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Purpose: The overall goal of the current study was to identify an optimal level and duration of acoustic experience that facilitates language development for pediatric cochlear implant (CI) recipients--specifically, to determine whether there is an optimal duration of hearing aid (HA) use and unaided threshold levels that should be considered before proceeding to bilateral CIs. Method: A total of 117 pediatric CI recipients (ages 5-9 years) were given speech perception and standardized tests of receptive vocabulary and language. The speech perception battery included tests of segmental perception (e.g., word recognition in quiet and noise, and vowels and consonants in quiet) and of suprasegmental perception (e.g., talker and stress discrimination, and emotion identification). Hierarchical regression analyses were used to determine the effects of speech perception on language scores, and the effects of residual hearing level (unaided pure-tone average [PTA]) and duration of HA use on speech perception. Results: A continuum of residual hearing levels and the length of HA use were represented by calculating the unaided PTA of the ear with the longest duration of HA use for each child. All children wore 2 devices: Some wore bimodal devices, while others received their 2nd CI either simultaneously or sequentially, representing a wide range of HA use (0.03-9.05 years). Regression analyses indicate that suprasegmental perception contributes unique variance to receptive language scores and that both segmental and suprasegmental skills each contribute independently to receptive vocabulary scores. Also, analyses revealed an optimal duration of HA use for each of 3 ranges of hearing loss severity (with mean PTAs of 73, 92, and 111 dB HL) that maximizes suprasegmental perception. Conclusions: For children with the most profound losses, early bilateral CIs provide the greatest opportunity for developing good spoken language skills. For those with moderate-to-severe losses, however, a prescribed period of bimodal use may be more advantageous for developing good spoken language skills.

Purpose: The aim of this study was to determine whether suprasegmental speech perception contributes unique variance in predictions of reading decoding and comprehension for prelingually deaf children using two devices, at least one of which is a cochlear implant (CI). Method: A total of 104, 5- to 9-year-old CI recipients completed tests of segmental perception (e.g., word recognition in quiet and noise, recognition of vowels and consonants in quiet), suprasegmental perception (e.g., talker and stress discrimination, nonword stress repetition, and emotion identification), and nonverbal intelligence. Two years later, participants completed standardized tests of reading decoding and comprehension. Using regression analyses, the unique contribution of suprasegmental perception to reading skills was determined after controlling for demographic characteristics and segmental perception performance. Results: Standardized reading scores of the CI recipients increased with nonverbal intelligence for both decoding and comprehension. Female gender was associated with higher comprehension scores. After controlling for gender and nonverbal intelligence, segmental perception accounted for approximately 4% and 2% of the variance in decoding and comprehension, respectively. After controlling for nonverbal intelligence, gender, and segmental perception, suprasegmental perception accounted for an extra 4% and 7% unique variance in reading decoding and reading comprehension, respectively. Conclusions: Suprasegmental perception operates independently from segmental perception to facilitate good reading outcomes for these children with CIs. Clinicians and educators should be mindful that early perceptual skills may have long-term benefits for literacy. Research on how to optimize suprasegmental perception, perhaps through hearing-device programming and/or training strategies, is needed.

