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PubMed2006

Eye fixations of deaf and hearing observers in simultaneous communication perception.

OBJECTIVES: The purpose of this study was to examine characteristics of eye gaze behavior, specifically eye fixations, during reception of simultaneous communication (SC). SC was defined as conceptually accurate and semantically based signs and fingerspelling used in conjunction with speech. Specific areas of focus were (1) the pattern of frequency, duration, and location of observers' eye fixations in relation to the critical source of disambiguating information (signs or speech) in SC, and (2) how the pattern of an observer's eye fixations was related to the source of critical information (sign or speech), expectations regarding the location of the critical information after exposure to the stimulus set, observer characteristics, and sender. DESIGN: The investigation used eye tracking technology to monitor eye fixations of observers who watched silent video clips of sentences rendered in SC by three senders. Each sentence contained one of a pair of sign-critical (e.g., "sleeves"/"leaves") or speech-critical (e.g., "invited"/"hired") contrast items designed to depend on information at the hands or mouth, respectively, to resolve its ambiguity. Observers were 20 adults: five faculty/staff with early onset deafness, five faculty/staff with normal hearing, and ten college students with early onset deafness. Faculty and staff were identified by a sign language assessment specialist to be experienced and skillful users of SC. Students, exposed to SC in classroom instruction, were recruited through paper and electronic ads. RESULTS: Generally, observers looked toward the face, regardless of whether signs or speech disambiguated the message, suggesting that eye fixations toward the hands of the sender are not necessary to apprehend essential information to accurately identify an ambiguous part of the message during SC. However, other aspects of eye behavior indicated sensitivity to type of critical contrast. In particular, fixations were shorter during sign-critical items compared to speech-critical items, even after adjusting for stimulus length. In addition, experienced, adult deaf users of SC made more, brief eye fixations than observers who had normal hearing. Finally, differences in eye fixation patterns toward different senders indicates that sender characteristics affect visual processes in SC perception. CONCLUSIONS: This study provides supportive evidence of brief, frequent eye movements by deaf perceivers over small areas of a video display during reception of visuospatial linguistic information. These movements could be used to enhance activation of brain centers responsible for processing motion, consistent with neurophysiological evidence of attentional mechanisms or visual processes unique to perception of a visual language.

Adult↗

PubMed2001

Language and space: some interactions.

Is language linked to mental representations of space? There are several reasons to think that language and space might be separated in our cognitive systems, but they nevertheless interact in important ways. These interactions are evident in language viewed as a means of communication and in language considered a form of representation. In communication, spatial factors may be explicit in language itself, such as the spatial-gestural system of American Sign Language. Even the act of conversing with others is a spatial behavior because we orient to the locations of other participants. Language and spatial representations probably converge at an abstract level of concepts and simple spatial schemas.

Journal Article↗

PubMed1984

An alternating treatments comparison of oral and total communication training with minimally verbal retarded children.

This study was a comparison of the effects of oral speech with total communication (speech plus sign language) training on the ability of mentally retarded children to repeat 4-word sentences. Three children were chosen who used single words to communicate but who did not combine words into complete sentences. Three sentence pairs were trained, with each pair having one sentence trained using oral methods and an equivalent one trained using the total communication approach. Both training procedures involved chaining sentence parts, reinforcement, and prompting. Oral methods involved presenting vocal stimuli and requiring vocal responses whereas total communication methods involved presenting vocal and signed stimuli and requiring vocal and signed responses. For the initial sentence pair with each child, an alternating treatments design was used to determine the relative efficacy of the two language training approaches. This was repeated with a second and third sentence pair using a multiprobe technique within a multiple baseline design. Results pointed to the superiority of the total communication approach in facilitating sentence repetition. Possible explanations of these results are offered and the utility of the alternating treatments experimental design is discussed.

Child↗

PubMed1993

Linguistic characteristics of neurotic, borderline and psychotic personality organization.

