Nonword Repetition in Children With Cochlear Implants: A Potential Clinical Marker of Poor Language Acquisition
Publication: American Journal of Speech-Language Pathology
Volume 23, Number 4
Pages 679-695
Abstract
Purpose
Cochlear implants (CIs) can facilitate the acquisition of spoken language for deaf children, but challenges remain. Language skills dependent on phonological sensitivity are most at risk for these children, so having an effective way to diagnose problems at this level would be of value for school speech-language pathologists. The goal of this study was to assess whether a nonword repetition (NWR) task could serve that purpose.
Method
Participants were 104 second graders: 49 with normal hearing (NH) and 55 with CIs. In addition to NWR, children were tested on 10 measures involving phonological awareness and processing, serial recall of words, vocabulary, reading, and grammar.
Results
Children with CIs performed more poorly than children with NH on NWR, and sensitivity to phonological structure alone explained that performance for children in both groups. For children with CIs, 2 audiological factors positively influenced outcomes on NWR: being identified with hearing loss at a younger age and having experience with wearing a hearing aid on the unimplanted ear at the time of receiving a 1st CI. NWR scores were better able to rule out than to rule in such language deficits.
Conclusions
Well-designed NWR tasks could have clinical utility in assessments of language acquisition for school-age children with CIs.
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References
Ambrose, S. E., Fey, M. E., & Eisenberg, L. S. (2012). Phonological awareness and print knowledge of preschool children with cochlear implants. Journal of Speech, Language, and Hearing Research, 55, 811–823.
Archibald, L. M., & Gathercole, S. E. (2006). Nonword repetition: A comparison of tests. Journal of Speech, Language, and Hearing Research, 49, 970–983.
Archibald, L. M., & Gathercole, S. E. (2007). Nonword repetition in specific language impairment: More than a phonological short-term memory deficit. Psychonomic Bulletin & Review, 14, 919–924.
Avons, S. E., Wragg, C. A., Cupples, L., & Lovegrove, W. J. (1998). Measures of phonological short-term memory and their relationship to vocabulary development. Applied Psycholinguistics, 19, 583–602.
Baddeley, A. D. (1992). Working memory. Science, 255, 556–559.
Baddeley, A. D. (2007). Working memory, thought, and action. Oxford, England: Oxford University Press.
Brady, S., Shankweiler, D., & Mann, V. (1983). Speech perception and memory coding in relation to reading ability. Journal of Experimental Child Psychology, 35, 345–367.
Briscoe, J., Bishop, D. V., & Norbury, C. F. (2001). Phonological processing, language, and literacy: A comparison of children with mild-to-moderate sensorineural hearing loss and those with specific language impairment. Journal of Child Psychology and Psychiatry, 42, 329–340.
Brownell, R. (2000). Expressive One-Word Picture Vocabulary Test (EOWPVT) (3rd ed.). Novato, CA: Academic Therapy.
Caldwell, A., & Nittrouer, S. (2013). Speech perception in noise by children with cochlear implants. Journal of Speech, Language, and Hearing Research, 56, 13–30.
Campbell, T., Dollaghan, C., Needleman, H., & Janosky, J. (1997). Reducing bias in language assessment: Processing-dependent measures. Journal of Speech, Language, and Hearing Research, 40, 519–525.
Carter, A. K., Dillon, C. M., & Pisoni, D. B. (2002). Imitation of nonwords by hearing impaired children with cochlear implants: Suprasegmental analyses. Clinical Linguistics & Phonetics, 16, 619–638.
Catts, H. W. (1989). Phonological processing deficits and reading disabilities. InKamhi, A. G., & Catts, H. W. (Eds.), Reading disabilities: A developmental language perspective (pp. 101–135). Boston, MA: College Hill Press.
Condouris, K., Meyer, E., & Tager-Flusberg, H. (2003). The relationship between standardized measures of language and measures of spontaneous speech in children with autism. American Journal of Speech-Language Pathology, 12, 349–358.
Conti-Ramsden, G. (2003). Processing and linguistic markers in young children with specific language impairment (SLI). Journal of Speech, Language, and Hearing Research, 46, 1029–1037.
Cooper-Martin, E. (1994). Measures of cognitive effort. Marketing Letters, 5, 43–56.
Crain, S., & Lillo-Martin, D. (1999). An introduction to linguistic theory and language acquisition. Malden, MA: Blackwell.
