Purpose: A significant association between neurotypical (NT) children's language abilities and theory of mind (ToM) false belief (FB) skills has been reported in the literature. Older school-aged children with developmental language disorder (DLD) are characterized by impaired language, yet their FB ToM skills show mixed results. This study aimed to shed light on whether FB skills are affected in children with DLD by investigating two related factors: task modality (verbal [V] vs. nonverbal [NV] mode of assessing ToM) and the potential impact of language abilities on FB performance. Method: A total of 50 NT children and children with DLD ( n = 25 each group) aged 9–11 years completed a first- and a second-order ToM task (true beliefs and FBs) in V and NV modes. The groups were matched on age and gender. Children were further evaluated via online one-on-one sessions for morphosyntax, vocabulary, working memory, and NV intelligence quotient. Results: The findings revealed that children with DLD scored lower than did NT children on FBs, and most importantly, they scored similarly in the V and NV modes. Furthermore, children's complement clauses were positively correlated with FBs and emerged as the only significant predictor of FBs in generalized linear mixed-model analyses. As expected, performance on second-order FBs was harder than on first-order FBs. Conclusions: The findings demonstrated that school-aged children with DLD have difficulties in FBs, which do not stem from the modality of the task assessing them when the task does not include complex language. Moreover, out of all sentences children produced, complement clauses were intimately related to their FB skills. These are important findings for the relation of language and FBs, as well as for clinical purposes, as FB skills are crucial for successful communication and hence should be considered carefully in language-impaired populations.
Purpose: The study examined the relative contribution of parent lexical diversity and grammatical complexity at different time points to subsequent language outcomes in Mandarin-speaking children with cochlear implants (CIs). Method: Participants were 25 Mandarin-speaking children who received cochlear implantation before 30 months of age. At 1 and 2 years after CI activation, we collected language samples that involved the child playing with the parent for 30 min. The parent's number of different words (NDW) and mean length of utterance (MLU) were computed from the free play for each time point. At 3 years after CI activation, we evaluated children's receptive and expressive language outcomes using a standardized language test. Results: Parent NDW and MLU at 1 and 2 years post-CI activation were significantly correlated with children's language scores at 3 years post-CI activation, except that parent MLU at 1 year was not significantly correlated with children's expressive language scores. Regression analyses further revealed that, at 1 year post-CI activation, parent NDW was stronger than parent MLU in accounting for both children's receptive and expressive language scores at 3 years post-CI activation. At 2 years post-CI activation, parent NDW was relatively more important for children's subsequent receptive language scores, whereas parent MLU at 2 years post-CI activation was relatively more important for children's subsequent expressive language scores. Conclusions: The relative contributions of parent lexical diversity (NDW) and grammatical complexity (MLU) to later language outcomes in Mandarin-speaking children with CIs evolved over time, particularly for expressive language. The emphasis on lexical diversity and grammatical complexity in parental input should change with the child's developmental level. Supplemental Material: https://doi.org/10.23641/asha.32014944
PURPOSE:This study evaluated the effects of computerized perceptual training by incorporating key modifications to address limitations identified in prior research. Training was specifically targeted to children identified as having "atypical perception," considered good candidates for perceptual training. METHOD:Ten monolingual English-speaking children aged 9;0-11;7 (years;months) with residual speech sound disorder (RSSD) affecting /ɹ/ participated in a multiple-baseline study, completing three to six baselines before receiving twelve 30-min perceptual training sessions. A midpoint production probe was administered immediately after the perceptual training phase to assess preliminary changes in /ɹ/ accuracy. Subsequently, participants engaged in exploratory practice sessions, focused on facilitating rhotic production, followed by three postprobe sessions and a 1-month follow-up. All study activities were conducted online. RESULTS:Visual inspection of individual trajectories and calculation of standardized effect sizes revealed meaningful changes in auditory-perceptual skills following the perception training. The majority of participants exhibited a reduction in categorical labeling consistency, suggesting more consistent categorization of speech stimuli along the /ɹ/-/w/ continuum, and all participants showed increased perceptual accuracy in the identification task. Category goodness ratings of /ɹ/ words also improved for all participants, with effect size values indicating clinically meaningful change. CONCLUSIONS:This study demonstrates that online computerized perceptual training holds promise as an effective intervention for improving speech, particularly when tailored to the needs of children with RSSD and atypical speech perception. With the long-term goal of making these tools freely available to clinical practitioners, we aim to empower clinicians to deliver targeted, effective interventions that accelerate progress for clients with RSSD. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.32015043.