Thirty patients were subjected to a Structural Interview by means of which 10 of them received the diagnosis NPO (Neurotic Personality Organization), 10 BPO (Borderline Personality Organization) and 10 PPO (Psychotic Personality Organization). About 2500 words and groups of words were extracted from the patients' utterances for analysis. The word-frequencies thus found were analyzed by a PLS discriminant analysis which yielded two significant principal components (main dimensions) explaining 57% of the variance. This analysis showed that the three groups of patients are well separated from one another and that there is a definite correlation between personality organization and linguistic variables. The main features of the BPO-patients in this study seem to be that they refer to positions outside themselves and their language is impersonal; we see this as an example of a vacillating identity. The NPO-group is characterized by an intense and rich language, signs of a more advanced symbolizing ability, deixis and high level defenses. The language of the PPO-patients is poor and its predominant feature is a lack of words; in our interpretation this indicates foreclosure and a lack of identity.

Adult↗

PubMed1997

Learning to look in the right place: a comparison of attentional behavior in deaf children with deaf and hearing mothers.

Eleven 18-month-old children with profound prelingual hearing loss were video-recorded in a free-play session with their mothers. Five of the mothers were profoundly deaf and fluent users of British Sign Language (BSL) or Auslan. The other six were hearing and had enrolled in a signing program. Ten-minute segments from each session were analyzed to determine the number of switches in attention shown by each child. Switches in attention were subdivided into three categories: spontaneous (where the child spontaneously looked to the mother); responsive (where the child responded to some maternal action such as moving an object); and elicited (where the mother made a direct attempt to gain the child's attention. Failed attempts to gain attention were also noted. A comparison of deaf and hearing mothers revealed no difference in the proportion of spontaneous or responsive switches in attention shown by their children. Responsive switches were by far the most frequent category for both groups, but these most commonly focused on objects and did not provide an opportunity for maternal signing. Successful perception of signing typically followed from spontaneous or elicited attentional switches. Deaf mothers were generally more insistent on their children turning to look at them, and they were more successful in eliciting attentional switches although they also had more failed attempts. These overall differences between the two groups were overshadowed by large individual differences within the groups. Within the sample there were both deaf and hearing mothers who achieved successful signed communication with their children.

Journal Article↗

PubMed2006

[Orientation of mental retardation from neurometabolic diseases].

INTRODUCTION AND DEVELOPMENT: Isolated mental retardation is rarely caused by metabolic factors. The application of a standardised protocol offers low diagnostic performance. There is no international agreement about what type of metabolic examination must be applied in patients with unspecific mental retardation. Nevertheless, and although they are infrequent, there are a number of inborn errors of metabolism that can present in this way. Urea cycle disorders, different forms of homocystinuria, creatine transport deficiency, 4-hydroxybutyric aciduria, Sanfilippo disease, adenylosuccinate lyase deficit and certain extraordinarily rare congenital disorders of the glycosylation of proteins are some examples of them. It is important first to consider those for which treatment is available and that could be diagnosed genetically for possible family counselling. CONCLUSIONS: Rather than applying a standardised study protocol it is essential is to perform a thorough appraisal of the signs and symptoms associated with the mental retardation (psychiatric disorders, autistic traits, predominant compromise of language, signs of cerebellar dysfunction, epilepsy, dysmorphic traits), since in most disorders it is necessary to apply specific analyses, which are not included in conventional metabolic studies and are only available in certain reference centres.

Algorithms↗

PubMed2006

Acoustic voice analysis of prelingually deaf adults before and after cochlear implantation.

It is widely accepted that many severe to profoundly deaf adults have benefited from cochlear implants (CIs). However, limited research has been conducted to investigate changes in voice and speech of prelingually deaf adults who receive CIs, a population well known for presenting with a variety of voice and speech abnormalities. The purpose of this study was to use acoustic analysis to explore changes in voice and speech for three prelingually deaf males pre- and postimplantation over 6 months. The following measurements, some measured in varying contexts, were obtained: fundamental frequency (F0), jitter, shimmer, noise-to-harmonic ratio, voice turbulence index, soft phonation index, amplitude- and F0-variation, F0-range, speech rate, nasalance, and vowel production. Characteristics of vowel production were measured by determining the first formant (F1) and second formant (F2) of vowels in various contexts, magnitude of F2-variation, and rate of F2-variation. Perceptual measurements of pitch, pitch variability, loudness variability, speech rate, and intonation were obtained for comparison. Results are reported using descriptive statistics. The results showed patterns of change for some of the parameters while there was considerable variation across the subjects. All participants demonstrated a decrease in F0 in at least one context and demonstrated a change in nasalance toward the norm as compared to their normal hearing control. The two participants who were oral-language communicators were judged to produce vowels with an average of 97.2% accuracy and the sign-language user demonstrated low percent accuracy for vowel production.