Dillon, C. M., & Pisoni, D. B. (2006). Nonword repetition and reading skills in children who are deaf and have cochlear implants. Volta Review, 106, 121–145.
Dollaghan, C., & Campbell, T. F. (1998). Nonword repetition and child language impairment. Journal of Speech, Language, and Hearing Research, 41, 1136–1146.
Edwards, J., Beckman, M. E., & Munson, B. (2004). The interaction between vocabulary size and phonotactic probability effects on children's production accuracy and fluency in nonword repetition. Journal of Speech, Language, and Hearing Research, 47, 421–436.
Edwards, J., & Lahey, M. (1998). Nonword repetitions of children with specific language impairment: Exploration of some explanations for their inaccuracies. Applied Psycholinguistics, 19, 279–309.
Ellis Weismer, S., Tomblin, J. B., Zhang, X., Buckwalter, P., Chynoweth, J. G., & Jones, M. (2000). Nonword repetition performance in school-age children with and without language impairment. Journal of Speech, Language, and Hearing Research, 43, 865–878.
Fox, B., & Routh, D. K. (1980). Phonemic analysis and severe reading disability in children. Journal of Psycholinguistic Research, 9, 115–119.
Gathercole, S. E. (1995). Is nonword repetition a test of phonological memory or long-term knowledge? It all depends on the nonwords. Memory & Cognition, 23, 83–94.
Gathercole, S. E. (2006). Nonword repetition and word learning: The nature of the relationship. Applied Psycholinguistics, 27, 513–543.
Gathercole, S. E., & Baddeley, A. D. (1990). Phonological memory deficits in language disordered children: Is there a causal connection? Journal of Memory and Language, 29, 336–360.
Gathercole, S. E., Willis, C. S., Baddeley, A. D., & Emslie, H. (1994). The Children's Test of Nonword Repetition: A test of phonological working memory. Memory, 2, 103–127.
Hewitt, L. E., Hammer, C. S., Yont, K. M., & Tomblin, J. B. (2005). Language sampling for kindergarten children with and without SLI: Mean length of utterance, IPSYN, and NDW. Journal of Communication Disorders, 38, 197–213.
James, D., Rajput, K., Brown, T., Sirimanna, T., Brinton, J., & Goswami, U. (2005). Phonological awareness in deaf children who use cochlear implants. Journal of Speech, Language, and Hearing Research, 48, 1511–1528.
Johnson, C., & Goswami, U. (2010). Phonological awareness, vocabulary, and reading in deaf children with cochlear implants. Journal of Speech, Language, and Hearing Research, 53, 237–261.
Kamhi, A. G., Catts, H. W., Mauer, D., Apel, K., & Gentry, B. F. (1988). Phonological and spatial processing abilities in language- and reading-impaired children. Journal of Speech and Hearing Disorders, 53, 316–327.
Leslie, L., & Caldwell, J. (2006). Qualitative reading inventory. New York, NY: Pearson.
Liberman, I. Y., & Shankweiler, D. (1985). Phonology and the problems of learning to read and write. Remedial and Special Education, 6, 8–17.
Marton, K., & Schwartz, R. G. (2003). Working memory capacity and language processes in children with specific language impairment. Journal of Speech, Language, and Hearing Research, 46, 1138–1153.
Michas, I. C., & Henry, L. A. (1994). The link between phonological memory and vocabulary acquisition. British Journal of Developmental Psychology, 12, 147–163.
Miller, J., & Iglesias, A. (2010). Systematic Analysis of Language Transcripts (SALT) (Research Version 2010) [Computer software]. Madison, WI: SALT Software.
Moeller, M. P., McCleary, E., Putman, C., Tyler-Krings, A., Hoover, B., & Stelmachowicz, P. (2010). Longitudinal development of phonology and morphology in children with late-identified mild-moderate sensorineural hearing loss. Ear and Hearing, 31, 625–635.
Munson, B., Kurtz, B. A., & Windsor, J. (2005). The influence of vocabulary size, phonotactic probability, and wordlikeness on nonword repetitions of children with and without specific language impairment. Journal of Speech, Language, and Hearing Research, 48, 1033–1047.
Nittrouer, S. (1999). Do temporal processing deficits cause phonological processing problems? Journal of Speech, Language, and Hearing Research, 42, 925–942.