PURPOSE:Infants gradually attune to the consonants of their native language throughout the first year of life. This study investigated the role of auditory temporal processing in this early perceptual attunement. METHOD:We used electrophysiological measures to investigate the processing of temporal modulations, the amplitude modulation (AM) and frequency modulation (FM) in speech. Cortical auditory evoked potentials (CAEPs) were measured for native (voiced /b/ and unvoiced unaspirated /p/) and nonnative (unvoiced aspirated English /p/) consonants in French-learning 6-month-old and 10-month-old infants. We also included a group of young adult listeners to serve as a reference group for qualitative comparisons with infants, as there were no prior studies on the effects of temporal degradation on adults' CAEPs. The three consonants were presented under three conditions where AM and FM were differentially degraded or preserved: (a) original FM and AM preserved (no stimulus degradation), (b) fast AM (degrading FM and preserving the original AM), and (c) slow AM only (degrading FM and faster AM fluctuations). RESULTS:Temporal degradation affected CAEPs differently across infant age groups, suggesting ongoing development of auditory processing mechanisms for FM and AM cues. Six-month-olds exhibited heightened sensitivity to the reduction of fast AM cues, whereas 10-month-olds were more sensitive to FM degradation. CONCLUSIONS:Age significantly shapes cortical auditory responses to speech temporal cues. Six-month-olds' neural responses were primarily influenced by fast AM reduction (> 8 Hz), whereas 10-month-olds' responses were more susceptible to FM degradation. Adults did not show either pattern, indicating that the perceptual weighting of temporal modulations in speech continues to develop beyond infancy. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.32030250.
PURPOSE:This study examined how bilingualism influences early linguistic and pragmatic alterations in idiopathic Parkinson's disease (IPD), integrating group-based and factorial analyses to identify early communicative markers. METHOD:Sixty-five participants (13 bilingual IPD, 14 monolingual IPD, 14 bilingual healthy, 24 monolingual healthy) produced Turkish narratives based on Frog, Where Are You? Group comparisons (Kruskal-Wallis H and Mann-Whitney U tests) were performed across four groups for microstructural indices (mean length of utterance in morphemes [MLU-M], type-token ratio [TTR], morphological errors, verbal fragmentations) and pragmatic markers (enrichment, exclamation, uncertainty, metaphor, emotional terms). Supplementary 2 × 2 factorial analyses (disease: IPD vs. healthy; bilingualism: bilingual vs. monolingual) were conducted to examine main and interaction effects, with acoustic parameters (fundamental frequency [F0] and intensity ranges) included for prosodic evaluation. RESULTS:Group comparisons revealed that bilingual IPD speakers exhibited the lowest MLU-M (p = .012), highest morphological error (p = .036), and greatest verbal fragmentation (p < .001). Pragmatically, they produced fewer enrichment expressions (p = .041) but more exclamations than monolingual IPD participants (p < .001). Acoustic analysis showed reduced but still broader F0 and intensity ranges in bilingual IPD speakers relative to monolingual IPD speakers (p = .012, p = .047). The 2 × 2 factorial analysis confirmed significant main effects of disease on MLU-M and TTR (p < .05) and Disease × Bilingualism interactions for morphological errors and enrichment (p < .05), demonstrating that bilingualism amplified morphosyntactic instability but mitigated prosodic flattening. CONCLUSIONS:Early-stage IPD involves concurrent microstructural and pragmatic decline, with bilingualism exerting both protective and burdening effects. Crucially, the reduction of enrichment expressions (p < .05) emerged as an early and sensitive indicator of pragmatic deterioration in bilingual Parkinson's disease, linking executive-control demands with sociopragmatic incompleteness. Discourse-level analyses combining group-based and factorial approaches thus provide a refined framework for identifying subclinical linguistic-pragmatic changes beyond conventional motor or lexical measures. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.31999344.