Adult↗

PubMed1989

Adult follow-up of the acquired aphasia-epilepsy syndrome in childhood. Report of 7 cases.

The authors report at adult age 7 patients (6 men, one woman) with the syndrome of "acquired aphasia-epilepsy", 6 of which had been previously studied as children. The results of the language, neuropsychological and socio-educational evaluation detailed many years after the onset of the aphasia are the subject of this report. One man has recovered completely, one has a normal oral language but is severely dyslexic, one has recovered normal comprehension but has severe expressive language problems. Four have absent language comprehension and lack of expressive speech, and only one of them has learned and is using sign language with some efficiency. None has developed functional written language. Attempts to offer a substitutive language to children with prolonged inability to understand and use oral language appears important but is fraught with problems. Although there are no conclusive data about the role of the continuous paroxysmal EEG discharges and the effect of their suppression with drug treatment on the prognosis of the aphasia, the definite fluctuations of the aphasia in some cases, the isolated recent case reports of definitive improvement with drug treatment justify further trials in this potentially severe and chronic condition.

Adolescent↗

PubMed2001

PET evaluation of bilingual language compensation following early childhood brain damage.

We report a positron emission tomography (PET) study in a 37-year-old, right handed, bilingual (English and American Sign Language) male with left frontal lobe damage, without evidence of language or general intellectual dysfunction. A brain MRI scan demonstrated an atrophic lesion of the left dorsolateral prefrontal, orbital, and opercular cortices extending from the frontal pole to precentral gyrus and including parts of anterior cingulate cortex, due to an probable infantile encephalitis. H(2) (15)O PET scans found evidence of increased right hemisphere activity compared to normal controls during spontaneous generation of narrative in both English and ASL. Neuropsychological data were within normal limits with the exception of visuospatial function. The results suggest the possibility that plasticity, unmasking of neural pathways, and or other adaptations of language function in the right hemisphere may have occurred, and are discussed with regard to the crowding hypothesis.

Adult↗

PubMed1998

Regional cerebral blood flow during signed and heard episodic and semantic memory tasks.

Ten deaf participants and 10 normal hearing participants performed 2 memory tasks during which their regional cerebral blood flow was measured with a high-resolution system. The deaf participants solved an episodic memory (i.e., recognition of words) and a semantic memory (i.e., classification of items into categories) task presented by means of sign language; the same material was presented to the hearing participants who heard the stimulus lists. The specific hypothesis that signed episodic recognition tasks would activate posterior, right-hemisphere cortical areas was supported. Expectedly, the remaining 3 memory activations were mainly located in the left hemisphere. Data from recent positron emission tomography studies suggest that one challenge for future research is to assess the relative localization for encoding and retrieval of signed episodes.

Journal Article↗

PubMed2002

Communication intervention for children with autism: a review of treatment efficacy.

Empirical studies evaluating speech and language intervention procedures applied to children with autism are reviewed, and the documented benefits are summarized. In particular, interventions incorporating sign language, discrete-trial training, and milieu teaching procedures have been used successfully to expand the communication repertoires of children with autism. Other important developments in the field stem from interventions designed to replace challenging behaviors and to promote social and scripted interactions. The few studies of the parent and classroom training studies that included language measures also are analyzed. This article seeks to outline the extent to which previous research has helped identify a compendium of effective instructional practices that can guide clinical practice. It also seeks to highlight needs for further research to refine and extend current treatment approaches and to investigate more comprehensive treatment packages.

Autistic Disorder↗

PubMed2006

Anatomical substrates of visual and auditory miniature second-language learning.

