and empirical data. Further strands of research were addressed, focussing on WMC and contextual use, and on WMC deployment in relation to hearing status. A wider discussion of task demands, concerning, for example, inference-making and priming, is also introduced and related to the overarching ELU functions of prediction and postdiction. Finally, some new concepts and models that have been inspired by the ELU-framework are presented and discussed.Conclusions: The ELU model has been productive in generating empirical predictions/expectations, the majority of which have been confirmed. Nevertheless, new insights and boundary conditions need to be experimentally tested to further shape the model.Funding Agencies|Linnaeus Centre HEAD excellence centre grant from the Swedish Research Council [349-2007-8654]; FORTE [2012-1693]; Swedish Research Council [2017-06092]</p