Purpose: Narrative abilities offer valuable insights into daily-life communication and can aid the complex task of identifying developmental language disorder (DLD) in bilingual children. However, there is limited consensus on which lin-guistic measures are most informative to distinguish bilingual children with DLD from their typically developing (TD) peers. This study aimed to quantitatively determine which combination of narrative measures most accurately classifies bilingual TD children and bilingual children with DLD. Method: Fifty bilingual TD children and 50 bilingual children with DLD aged 5-9 years who spoke Dutch as a second language participated. Narrative skills were assessed in Dutch using both storytelling and retelling tasks. Eleven mea-sures reflecting narrative productivity, complexity, and accuracy were analyzed across both tasks. Both group-level differences between TD children and chil-dren with DLD, and individual diagnostic performance were examined. Results: While most measures accurately distinguished between children with and without DLD at group level, they did not achieve sufficient diagnostic accu-racy at the individual level. Nevertheless, combining multiple measures improved classification. The storytelling task reached 82% diagnostic accuracy using four measures, while the retelling task achieved 80% diagnostic accuracy using 10 measures. A combined approach using four measures from both tasks increased accuracy to 85%. The most informative measures were the number of utterances, mean length of utterance, number of different words, and mean number of (gram-matical) errors per utterance. Conclusion: Extracting a limited set of measures from narrative tasks can pro-vide both diagnostic effectiveness and clinical feasibility, supporting the inclu-sion of narrative tasks in bilingual language assessment. Supplemental Material: https://doi.org/10.23641/asha.32035188
PURPOSE:Children with developmental language disorder (DLD) have difficulty making online predictions of language material following verbs (e.g., "The monkey eats a very delicious … [banana]"). We explore the contributions of lexicosemantic knowledge deficits and online processing deficits by comparing performance across offline lexicosemantic and online processing tasks in sentences with higher versus lower speed and complexity. METHOD:Participants included twenty-six 4- to 5-year-old children with DLD and 26 age-matched children with typical development (TD). In Experiment 1, participants' lexicosemantic knowledge about verb-patient associates was assessed (e.g., "What do babies usually wear? A bib or a necklace?") in an offline pointing task. Following the offline task, participants' online predictive processing for the same verb-patient associates was assessed using eye tracking (e.g., "The baby is wearing a very special [bib vs. necklace]"). In Experiment 2, the same tasks were completed with simpler sentences spoken at a slower rate with a reduced number of words. RESULTS:Across the two experiments, the quality of lexicosemantic knowledge impacted the quality of sentence prediction for children in both groups. In addition, children with DLD had poorer lexicosemantic knowledge compared to peers with TD. Yet even after accounting for item-level lexicosemantic knowledge, the children with DLD differed from their peers with TD in sentence prediction. Specifically, children with DLD showed similar sentence prediction to peers with TD in faster sentences, but in slower sentences, their predictions decayed over time. CONCLUSIONS:Children with DLD have sentence prediction deficits due to a combination of lexicosemantic knowledge deficits and problems with working memory decay and sustained attention. Sentence prediction deficits in DLD arise from both lexicosemantic and processing factors. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.31999236.
