To Örebro University

The everyday lives of young children with speech sound disorder (SSD) are not well described, with few studies taking a holistic view with interaction in focus. The aim of this study was to investigate how SSD affects communicative activity and participation in everyday life of four children in a Swedish context. The study involved 4 triads: 4 children with SSD aged 4 to 7, their parents (n = 4), grandmothers (n = 2) and pedagogues, i.e. preschool teachers (n = 2). The research design was a case series, including speech language tests, questionnaires and structured interviews. The International Classification of Functioning, Disability and Health (ICF) served as an analytical framework. Results showed reduced speech intelligibility in all children. Interrupted thought processes, tantrums and social withdrawal were negative effects of the SSD. Having a friend in the out-of-home environment was a facilitating factor, enabling the children with SSD use their full capacity in social interaction. When knowledge about SSD is shared in all environments, all forces that influence the child positively may be aligned in a collaborative effort and a holistic understanding can be reached. To accomplish this, ICF serves as a valuable conceptual framework.

This article explores the tensions within inclusive education and emphasises the research community’s responsibility to enhance the understanding and practical application of inclusive practices. It highlights the challenges the researchers face when navigating diverse scientific disciplines, often leading to entrenched policies that overlook varied epistemologies. We aim to display and open up for scrutiny current and ongoing social epistemologies in research on inclusive education that can be achieved through a diverse research environment in the field of inclusive education, and its attempt to recognise and accommodate diverse epistemologies within research on inclusive education. Utilising Bacchi’s comparative policy analysis, we analyse researchers’ interpretations of inclusion and its implications. The article concludes by advocating for a broader embrace of theoretical diversity and a more nuanced, lived understanding of inclusion, challenging prevailing monocultural interpretations.

Research shows that the physical environment, such as meeting rooms and offices, affects prerequisites and outcomes in various forms of human services. This study focuses on the importance of the physical environment in meetings between child welfare workers and children within the Social Services’ activities. The conduction of the study has been inspired by the framework stages for a scoping review described by Arksey and O’Malley (2005). Results show that there is a clear lack of research on this matter. The small number of studies that do exist emphasize that physical and spatial factors clearly affect how contacts and relationships between welfare workers and children are shaped. Included studies show that spatial factors affect children’s participation in assessments, decisions, and the setup of support. The importance of the professionals’ ability to acknowledge the unique needs and desires of each child while at the same time recognising how to benefit from the physical environment where their meetings take place is stressed. Studies show that there is a trend towards contemporary child welfare work shifting from a focus on relational factors to gathering and dealing with information. In general, this field is under-theorized warranting more research with deeper theoretical aspirations.

There is a lack of longitudinal studies on the broad-based outcomes in children with Developmental Phonological Disorder (DPD). The aim of this study was to investigate listening and processing skills in a clinical sample of 7-to-10-year-old children diagnosed with DPD in their preschool years and compare these to same-aged typically developing (TD) children. The Evaluation of Children's Listening and Processing Skills (ECLiPS) was completed by parents of 115 children with DPD and by parents of 46 TD children. The total ECLiPS mean score, and the five subscale mean scores, the proportion of children with clinically significant difficulties (<= 10th percentile), and the proportion of children with co-occurrence of clinically significant difficulties on more than one subscale, were calculated. Results showed that the ECLiPS mean scores did not differ between the groups. There was no difference between groups regarding language and literacy, but a higher proportion of children with DPD than TD had difficulties in the total score, speech, and auditory processing, environmental and auditory sensitivity, and pragmatic and social skills. In addition, 33.9% of children with DPD had clinically significant difficulties in two or more subscales compared to 10.9% of TD children.

Deaf and hard of hearing children with cochlear implants (CI) often display impaired spoken language skills. While a large number of studies investigated brain responses to sounds in this population, relatively few focused on semantic processing. Here we summarize and discuss findings in four studies of the N400, a cortical response that reflects semantic processing, in children with CI. A study with auditory target stimuli found N400 effects at delayed latencies at 12 months after implantation, but at 18 and 24 months after implantation effects had typical latencies. In studies with visual target stimuli N400 effects were larger than or similar to controls in children with CI, despite lower semantic abilities. We propose that in children with CI, the observed large N400 effect reflects a stronger reliance on top-down predictions, relative to bottom-up language processing. Recent behavioral studies of children and adults with CI suggest that top-down processing is a common compensatory strategy, but with distinct limitations such as being effortful. A majority of the studies have small sample sizes (N < 20), and only responses to image targets were studied repeatedly in similar paradigms. This precludes strong conclusions. We give suggestions for future research and ways to overcome the scarcity of participants, including extending research to children with conventional hearing aids, an understudied group.

OBJECTIVES: We completed a registered double-blind randomized control trial to compare acclimatization to two hearing aid fitting algorithms by experienced pediatric hearing aid users with mild to moderate hearing loss. We hypothesized that extended use (up to 13 months) of an adaptive algorithm with integrated directionality and noise reduction, OpenSound Navigator (OSN), would result in improved performance on auditory, cognitive, academic, and caregiver- or self-report measures compared with a control, omnidirectional algorithm (OMNI).