Longitudinal changes in brain activity during second language (L2) acquisition of a miniature finite-state grammar, named Wernickese, were identified with functional magnetic resonance imaging (fMRI). Participants learned either a visual sign language form or an auditory-verbal form to equivalent proficiency levels. Brain activity during sentence comprehension while hearing/viewing stimuli was assessed at low, medium, and high levels of proficiency in three separate fMRI sessions. Activation in the left inferior frontal gyrus (Broca's area) correlated positively with improving L2 proficiency, whereas activity in the right-hemisphere (RH) homologue was negatively correlated for both auditory and visual forms of the language. Activity in sequence learning areas including the premotor cortex and putamen also correlated with L2 proficiency. Modality-specific differences in the blood oxygenation level-dependent signal accompanying L2 acquisition were localized to the planum temporale (PT). Participants learning the auditory form exhibited decreasing reliance on bilateral PT sites across sessions. In the visual form, bilateral PT sites increased in activity between Session 1 and Session 2, then decreased in left PT activity from Session 2 to Session 3. Comparison of L2 laterality (as compared to L1 laterality) in auditory and visual groups failed to demonstrate greater RH lateralization for the visual versus auditory L2. These data establish a common role for Broca's area in language acquisition irrespective of the perceptual form of the language and suggest that L2s are processed similar to first languages even when learned after the "critical period." The right frontal cortex was not preferentially recruited by visual language after accounting for phonetic/structural complexity and performance.

Acoustic Stimulation↗

PubMed2005

Management of Landau-Kleffner syndrome.

Landau-Kleffner syndrome (LKS) is an acquired epileptic aphasia disorder in which children, usually 3-8 years of age who have developed age-appropriate speech, experience language regression with verbal auditory agnosia, abnormal epileptiform activity, behavioral disturbances, and sometimes overt seizures. There are no controlled clinical trials investigating the therapeutic options for LKS. Only open-label data are available. Early diagnosis and initiation of prompt medical treatment appear to be important to achieving better long-term prognosis.Several antiepileptic drugs have been reported to be beneficial in treating this syndrome. These include valproic acid (valproate sodium), diazepam, ethosuximide, clobazam, and clonazepam. Reports on the efficacy of lamotrigine, sultiame, felbamate, nicardipine, vigabatrin, levetiracetam, vagal nerve stimulation, and a ketogenic diet are few and more experience is needed. Carbamazepine and possibly phenobarbital and phenytoin have been reported to occasionally exacerbate the syndrome. As initial therapy, valproic acid or diazepam is often empirically chosen. Subsequently, other antiepileptic drugs, corticosteroids, or intravenous immunoglobulin (IVIG) therapy are often used. Corticosteroid therapy should probably not be delayed more than 1-2 months after the initial diagnosis. Various corticosteroid regimens including oral prednisone and, recently, high doses of intravenous pulse corticosteroids, as well as corticotropin (adrenocorticotropic hormone) have been reported to be effective in LKS. Oral corticosteroids are used more often and usually need to be maintained for a long period of time to prevent relapses. The use of IVIG has been associated with an initial dramatic response in only a few patients. In our experience, a long-term worthwhile improvement has been noted in only 2 of 11 patients. These two patients had an immediate response to IVIG initially and after relapses before eventually achieving a long-term sustained remission. Surgical treatment by multiple subpial transection, which is reserved for patients who have not responded to multiple medical therapies, has been followed in selected cases by a marked improvement in language skills and behavior. However, a widely accepted consensus about suitable candidates for this surgery and about its efficacy is still lacking. Speech therapy, including sign language, and a number of classroom and behavioral interventions are helpful in managing LKS, and should be used in all patients.

Adrenocorticotropic Hormone↗

PubMed2005

Aural rehabilitation for deaf children: a northeastern Thailand experience.

Aural rehabilitation for deaf children (hearing loss > 90 dB) has been established since World War II. Many developed countries such as USA, Canada, United Kingdom, Netherlands and Australia have famous institutes providing aural rehabilitation for these children so that they are able to communicate with other people in the hearing society. Teaching programs include auditory training, speech stimulation, speech correction and developing language skills by using natural conversation and real models. In Thailand, the most common mode of communication for deaf children is total communication which focuses on sign language, thus, limiting the ability to communicate with other people. With the realization of this problem, the preschool program for deaf children was set up in 1993 by an audiologist and a speech pathologist at the speech and hearing clinic, Department of Otolaryngology, Faculty of Medicine, Khon Kaen University. A study of 31 deaf children with the average better ear hearing threshold of 103 dB (103.5 +/- 7.01), who visited the program regularly showed that it took an average of 277 days or approximately 9 months (9.25 +/- 4.1) after hearing aid fitting, in acquiring spontaneous meaningful single words or 638 days or approximately 21 months (21.3 +/- 4.3) in acquiring simple conversation or sentences of more than three words. The limitation and problems of the program will be discussed.