PURPOSE:Oral and oropharyngeal cancer and its treatment can have a devastating impact on speech. The goal of this study is to characterize the changes in English sibilant /s/ production associated with resection site and the sex and age of the patients following surgical removal of oral and oropharyngeal tumors. METHOD:The acoustics of 4,371 productions of /s/ from read continuous speech of 89 patients (66 men, 23 women) with an mean age of 58.2 years (range: 22-82) were analyzed before and after surgery for oral and/or oropharyngeal cancer. The center of gravity (COG) of the fricative power spectrum was analyzed with a linear mixed-effects model with assessment time (pre-operative and 1, 6, and 12 months postoperative), age, sex, and proportion of resections (%) within oral and pharyngeal structures as fixed effects and random intercepts for speaker and phonetic context. RESULTS:Before surgery, male sex and older age were associated with lower COG. After surgery, COG was reduced with partial recovery at 1 year and dropped more for females than males. Overall, recovery was better among those who did not have radiation. At 1 year, the COG of /s/ was most impacted by resections to the tongue (without radiation), followed by resections to the velopharyngeal mechanism (with radiation). The additional effect of radiation treatment was modulated by age. CONCLUSIONS:The results suggest partial recovery of speech function at 1 year. The recovery was gendered with females remaining further away from the pretreatment values after surgery compared to the males. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.31953024.
PURPOSE:This study proposes three cue-signaling gestures corresponding to duration, intensity, and pitch. The aims are to assess the effects of the three gestures on the perception and production of English stress across various intonation and stress patterns. METHOD:Seventy-nine Chinese adolescents aged 15.1 years were divided into three groups using the three gestures. Individual differences in age, gender, English learning experience, musical experience, phonological working memory, and auditory acuity were controlled across the groups. A perception and a production test were conducted in the pre- and posttests. Generalized linear and linear mixed-effects models were constructed to estimate the accuracy of stress identification and the acoustic characteristics of the stress production across the three groups, two stress patterns, and two intonations. RESULTS:The duration gesture group outperformed the other two groups in both perception and production, and the effect was generalized to untrained items. The trochaic pattern (strong-weak) was more challenging than the iambic pattern (weak-strong), and the stress in rising intonations caused more difficulty than in falling intonations. CONCLUSIONS:The duration gesture is more recommended for teaching English lexical stress, while the trochaic stress pattern, especially with rising intonations, requires additional attention. The current findings furnish novel implications for multimodal phonetic instruction; the visual and tactile modalities of gestures could be potentially helpful for individuals with pathological conditions.
Purpose: Pupillometry has been frequently used to examine the influence of auditory task demand on listening effort. However, the intelligibility effect on the pupil dilation response might be altered under high memory load. Method: We assessed the effects of signal-to-noise ratio (SNR; auditory demand), memory load, and stimulus rehearsal on the pupil dilation response. Twenty-four participants with normal hearing were included (Mage = 22 years, 16 women). Sequences of four or six digits were presented in stationary noise at two auditory demand levels. For either 20% or 80% of the trials, digits were rehearsed. Participants rated listening effort, task difficulty, performance, and tendency to give up. Results: Linear mixed-model analyses indicated that intelligibility was higher for four digits compared to six digits and for lower auditory demand compared to higher auditory demand. The mean pupil dilation was larger for lower auditory demand during listening. In the repetition interval, the peak and mean pupil dilations were larger for lower auditory demand compared to higher auditory demand, for