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The purpose of this pilot study was to investigate the extent to which a naturalistic communication intervention, enhanced milieu teaching with phonological emphasis (EMT+ PE), improved the language and speech outcomes of toddlers with cleft lip and/or palate (CL/P). Nineteen children between 15 and 36 months (M = 25 months) with nonsyndromic CL/P and typical cognitive development were randomly assigned to a treatment (EMT+PE) or nontreatment, business-as-usual (BAU), experimental condition. Participants in the treatment group received forty-eight 30-min sessions, biweekly during a 6-month period. Treatment was delivered in a university clinic by trained speech language pathologists; fidelity of treatment was high across participants. Children in the treatment group had significantly better receptive language scores and a larger percentage of consonants correct than children in the BAU group at the end of intervention. Children in the treatment group made greater gains than children in the BAU group on most language measures; however, only receptive language, expressive vocabulary (per parent report), and consonants correct were significant. The results of this preliminary study indicate that EMT+PE is a promising early intervention for young children with CL/P. Replication with a larger sample and long-term follow-up measures are needed.

Diane Frome Loeb The University of Kansas, Lawrence LaVae M. Hoffman University of Oklahoma Health Sciences Center, Oklahoma City Thomas Bohman Craig A. Champlin The University of Texas at Austin Linda Thibodeau The University of Texas at Dallas Judith Widen Jayne Brandel The University of Kansas, Lawrence Sandy Friel-Patti The University of Texas at Dallas Contact author: Ronald B. Gillam, Department of Communicative Disorders and Deaf Education, 1000 Old Main Hill, Logan, UT 84322. E-mail: ron.gillam{at}usu.edu . Purpose: A randomized controlled trial was conducted to compare the language and auditory processing outcomes of children assigned to receive the Fast ForWord Language intervention (FFW-L) with the outcomes of children assigned to nonspecific or specific language intervention comparison treatments that did not contain modified speech. Method: Two hundred sixteen children between the ages of 6 and 9 years with language impairments were randomly assigned to 1 of 4 conditions: (a) Fast ForWord Language (FFW-L), (b) academic enrichment (AE), (c) computer-assisted language intervention (CALI), or (d) individualized language intervention (ILI) provided by a speech-language pathologist. All children received 1 hr and 40 min of treatment, 5 days per week, for 6 weeks. Language and auditory processing measures were administered to the children by blinded examiners before treatment, immediately after treatment, 3 months after treatment, and 6 months after treatment. Results: The children in all 4 conditions improved significantly on a global language test and a test of backward masking. Children with poor backward masking scores who were randomized to the FFW-L condition did not present greater improvement on the language measures than children with poor backward masking scores who were randomized to the other 3 conditions. Effect sizes, analyses of standard error of measurement, and normalization percentages supported the clinical significance of the improvements on the Comprehensive Assessment of Spoken Language (E. Carrow-Woolfolk, 1999). There was a treatment effect for the Blending Words subtest of the Comprehensive Test of Phonological Processing (R. K. Wagner, J. K. Torgesen, & C. A. Rashotte, 1999). Participants in the FFW-L and CALI conditions earned higher phonological awareness scores than children in the ILI and AE conditions at the 6-month follow-up testing. Conclusion: Fast ForWord Language, the intervention that provided modified speech to address a hypothesized underlying auditory processing deficit, was not more effective at improving general language skills or temporal processing skills than a nonspecific comparison treatment (AE) or specific language intervention comparison treatments (CALI and ILI) that did not contain modified speech stimuli. These findings call into question the temporal processing hypothesis of language impairment and the hypothesized benefits of using acoustically modified speech to improve language skills. The finding that children in the 3 treatment conditions and the active comparison condition made clinically relevant gains on measures of language and temporal auditory processing informs our understanding of the variety of intervention activities that can facilitate development. KEY WORDS: Fast ForWord, language intervention, auditory processing, clinical trial CiteULike     Connotea     Del.icio.us     Digg     Facebook     Reddit     Technorati     Twitter     What's this?

Purpose: In a previous article, we reported that beginning treatment for regular past tense \"-ed\" with certain types of verbs led to greater generalization in children with developmental language disorder than beginning treatment with other types of verbs. This article provides updated data from that study, including the addition of data from 3 children, results from naturalistic language samples, and data from a third time point. Method: Twenty 4- to 9-year-old children with developmental language disorder (10 per condition) were randomly assigned to receive language intervention in which the verbs used to teach regular past tense \"-ed\" were manipulated. Half received easy first intervention, beginning with highly frequent, telic, phonologically simple verbs, and half received hard first intervention, beginning with less frequent, atelic, and phonologically complex verbs. The design used a train-to-criterion approach, with children receiving up to 36 visits. Performance was assessed using elicited production probes and language samples before intervention, immediately following intervention and 6-8 weeks later. Results: Children in the hard first group showed greater gains on the use of regular past tense \"-ed\" in both structured probes (at immediate post only) and in language samples (at both immediate and delayed post). Gains attributable to therapy were not observed in untreated morphemes. Conclusions: This study suggests that the choice of therapy materials, with an eye on the role that treatment stimuli play in generalization, is important for treatment efficacy. Clinicians should consider early selection of atelic, lower-frequency, phonologically complex verbs when teaching children to use regular past tense \"-ed\". Further work expanding this to other morphemes and a larger population is needed to confirm this finding.

The present study investigated the role of early stimulation in the home and child language delays in the emergence of depressive symptoms. Data were from a longitudinal study of at-risk children in Hawaii ( n  = 587). Low learning stimulation in the home at age 3 and language delays in first grade both significantly increased risk for child depressive symptoms in third grade. Structural equation modeling supported the hypothesized path models from home learning environment at age 3 to depressive symptoms in third grade controlling for a host of correlated constructs (maternal depression, child temperament, and child internalizing symptoms). Total language skills in the first grade mediated the effect of home learning environment on depressive symptoms. The study and findings fit well with a nurturing environment perspective. Implications for understanding the etiology of child depression and for designing interventions and prevention strategies are discussed.