Central Institute for the Deaf, Washington University, St. Louis, MO Margaret W. Skinner Washington University School of Medicine, St. Louis, MO Contact author: Lisa S. Davidson, Central Institute for the Deaf at Washington University, Department of Otolaryngology-Head & Neck Surgery, 4560 Clayton Avenue, St. Louis, MO 63110. E-mail: davidsonl{at}ent.wustl.edu . PURPOSE: This study examined the relation of audibility for frequency-specific sounds and the Speech Intelligibility Index (SII) to speech perception abilities of children with sensorineural hearing loss using digital signal-processing hearing aids with wide dynamic range compression. METHOD: Twenty-six children age 5–15 years with pure-tone averages (0.5, 1.0, and 2.0 kHz) from 60-98 dB HL participated. Three subgroups were created based on the compression characteristics of each hearing aid. Minimum audibility was determined using aided thresholds for frequency-modulated tones and the SII calculated at 55 and 70 dB SPL using the simulated real-ear output of the hearing aid. The Lexical Neighborhood Test (LNT; K. I. Kirk, D. B. Pisoni, & M. J. Osberger, 1995) was presented at 50 and 70 dB SPL. RESULTS: LNT scores at 70 dB SPL were significantly higher than at 50 dB SPL. Average aided thresholds at 0.5, 1.0, and 2.0 kHz were negatively correlated with LNT scores at 50 dB SPL, and SIIs at 55 and 70 dB SPL were positively correlated with LNT scores at 50 and 70 dB SPL. CONCLUSIONS: Results support using aided thresholds and speech test scores at soft to loud levels as part of the amplification fitting process. Key Words: digital hearing aids, wide dynamic range compression, severe-to-profound hearing loss, minimum audibility, speech perception CiteULike     Connotea     Del.icio.us     Digg     Facebook     Reddit     Technorati     Twitter     What's this?

The effect of oral vs total communication modes on the speech perception & production, language, & reading performance of children with the Nucleus 22-channel cochlear implant is examined in a preliminary report on representative tests selected from a 6-hour battery administered over 3 days. Each S was enrolled in a different public or private educational program across the US & Canada; Ss are grouped by the use vs absence of signs in the educational setting (N = 23 & 20 respectively, aged 8-9) & had 4-6 years' experience with cochlear implants. Results indicate a significant advantage for the purely oral group in (1) overall scores & manner & vowel cue discrimination on the Video Speech Pattern Contrast (VIDSPAC) test, (2) all closed- & open-set speech perception tasks, & (3) speech production intelligibility on McGarr sentences with high & low contextual support. No significant difference between groups was found in voicing & place cue perception or in language & reading scores. 1 Table, 11 References. J. Hitchcock

In light of data indicating the importance of perceived loudness growth for speech perception, reported by M. W. Skinner et al (1999) in a study of adult cochlear implant users, loudness scaling variables & characteristics of the Nucleus 22 cochlear implant processor map were investigated in children (N = 46, aged 8-9) who had received implants before age 5. Map characteristics obtained from each S's processor were the number of active electrodes, the average dynamic range between threshold & maximum comfort levels, & the highest frequency coded. The loudness scaling task used picture stimuli to elicit Ss' judgments on a five-point scale of the loudness of three sets of babble stimuli (broadband & centered at 500 Hz & 2,000 Hz) presented in 5 dB increments from 50 dB to 80 dB. A loudness growth score was developed from averaged loudness ratings at each intensity level; results show that Ss tended to perceive an average 44% increase in loudness from one level to the next higher level & that loudness ratings were consistent within one rating point across Ss. Map characteristics & loudness scaling performance were found to correlate significantly with Ss' speech perception scores on the Word Intelligibility by Picture Identification (WIPI) test. 2 Tables, 1 Figure, 4 References. J. Hitchcock

Antimicrobial resistance is increasing; however, antimicrobial drug development is slowing. Now more than ever before, antimicrobial stewardship is of the utmost importance as a way to optimize the use of antimicrobials to prevent the development of resistance and improve patient outcomes. This review describes the why, what, who, how, when, and where of antimicrobial stewardship. Techniques of stewardship are summarized, and a plan for implementation of a stewardship program is outlined.

In some languages, creaky voice is used over relatively long stretches of speech as a prosodic element, to convey emotion, and/or stylistically. A primary acoustic and perceptual cue to creaky voice quality is a low fundamental frequency. Previous research has shown that listeners can make fine-grained comparisons of speakers' habitual modal pitch, but this study focuses on how a combination of modal and nonmodal phonation affects the perception of habitual pitch. A perception experiment assesses whether listeners are more likely to rate a speaker's utterance as being holistically lower in pitch if it contains both modal and creaky voice than if it is fully modal speech. Results indicate that for female American English speakers with higher modal pitch, the inclusion of creaky voice leads listeners to rate such utterances as lower in pitch than fully modal utterances, but not for speakers with lower modal pitch. These results are consistent with studies showing that pitch perception interacts with nonmodal phonation, and they relate to previous observations that speakers may utilize nonmodal phonation to manipulate their intended habitual pitch.