six digits compared to four digits, and for 80% compared to 20% stimulus rehearsal. Subjective listening effort and task difficulty were higher for higher auditory demand than for lower auditory demand and for six digits than for four digits. A lower auditory demand also resulted in higher performance ratings and lower tendency to give up compared to higher auditory demand. Conclusions: The established decrease in the pupil dilation response with decreasing auditory demand (higher SNR) can be altered in tasks with relatively high memory demands. It is important to consider the memory demands imposed by the listening task when assessing the pupil dilation response. Supplemental Material: https://doi.org/10.23641/asha.31974978
Purpose: This study aimed to examine vocal fold kinematic characteristics associated with typical-frequency and vocal-intensity, high-frequency, and soft-intensity phonation in vocally healthy adults. Method: Glottal area waveform (GAW) was measured from high-speed videoendoscopy in a total of 66 adults (41 women and 25 men) during sustained /i:/ production across the three tasks, resulting in a total of 594 phonations. Statistical analysis of glottal cycle quotients (open quotient [OQ], speed quotient [SQ], rate quotient [RQ], glottal gap index [GGI]), glottal cycle periodicity (amplitude, time periodicity [TP]), glottal cycle symmetry (phase asymmetry index, spatial symmetry index, amplitude symmetry index), normalized maximum area declination rate (MADRn), and amplitude-to-length ratio (ALR) was conducted. Principal component analysis was used to identify laryngeal strategies underlying the three tasks. Results: High frequency and soft intensity resulted in changes in SQ, RQ, MADRn, and ALR in female participants, whereas in male participants, they impacted OQ, RQ, GGI, TP, MADRn, and ALR. High-frequency phonation is primarily achieved through increased cricothyroid muscle activity, while soft intensity is primarily achieved by reduced vocal fold adduction and subglottal pressure with compensatory cricothyroid activation. Conclusion: High-frequency and soft-intensity phonations involve distinct laryngeal adjustments and clinically measurable, sex-dependent changes in GAW, highlighting the need to tailor voice therapy to physiological strategies and sex-based differences.
Purpose: This study aimed to advance the understanding of consonant acquisition with quantitative and qualitative evidence from various groups of Chinese-speaking children. Normative patterns of phonological development of consonants were affirmed by utilizing phoneme transcription and perceptual judgment of a single-word normative data set, followed by analyses of comparable characteristics of a multiword data set of hearing and deaf/hard of hearing children. Method: The single-word normative data set comprised 798 typically developing Chinese-speaking children, whereas the multiword data set consisted of 79 normal hearing and 45 deaf/hard of hearing children. The percentage of consonants correct (PCC) was derived from phonemes transcribed by automatic alignment and human verification. Perceptual acceptability/intelligibility ratings include the percentage of correctly produced words (AccWord) in the normative data set and the intelligibility scores (IntScore) in the multiword data set. Distribution and correlation of PCC and AccWord/IntScore, as well as consonant error patterns, were examined and compared. Results: Developmental patterns and phonological aspects of consonant acquisition in Chinese-speaking children were thoroughly reported. PCC was significantly correlated with AccWord/IntScore across all subject groups in both single-word and multiword data sets. This finding suggested that PCC can indicate speech performance above the phoneme level. In all subject groups, stopping errors occurred more frequently than frication, the accuracy rates of retroflex sounds were low, and there was a mixed use of /n, l, ʐ/. Conclusions: The current study featured developmental growth curves, error analysis, and possible clinical applications of a wordlist-based normative data set as reference standards. The fact that PCC is correlated with acceptability/intelligibility ratings across data sets and subject groups supports its efficacy as a quantitative indicator of child speech assessment.