Nittrouer, S. (2010). Early development of children with hearing loss. San Diego, CA: Plural.
Nittrouer, S., & Burton, L. (2002). The role of early language experience in the development of speech perception and language processing abilities in children with hearing loss. Volta Review, 103, 5–37.
Nittrouer, S., & Burton, L. T. (2005). The role of early language experience in the development of speech perception and phonological processing abilities: Evidence from 5-year-olds with histories of otitis media with effusion and low socioeconomic status. Journal of Communication Disorders, 38, 29–63.
Nittrouer, S., Caldwell, A., Lowenstein, J. H., Tarr, E., & Holloman, C. (2012). Emergent literacy in kindergartners with cochlear implants. Ear and Hearing, 33, 683–697.
Nittrouer, S., Caldwell-Tarr, A., & Lowenstein, J. H. (2013). Working memory in children with cochlear implants: Problems are in storage, not processing. International Journal of Pediatric Otorhinolaryngology, 77, 1886–1898.
Nittrouer, S., & Chapman, C. (2009). The effects of bilateral electric and bimodal electric-acoustic stimulation on language development. Trends in Amplification, 13, 190–205.
Nittrouer, S., & Miller, M. E. (1999). The development of phonemic coding strategies for serial recall. Applied Psycholinguistics, 20, 563–588.
Nittrouer, S., Shune, S., & Lowenstein, J. H. (2011). What is the deficit in phonological processing deficits: Auditory sensitivity, masking, or category formation? Journal of Experimental Child Psychology, 108, 762–785.
Noble, T. H. (1980). The day Jimmy's boa ate the wash. New York, NY: Dial Books for Young Readers.
Papagno, C., & Vallar, G. (1995). Verbal short-term memory and vocabulary learning in polyglots. Quarterly Journal of Experimental Psychology: Human Experimental Psychology, 48(A), 98–107.
Pisoni, D. B., & Cleary, M. (2003). Measures of working memory span and verbal rehearsal speed in deaf children after cochlear implantation. Ear and Hearing, 24, 106S–120S.
Pisoni, D. B., Kronenberger, W. G., Roman, A. S., & Geers, A. E. (2011). Measures of digit span and verbal rehearsal speed in deaf children after more than 10 years of cochlear implantation. Ear and Hearing, 32(1, Suppl.), 60S–74S.
Roid, G. H., & Miller, L. J. (2002). Leiter International Performance Scale—Revised (Leiter–R). Wood Dale, IL: Stoelting.
Sáhlen, B., Reuterskiöld-Wagner, C., Nettelbladt, U., & Radeborg, K. (1999). Non-word repetition in children with language impairment—Pitfalls and possibilities. International Journal of Language Communication Disorders, 34, 337–352.
Shriberg, L. D., & Kwiatkowski, J. (1994). Developmental phonological disorders. I: A clinical profile. Journal of Speech, Language, and Hearing Research, 37, 1100–1126.
Snider, V. E. (1997). The relationship between phonemic awareness and later reading achievement. Journal of Educational Research, 90, 203–211.
Spring, C., & Perry, L. (1983). Naming speed and serial recall in poor and adequate readers. Contemporary Educational Psychology, 8, 141–145.
Stanovich, K. E., Cunningham, A. E., & Cramer, B. B. (1984). Assessing phonological awareness in kindergarten children: Issues of task comparability. Journal of Experimental Child Psychology, 38, 175–190.
Wagner, R. K., & Torgesen, J. K. (1987). The nature of phonological processing and its causal role in the acquisition of reading skills. Psychological Bulletin, 101, 192–212.
Weschler, D. (1991). Weschler Intelligence Scale for Children—Third Edition. San Antonio, TX: Psychological Corporation.
Wilkinson, G. S., & Robertson, G. J. (2006). The Wide Range Achievement Test (4th ed.). Lutz, FL: Psychological Assessment Resources.
Yopp, H. K. (1988). The validity and reliability of phonemic awareness tests. Reading Research Quarterly, 23, 159–177.
Information & Authors
Information
Published In
American Journal of Speech-Language Pathology
Volume 23 • Number 4 • November 2014
Pages: 679-695
PubMed: 25340675
Copyright
Copyright © 2014 American Speech-Language-Hearing Association.
History
- Received: Mar 16, 2014
- Revised: Jul 3, 2014
- Accepted: Aug 25, 2014
- Published in issue: Nov 1, 2014
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