Child↗

PubMed2003

Graham Fraser Memorial Lecture 2002. From frogs' legs to pieds-noirs and beyond: some aspects of cochlear implantation.

The 2002 Graham Fraser Memorial Lecture deals first with the French origins of cochlear implantation in Paris in the 1950s and the role of André Djourno and Charles Eyriès. Following this work in Paris Dr William House in Los Angeles continued work on cochlear implants and, subsequently, experimental implant programmes were started in California, Paris, Vienna and Melbourne. The next section of this lecture covers the experimental work of Galvani in establishing the role of electricity in physiology. The results of his first experiments were published in 1791, the year that Mondini produced the first account of a cochlear malformation in a congenitally deaf child. At around the same time sign language for congenitally deaf children was being developed for the first time in Paris by Epée and the first disputes occurred between oralists and those who promoted signing for the education of congenitally deaf children. In a present day cochlear implant programme good results from implanting congenitally deaf children at an early age and implanting adults who have become profoundly deaf are now taken for granted. We do have much to learn, however, from more complex implant candidates and some examples of such candidates are presented. Lastly, looking to the future, the use of PET scanning to try and gain information about how the brain handles the information provided to it by a cochlear implant is described.

Cochlear Implantation↗

PubMed1983

Late language development in a child unable to recognize or produce speech sounds.

A boy with severe quadriplegia who neither recognized nor uttered speech sounds acquired language. Until the age of 6 years he was considered to be of severely subnormal intelligence. At age 6 years 9 months he was introduced to a manual sign system. Subsequently he was able to read, write, converse, and produce imaginative stories. Attention and memory were unimpaired and affective and social responsiveness developed appropriately. The case history demonstrates the selective effects of brain lesions that, despite extensive damage, may spare functional systems necessary for cognitive and linguistic development. It highlights the difficulty in diagnosing and evaluating the intellectual and affective potential of a multihandicapped child without functional hearing or speech and emphasizes the importance of sign language as a communication channel and prerequisite for the acquisition of reading and writing skills.

Aphasia↗

PubMedDate not supplied

Late diagnosis of congenital hearing impairment in children: the parents' experiences and opinions.

The purpose of the present investigation is to describe how parents experience a delayed identification of their child's hearing impairment. Ten parents of 8 children were interviewed. The impairment was confirmed when the children were between 2 years, and 5 years and 8 months. The results show that the parents and their child pass through a series of distinct phases: Unawareness, Suspicion, Confirmation and Habilitation. After the birth of the child there was first a calm period, which lasted until the possibility of a hearing impairment was suspected. Once the suspicion was raised, a time of much anxiety and frustration ensued. The parents described how defective communication and misunderstanding lead to frequent conflicts with their child. The differing behaviour of the child, in combination with poor language development, initiated referral to audiological assessment and confirmation of the hearing impairment. After confirmation, the parents felt relief but at the same time a sorrow. When hearing aids had been fitted and education in sign language was under way, the child's language and social behaviour improved. Supposedly, the late detection is explained by the combination of an insufficient test method that cannot detect all children with a hearing impairment and, in cases of uncertainty, a tendency to let the child pass rather than "bringing bad news". All parents in the present study would have wished to participate in a hearing screening program for new-borns, had the opportunity been present.

Adult↗

PubMed2003

Decisions Hispanic families make after the identification of deafness.

This study examines the decision-making process for Hispanic families living in the United States who have a child with a hearing loss. Twenty-nine families in four geographical areas shared their experiences in searching for appropriate interventions and making choices regarding communication and education. We explored the impact of language, culture, minority status, and access to information and services on the decision-making process. The results indicate that the deliberations of Hispanic parents are often complicated by language and cultural barriers and by limited access to information, resources, and a full range of options. The communication method chosen tended to be the one recommended by professionals, usually a combination of spoken English and sign language. Parents frequently expressed the hope that their child would learn Spanish as well. These subjects displayed a higher degree of assertiveness in obtaining services for their children than other studies have suggested.

Journal Article↗