Background: Young autistic children have a range of language and cognitive abilities and, as a result, may differentially benefit from interventions supporting skills in these and related domains. Although studies have previously examined the extent to which participant characteristics interact with intervention effects, they have primarily restricted the analyses to a single intervention approach. Method: In the present study, we drew on data from a comprehensive metaanalysis of group design, nonpharmacological intervention studies for young autistic children to test these effects. Specifically, we conducted a secondary meta-regression analysis to examine whether cognitive and language standard scores and age equivalents at study entry significantly moderated intervention effects across intervention type on adaptive, cognitive, language, and social communication outcomes and separately across outcome type for behavioral, developmental, naturalistic developmental behavioral interventions and technologybased interventions. Cognitive and language ability was quantified using reported or estimated standard scores, and cognitive and language level was quantified using reported or estimated age-equivalent scores. Analyses within outcome type were conducted using a data set of 1,911 effect sizes from 202 independent samples, and analyses within intervention type were conducted using a data set of 2,137 effect sizes from 144 independent samples. Results: Few studies reported standard scores and/or age equivalents for participant language. None of the putative moderators significantly predicted intervention effects by outcome domain (i.e., adaptive, cognitive, language, and social communication). Both cognitive standard and age-equivalent scores positively and significantly predicted effects of technology-based interventions exclusively, but we did not find robust evidence that language standard or age-equivalent scores significantly predicted effects by intervention type. Conclusions: These findings are exploratory and warrant cautious interpretation. Future intervention researchers should extensively characterize participant samples in terms of their language and cognitive ability to aid meta-analytic investigation. The field would benefit from additional high-quality randomized controlled trials testing whether intervention effects vary by participant characteristics, using preplanned moderator analyses, valid measures, and large representative samples. Supplemental Material: https://doi.org/10.23641/asha.31967844
Purpose: Hearing aid use in older adults has been suggested to reduce cognitive load, thereby improving performance on auditory-based cognitive tasks. However, there is limited research regarding how hearing aids impact performance during cognitively demanding auditory and visual tasks. The purpose of this study was to investigate the impact of advanced-level hearing aid use during auditory (on-domain) and visual (off-domain) cognitive tasks in background noise. Method: Thirty-one older adults aged 60-87 years participated in the study. All participants were experienced and satisfied hearing aid users. Participants were fitted with a study hearing aid to ensure consistent signal processing characteristics. A series of six cognitive tasks were completed in quiet and background noise with and without hearing aids. The visual tasks included the Trail Making Test, Stroop Color Word Test, and Size Comparison Span Test. The auditory tasks were the Oral Trail Making Test, Auditory Stroop Task, and Word Auditory Recognition and Recall Measure. Results: Results indicated that, for measures of inhibition, executive function, and attention, there was no significant benefit to the use of hearing aids. In contrast, hearing aid use resulted in better performance on working memory tasks. Conclusions: Results indicated that the benefit from hearing aids for auditory (on-domain) and visual (off-domain) cognitive task performance was mixed. Older adults performed better in quiet than in noise with and without hearing aids. Furthermore, hearing aids were beneficial in quiet environments when the working memory task was auditory (on-domain). The findings from the current study support that the use of hearing aids improves access to working memory in both quiet and noisy conditions, which may ultimately improve speech understanding.
Purpose: The ease of language understanding (ELU) model predicts two processing streams-fast, implicit prediction and slower, explicit postdiction- challenging single-factor "general speed" accounts. The present study examined whether cognitive speed is unitary or fractionated, whether both speed and accuracy predict speech in noise (SPIN), and how SPIN relates to rapid automatized naming (RAN). Method: Adults with normal hearing or hearing loss (n = 303) from the N200 study completed latency-based tasks indexing long-term memory access, executive control, Working Memory Tests, SPIN, and RAN. Exploratory and confirmatory factor analyses were used. Results: Two speed factors emerged-long-term memory access speed and executive speed-contradicting a general speed model. Speed-SPIN associations were small and clearest in easier listening conditions. Executive speed predicted RAN. SPIN correlated with RAN, especially among hard of hearing participants. Conclusions: Cognitive speed fractionates in line with the ELU. Working memory speed, unlike accuracy, does not drive SPIN. Executive speed selectively predicts RAN, and SPIN relates to RAN, supporting SPIN's potential as an early proxy for cognitive decline.