Objectives: This study verified the efficacy of a formal auditory training (AT) program in children with hearing and language disorders using the auditory brainstem response to complex sounds (c-ABR) with and without background noise. Patients and Methods: Thirty children (7–13 years) were distributed into four groups: typical development (TD: n = 7), auditory processing disorder (APD: n = 9) and specific language disorder (SLIa: n = 6, and SLIb: n = 8). All children underwent behavioral assessment of auditory processing and c-ABR with and without background noise. The APD and SLIa groups underwent 8 weeks of formal AT, but all children were reevaluated 12 weeks after the initial assessment. Results: The TD group presented better behavioral performance than the other groups. For c-ABR in silence, no significant differences were observed among groups or assessments, except regarding VA complex measures, which were altered in the APD group. For c-ABR with background noise, however, the APD, SLIa and SLIb groups presented delayed latencies. Groups that underwent formal AT improved behavioral performance and decreased latencies to c-ABR in background noise at final assessment. Conclusions: These data suggest that efficacy of formal AT can be demonstrated by c-ABR with background noise.

In most people, language is processed predominantly by the left hemisphere of the brain, but we do not know how or why. A popular view is that developmental language disorders result from a poorly lateralized brain, but until recently, evidence has been weak and indirect. Modern neuroimaging methods have made it possible to study normal and abnormal development of lateralized function in the developing brain and have confirmed links with language and literacy impairments. However, there is little evidence that weak cerebral lateralization has common genetic origins with language and literacy impairments. Our understanding of the association between atypical language lateralization and developmental disorders may benefit if we reconceptualize the nature of cerebral asymmetry to recognize its multidimensionality and consider variation in lateralization over developmental time. Contrary to popular belief, cerebral lateralization may not be a highly heritable, stable characteristic of individuals; rather, weak lateralization may be a consequence of impaired language learning.

For generations the study of vocal development and its role in language has been conducted laboriously, with human transcribers and analysts coding and taking measurements from small recorded samples. Our research illustrates a method to obtain measures of early speech development through automated analysis of massive quantities of day-long audio recordings collected naturalistically in children's homes. A primary goal is to provide insights into the development of infant control over infrastructural characteristics of speech through large-scale statistical analysis of strategically selected acoustic parameters. In pursuit of this goal we have discovered that the first automated approach we implemented is not only able to track children's development on acoustic parameters known to play key roles in speech, but also is able to differentiate vocalizations from typically developing children and children with autism or language delay. The method is totally automated, with no human intervention, allowing efficient sampling and analysis at unprecedented scales. The work shows the potential to fundamentally enhance research in vocal development and to add a fully objective measure to the battery used to detect speech-related disorders in early childhood. Thus, automated analysis should soon be able to contribute to screening and diagnosis procedures for early disorders, and more generally, the findings suggest fundamental methods for the study of language in natural environments.

Purpose: To examine patterns of sensory responsiveness (i.e., hyperresponsiveness, hyporesponsiveness, and sensory seeking) as factors that may account for variability in social-communicative symptoms of autism and variability in language, social, and communication skill development in children with autism or other developmental disabilities (DDs). Method: Children with autistic disorder (AD; n = 72, mean age = 52.3 months) and other DDs (n = 44, mean age = 48.1 months) participated in a protocol measuring sensory response patterns; social-communicative symptoms of autism; and language, social, and communication skills. Results: Hyporesponsiveness was positively associated with social-communicative symptom severity, with no significant group difference in the association. Hyperresponsiveness was not significantly associated with social-communicative symptom severity. A group difference emerged for sensory seeking and social-communicative symptom severity, with a positive association for the AD group only. For the 2 groups of children combined, hyporesponsiveness was negatively associated with language skills and social adaptive skills. Sensory seeking also was negatively associated with language skills. These associations did not differ between the 2 groups. Conclusions: Aberrant sensory processing may play an important role in the pathogenesis of autism and other DDs as well as in the rate of acquisition of language, social, and communication skills.

A study used positron emission tomography (PET) to study patterns of brain activation during auditory processing in five high-functioning adults with autism. Results found that participants showed reversed hemispheric dominance during the verbal auditory stimulation and reduced activation of the auditory cortex and cerebellum. (CR)

Previous studies have observed evoked response latency as well as gamma band superior temporal gyrus (STG) auditory abnormalities in individuals with autism spectrum disorders (ASD). A limitation of these studies is that associations between these two abnormalities, as well as the full extent of oscillatory phenomena in ASD in terms of frequency and time, have not been examined. Subjects were presented pure tones at 200, 300, 500, and 1,000 Hz while magnetoencephalography assessed activity in STG auditory areas in a sample of 105 children with ASD and 36 typically developing controls (TD). Findings revealed a profile such that auditory STG processes in ASD were characterized by pre-stimulus abnormalities across multiple frequencies, then early high-frequency abnormalities followed by low-frequency abnormalities. Increased pre-stimulus activity was a ‘core’ abnormality, with pre-stimulus activity predicting post-stimulus neural abnormalities, group membership, and clinical symptoms (CELF-4 Core Language Index). Deficits in synaptic integration in the auditory cortex are associated with oscillatory abnormalities in ASD as well as patient symptoms. Increased pre-stimulus activity in ASD likely demonstrates a fundamental signal-to-noise deficit in individuals with ASD, with elevations in oscillatory activity suggesting an inability to maintain an appropriate ‘neural tone’ and an inability to rapidly return to a resting state prior to the next stimulus.