This Week in Speech Science #2

Mapping the Early Language Environment Using All-Day Recordings and Automated Analysis

Authors: Jill Gilkerson, Jeffrey A. Richards, Steven F. Warren, Judith K. Montgomery, Charles R. Greenwood, D. Kimbrough Oller, John H. L. Hansen, and Terrance D. Paul

Background: Previous research has demonstrated the significance of children’s early language environment by examining quantitative factors existing prior to the age of three such as interaction behaviors, exposure to vocabulary, quantity and type of caregiver-child interaction and how they impact the development of language and cognition. The child’s early language environment may vary widely between families resulting in disparities. Differences noticed in higher socioeconomic children include exposure to more complex language and higher parental responsitivity. In addition, children with developmental delays, social-emotional disorders, and intellectual disabilities may seek less interactions with caregivers resulting in possible negative outcomes. Prior quantitative measures of a child’s natural language environment have been obtained through audio and video recordings and analyzed either manually or through automated analysis, however these have focused on small population samples.

Research Questions: 1) What are the overall by-age distributions observed for automated estimates of child vocalization frequency, adult word count (AWCs), and conversational turn-taking from naturalistic recordings within a large sample of children 2–48 months of age living in monolingual English-speaking households?; 2) Do Language Environment Analysis (LENA) System measures correlate with standard language assessments?; 3) Do observable differences exist in the automated estimates of language behaviors of families across socioeconomic groups?

Methods: Participants data was collected over 38 months: Phase I - 6 months; Phase II - 32 months. Phase I participants - 329 monolingual English-speaking families with typically developing children 2–48 months of age. Phase II participants - 80 families recruited from Phase I. Sample was of convenience and not ethnically diverse, although balanced for mother’s highest level of education. The LENA System incorporated a digital recorder worn in child’s front pocket of clothing worn 12 hours for Phase I and 16 hours for Phase II.

What this means for your practice: This study observed adult word production, adult-child conversational turn-taking, and child vocalization frequency in the natural infant and toddler language environment. The relationship between standard assessments and LENA measures suggest that automated language environment analysis may be used as a Level 1 screener to identify children at risk due to disadvantaged language environments and to develop interventions to facilitate a rich home language environment.

Language Development in Children With Cleft Palate With or Without Cleft Lip Adopted From Non–English-Speaking Countries

Authors: Amy R. Morgan, Claudia Crilly Bellucci, Jody Coppersmith, Sebastian B. Linde, Arthur Curtis, Meredith Albert, Mary M. O'Gara, and Kathleen Kapp-Simon

Background: Out of 12,000 internationally adopted (IA) children into families in the United States in 2012, one third were from China with a number of them having congenital anomalies, such as cleft lip and palate (1.3 of every 1000 live births). International adoption (IA) and orofacial clefts (OFCs) are known risk factors for language delay. Risk factors for language delay in IAs include the preadoption environment, sudden shifts in language exposure, and introduction to the language of the adopted family at an older age.  Children who have a disruption in their native language acquisition before it is mastered by being introduced to a second language, typically present with disordered language present in both languages. Due to the different language development of IA children, they cannot be compared to the typical development of monolingual and/or bilingual children, thus leading to difficulty in the identification and treatment of language delays and/or disorders. Variability in research findings indicate that children with OFCs may present with mild language delays. However, there is a lack of research exploring the severity of language delay in children with OFCs.

Research Questions: 1) Are children with cleft palate with or without cleft lip (CP±CL) at a greater risk for language impairment when they have late English (LE) vs. early English (EE) exposure?; 2) Do children with CP±CL and LE have poorer mean language skills than children with CP±CL and EE after adjusting for child's age at assessment, sex, family SES, mean hearing acuity, and nonverbal cognitive abilities?; 3) For children with CP±CL who are IA, is age at adoption or time since adoption a more critical variable when assessing language outcomes?

Methods: 51 LE and 67 EE children ages 3;0 to 9;0 were selected who presented with a diagnosis of isolated CLP or CP and with English as the primary language spoken in the home. Children were excluded with medical diagnosis that could affect cognitive or language development. Each child was administered the Preschool Second Edition or Fourth Edition (ages 3;0 to 4;11) or the Clinical Evaluation of Language Fundamentals (CELF) (ages 5;0 older). 

What this means for your practice: Overall, results from this study indicate that children with cleft palate with or without cleft lip and are international adoptees are at greater risk for language impairment. Children with cleft palate with or without cleft lip and are international adoptees should be carefully observed and provided with interventions to address language delays and/or impairments.

Language Development and Impairment in Children With Mild to Moderate Sensorineural Hearing Loss

Authors: Lorna F. Halliday, Outi Tuomainen, and Stuart Rosen

Background: Sensorineural hearing loss (SNHL) is a type of permanent hearing impairment as a result of damage to the cochlea or auditory nerve. Individuals with mild hearing loss (21–40 dB HL) and moderate hearing loss (41–70 dB HL) present with residual hearing loss that although degraded is useful without the use of hearing aids or cochelear implants. Globally, it is estimated that 6.2% of children ages 5 to 14 years present with a mild hearing loss while 0.2%–1.7% present with a moderate hearing loss. Children with a mild or moderate SNHL (MMHL) experience a different language learning environment (partial, distorted, and/or degraded auditory signal) as compared with children with normal hearing. Although most Children with MMHL develop oral language spontaneously, some do rely on sign language or cued speech, with most relying on speech-reading. Some studies indicate that children with MMHL may perform poorly as compared to normal hearing peers on standardized language measures (vocabulary, morphology and syntax, phonology, reading). Recent studies indicate that on average, children with MMHL achieve reading scores that are comparable to children with normal hearing. It is noted that there is individual variability in performances on these measures. Understanding these individual differences may aid in developing language intervention and remediation for children with MMHL. There is need for further research to understand the outcomes of children with MMHL.

Research Questions: 1) Do children and adolescents with MMHL have impaired or delayed language relative to (a) their peers and/or (b) population norms? If so, what aspects of language are affected?; 2) What proportion of children and adolescents with MMHL has clinically significant language difficulties? What factors characterize these children?

Method: Two groups of children were recruited for this study. MMHL group included 57 children ages 8 to 16 years with bilateral MMHL. Control group included 44 children ages 8 to 16 years with typical hearing. All children were from mono-lingual English backgrounds, communicated only through oral/aural modality, and did not have any additional known concerns. Parents completed a questionnaire about the child's developmental and medical history including mother's highest level of education. Assessments included: Children's Communication Checklist–Second Edition (completed by parent), Block Design subtest of the Wechsler Abbreviated Scale of Intelligence, Repetition of Nonsense Words, British Picture Vocabulary Scale, Clinical Evaluation of Language Fundamentals (CELF) subtests Expressive Vocabulary and Word Definitions, Test for the Reception of Grammar,  and Word Reading and Pseudoword Decoding subtests of the Wechsler Individual Achievement Test.

What this means for your practice: Results indicate that children with MMHL performed significantly more poorly as compared with age-matched peers with normal hearing on standardized measures of expressive vocabulary, receptive grammar, recalling sentences, and nonword repetition, but not on measures of receptive vocabulary, or word or nonword reading. However, some children with MMHL performed within the normal limits. Factors that may be linked to language difficulties in children with MMHL include maternal education and family history of language problems with non-verbal ability designated a possible a protective factor. More research is needed with this population to determine the confluence of key features that may predict children with MMHL at risk of developing significant language difficulties.

This Week in Speech Science #3

This Week in Speech Science #1