This study presents a detailed acoustic analysis of phonation in voiceless obstruents in American English (AE) to investigate the acoustic consequences of the laryngeal timing that has been reported in the literature. The current study examines the appearance of phonation in voiceless obstruents in a corpus of read speech with 37 AE speakers. Linguistic factors such as phrase and word position, stress, and the preceding phoneme are examined and are shown to condition the presence and degree of phonation during the constriction period of stops and fricatives. The amount of phonation present is further analyzed by characterizing where in the constriction interval phonation appears. Carryover phonation (or bleed) from a preceding sonorant is most common for stops, while a trough pattern (phonation that dies out and then begins again before the end of the closure) is more prevalent for fricatives. These acoustic patterns, together with previous reports of laryngeal articulation and air pressure measures, have implications for the representation of laryngeal timing in a gestural phonology framework.

The burden and presentation of post-acute sequela of SARS-CoV-2 infection (PASC) are a developing major public health concern. To characterize the burden of PASC in community-dwelling individuals and understand the experiences of people living with PASC. This mixed-methods study of COVID-19 positive community-dwelling persons involved surveys and in-depth interviews. Main outcome was self-report of possible PASC symptoms 3 weeks or longer after positive COVID-19 test. In-depth interviews were guided by a semi-structured interview guide with open-ended questions and probes based on emerging literature on PASC and the impact of COVID-19. With a survey response rate of 70%, 442 participants were included in this analysis, mean (SD) age 45.4 (16.2) years, 71% female, 12% Black/African American. Compared to those with no PASC symptoms, persons who reported PASC symptoms were more likely to be older (mean age: 46.5 vs. 42; p = 0.013), female (74.3% vs. 61.2%; p = 0.010), to have pre-existing conditions (49.6% vs. 34%; p = 0.005), and to have been hospitalized for COVID-19 (14.2% vs. 2.9%; p = 0.002). About 30% of the participants experienced severe fatigue; the proportion of persons reporting severe fatigue was 7-fold greater in those with PASC symptoms (Adjusted Prevalence Ratio [aPR] 6.73, 95%CI: 2.80-16.18). Persons with PASC symptoms were more likely to report poor quality of life (16% vs. 5%, p<0.001) and worse mental health functioning (Mean difference: -1.87 95%CI: -2.38, -1.37, p<0.001). Themes from in-depth interviews revealed PASC was experienced as debilitating. In this study, the prevalence of PASC among community-dwelling adults was substantial. Participants reported considerable coping difficulties, restrictions in everyday activities, invisibility of symptoms and experiences, and impediments to getting and receiving PASC care.

Meta-analytic research suggests that women have slightly lower levels of self-compassion than men, but the contribution of gender role orientation has not been carefully explored. The current study examines the joint associations of self-identified gender and gender role orientation with self-compassion in undergraduate ( N  = 504) and community adult ( N  = 968) samples, using two measures of gender role orientation. The Bem Sex Role Inventory (BSRI) and the Personal Attributes Questionnaire (PAQ) were used to classify each participant into a single gender role orientation category based on relative scores on the masculinity and femininity subscales, with respect to the sample, and average scores for each continuous subscale were also retained. The categorical gender role orientation classifications were used in mean comparisons of self-compassion across groups, and the average masculinity and femininity subscale scores were used in regression modeling. Results replicated the small effect size for gender differences in self-compassion for both samples, with self-identified men having significantly higher levels of self-compassion than self-identified women. Results also consistently showed that the impact of self-identified gender on self-compassion was smaller than the impact of masculine gender role orientation, suggesting that socialization plays a strong role, and that those high in both femininity and masculinity tended to have the highest levels of self-compassion. Effect sizes and specific findings differed by gender, sample, and gender role orientation measure. Therefore, a nuanced understanding of differences in self-compassion based on gender and gender role orientation is needed.