OBJECTIVE:The spectral aggregate of the high-passed fundamental frequency (SAHfo) is an automated acoustic measure associated with the primary acoustic discontinuities present in the speech of individuals with adductor laryngeal dystonia (AdLD). Acoustic discontinuities (e.g., phonation breaks, frequency shifts, creak) are also associated with supraglottic compression and visual laryngeal obstruction postures that occur during laryngeal spasms (i.e., phasic or tonic laryngeal dystonic activity). The purpose of this study was to determine whether SAHfo is similarly reflective of these physiological manifestations of AdLD. METHOD:Thirty-two speakers with AdLD read voiced and voiceless phoneme-loaded sentences while undergoing transnasal laryngoscopy. Simultaneous microphone and high-speed videoendoscopy signals were recorded. SAHfo was automatically calculated from the acoustic signal, and laryngeal postures (visual laryngeal obstructions, anterior-posterior and mediolateral supraglottic compression) were manually labeled. A generalized linear mixed-effects analysis assessed the effects of sentence type (voiced, voiceless), obstruction events (obstructed view of vocal folds, visible vocal folds), mediolateral compression, anterior-posterior compression, and the interaction of Mediolateral × Anterior-Posterior compression on SAHfo. RESULTS:Sentence type, obstruction events, and mediolateral compression were significantly related to SAHfo. Anterior-posterior compression did not have a significant effect, but there was a significant interaction between mediolateral and anterior-posterior compression. SAHfo was significantly lower when both mediolateral and anterior-posterior compression were mild and significantly higher when mediolateral compression was severe, regardless of presence or severity of anterior-posterior compression. CONCLUSION:Findings suggest that SAHfo is related to the laryngeal postures associated with AdLD-specific acoustic discontinuities, providing preliminary physiological support of the use of SAHfo in speakers with AdLD.
PURPOSE:Intensive and Comprehensive Aphasia Programs (ICAPs) have been implemented in various settings in English-speaking regions, demonstrating beneficial effects on participants' communication abilities, participation levels, and overall well-being. Considering the limited number of ICAP studies involving Chinese- or Cantonese-speaking people with aphasia (PWA) and the existing gaps in local rehabilitation services in Hong Kong, our research aimed to develop a culturally and linguistically specific ICAP for Cantonese-speaking PWA. We first outlined the logistical constructs for the Hong Kong Intensive and Comprehensive Aphasia Program (HK-ICAP). Then, we examined the effects of the ICAP on language recovery and quality of life among PWA. METHOD:Our research team developed the HK-ICAP construct based on the knowledge shared in published ICAP research studies. Subsequently, we adapted evidence-based treatment approaches to our language and developed culturally tailored treatment stimuli for this purpose. Twenty-eight right-handed adults with chronic aphasia were provided with a 2.5-week, 39-hr ICAP intervention in Hong Kong between 2023 and 2025. Linguistic and quality of life-related measurements were taken at baseline, immediately posttreatment, and at 1 month follow-up. Data were analyzed at both group and individual levels. RESULTS:At the group level, significant improvements were observed in all linguistic and quality of life measures at posttreatment, and most of the gains were maintained at 1 month follow-up. At the individual level, the Minimum Detectable Change90 was used to identify therapeutic gains across various linguistic measures. The findings demonstrated that 33%-42% of the participants achieved therapeutic gains in each corresponding measure. A post hoc analysis of individual performance revealed that 90% of the participants (i.e., 25 of 28) achieved at least one therapeutic improvement in at least one measure at posttreatment. CONCLUSIONS:The findings indicate that an ICAP is a feasible intervention model in culturally and linguistically diverse settings. This study provides robust evidence supporting the application of this intervention model among Cantonese- or Chinese-speaking populations. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.31934634.
Objectives: Hearing loss is among the most common chronic conditions worldwide, substantially affecting daily life. Its management typically involves person-centered rehabilitation focusing on hearing aid fitting and active client participation. The Empowerment Audiology Questionnaire (EmpAQ) is a self-report instrument assessing empowerment, available in 15-and five-item versions. The EmpAQ was recently translated into Swedish (EmpAQ SWE), with satisfactory content validity, convergent validity, and reliability. This study aimed to further evaluate the EmpAQ SWE by examining its construct validity. Design: Adults with hearing loss (pure-tone average > 20 dB HL in the better ear) were invited to complete a digital survey (n = 1,176); 152 participants responded. The survey included demographic questions and both EmpAQ-15 and EmpAQ-5. Rasch analysis was applied to assess item targeting, threshold ordering, item fit, differential item functioning (DIF), local dependency (LD), unidimensionality, and reliability. Results: The EmpAQ SWE demonstrated acceptable measurement properties with adequate item targeting, covering most individuals in the sample and distinguishing approximately three clinically meaningful empowerment levels. Unidimensionality was supported, confirming that the instrument measures a single underlying construct. DIF was identified for Item 1 of the EmpAQ-5 between working and nonworking participants, while Item 6 of the EmpAQ-15 showed misfit and weak discrimination. LD was observed within empowerment dimensions but without broader residual correlations. The person separation index (PSI) was 0.77 for the EmpAQ-15 and 0.55 for the EmpAQ-5. Mean person locations were 1.6 (SD = 1.1) and 1.1 (SD = 1.3), respectively. Conclusions: The EmpAQ SWE demonstrated acceptable psychometric properties, supporting its validity for assessing self-reported empowerment among individuals with hearing loss in Sweden. Findings align with results from the original English version, reinforcing its clinical relevance. Future research should address item-level refinements to further enhance the instrument.
Purpose: The importance of joint attention and joint engagement to language development in typically developing children and children with autism is well understood; however, the importance of these same skills in children with language delays is often overlooked. The goals of this study were to describe joint attention, joint engagement, and language development in children with language delays and describe how these constructs are related. Method: Six mother-child dyads were recorded playing for 15 min, and the middle 10 min of their play was coded for acts of joint attention, joint attention episodes (JAEs), and use of language. Children's receptive and expressive vocabulary were gathered from parents' responses to the MacArthur-Bates Communicative Developmental Inventory. Results: Results were analyzed using Ordinal Pattern Analysis (Crossed Orderings) in Observation Oriented Modeling software. Observation Oriented Modeling is a recent alternative to traditional inferential statistics. A modest pattern was found: The children with more initiating joint attention had more receptive vocabulary, expressive vocabulary, and a higher mean length of utterance (MLU). In contrast, the pattern of greater responding joint attention and greater language skills was quite weak. Stronger patterns were found as the dyad had more engagement in JAEs, the children had higher expressive vocabulary, receptive vocabulary, and MLU. Finally, modest patterns were found: The longer the children were engaged in JAEs, the longer their utterances became. Conclusions: Results suggested that for children with language delays, it was not important who initiated and who responded in JAEs. If the child entered into JAEs, they had better language outcomes.
PURPOSE:This study examined vocabulary growth in low-income African American English (AAE)-speaking toddlers aged 30 and 42 months. Specifically, we investigated whether traditional child-level language production, discourse measures, or maternal language input at Time 1 predicted receptive vocabulary growth at Time 2. METHOD:Language samples were collected from 101 African American toddlers during home-based play interactions with their caregivers at 30 and 42 months. Child and maternal language measures were derived from transcripts using Systematic Analysis of Language Transcripts, and receptive vocabulary was assessed at both time points using the Peabody Picture Vocabulary Test-Revised. Hierarchical multiple linear regression analyses examined the predictive value of child- and caregiver-level language variables, including interactions with gender. RESULTS:Children demonstrated substantial vocabulary growth from 30 to 42 months. Caregivers demonstrated responsive, developmentally appropriate language and frequent spontaneous questioning. However, neither traditional syntax measures (mean length of utterance [MLU]) nor culturally relevant measures of discourse (caregivers' use of spontaneous questions to direct discourse and children's responses to questions) significantly predicted vocabulary growth. A marginal trend suggested that the relation between maternal MLU and child vocabulary growth may differ by gender. CONCLUSIONS:Although neither syntax nor discourse measures significantly predicted vocabulary, these findings highlight the importance of continuing to examine culturally embedded interaction patterns in AAE-speaking families. The results suggest that broad language measures may obscure variability in the discourse strategies caregivers use to guide and engage children's language and that more fine-grained approaches may be needed to capture how language input supports vocabulary growth across gender and context. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.31894576.