DESIGN: Forty children aged 6 to 13 years with mild to moderate/severe symmetric sensorineural hearing loss completed this study. They were all experienced hearing aid users and were recruited through the Cincinnati Children's Hospital Medical Center Division of Audiology. The children were divided into 20 pairs based on similarity of age (within 1 year) and hearing loss (level and configuration). Individuals from each pair were randomly assigned to either an OSN (experimental) or OMNI (control) fitting algorithm group. Each child completed an audiology evaluation, hearing aid fitting using physically identical Oticon OPN hearing aids, follow-up audiological appointment, and 2 research visits up to 13 months apart. Research visit outcome measures covered speech perception (in quiet and in noise), novel grammar and word learning, cognition, academic ability, and caregiver report of listening behaviors. Analysis of outcome differences between visits, groups, ages, conditions and their interactions used linear mixed models. Between 22 and 39 children provided useable data for each task.

RESULTS: Children using the experimental (OSN) algorithm did not show any significant performance differences on the outcome measures compared with those using the control (OMNI) algorithm. Overall performance of all children in the study increased across the duration of the trial on word repetition in noise, sentence repetition in quiet, and caregivers' assessment of hearing ability. There was a significant negative relationship between age at first hearing aid use, final Reading and Mathematical ability, and caregiver rated speech hearing. A significant positive relationship was found between daily hearing aid use and study-long change in performance on the Flanker test of inhibitory control and attention. Logged daily use of hearing aids related to caregiver rated spatial hearing. All results controlled for age at testing/evaluation and false discovery rate.

CONCLUSIONS: Use of the experimental (OSN) algorithm neither enhanced nor reduced performance on auditory, cognitive, academic or caregiver report measures compared with the control (OMNI) algorithm. However, prolonged hearing aid use led to benefits in hearing, academic skills, attention, and caregiver evaluation.

In the present study, hearing sensitivity in children with speech sound disorder (SSD) is scrutinized. Middle ear function (wideband tympanometry and acoustic stapedial reflexes, ASR) and inner ear function (audiometric thresholds in the conventional_{1-8 kHz} and extended_{10-16 kHz} high frequency (EHF) range, and distortion product otoacoustic emissions (DPOAEs_{2-10 kHz}) were investigated. Hearing results were analyzed in relation to speech discrimination of phonemic contrasts (quiet and in noise conditions) and reproduction. Thirty-two children with SSD and 41 children with typical development (TD) ages 4-5 years participated. Children with SSD exhibited significantly less sensitive hearing compared to children with TD. This was demonstrated as more absent contralateral ASR (right ear SSD 43.7%; TD 22.0%), a higher prevalence of minimal hearing loss (MHL, > 15 dB HL at one or more frequencies or ears_{1-8 kHz} and PTA ≤ 20 dB HL, SSD 53.1%; TD 24.3%) and EHF hearing impairment (EHF HI, > 20 dB HL at one or more frequencies or ears_{10-16 kHz}, SSD 31.3%; TD 24.3%). At 2 kHz bilaterally, children with SSD showed significantly higher hearing thresholds than children with TD (mean difference, left ear 3.4 dB: right ear 4.3 dB), together with a significantly lower SNR in DPOAEs at 2.2 kHz (left ear 5.1 dB mean difference between groups). In all children, audiometric thresholds at the key-frequencies for speech, 2 and 4 kHz and DPOAEs within similar spectral regions, predicted 7-12% of the variance in phonemic discrimination and reproduction. Overall, these results suggest that hearing should be more fully investigated in children with SSD.

Objectives: The primary aim was to examine how event-related potentials (ERPs) and mismatch negativity (MMN) change and develop over time among children with hearing loss (HL) using hearing aids (HAs) or cochlear implants (CIs). Children with normal hearing (NH) were tested as a reference group.

Methods: This three-year follow-up study included 13 children with sensorineural HL (SNHL); 7 children using bilateral HAs and 6 children using CIs; and 10 children with NH as a reference group. ERPs were recorded at baseline and after three years. At time for the original study the children were approximately 5-8 years old and at the follow-up study 8-11 years old. ERP recordings and data processing were identical in both sessions. A standard stimulus alternated with five different deviants (gap, intensity, pitch, location and duration), presented in a pseudorandom sequence, thus following the multi-feature paradigm, Optimum-1. MMN was calculated from the average ERP of each deviant minus the standard stimuli. Repeated measures ANOVA was used for the statistical analyses and the results were based on samples within a specific time interval; 80-224 ms.

Results: There was a statistically significant difference in the obligatory responses between the NH and HA groups at baseline, but this difference disappeared after three years in our follow-up study. The children with HA also showed a significant difference in mean ERP at baseline compared to follow-up, and significant differences between the deviants at follow-up but not at baseline. This suggests an improvement over time among the children with HAs. On the other hand, the children with CIs did not differ from the NH children at baseline, but after three years their mean ERP was significantly lower compared to both the children with HA and NH, indicating a reduced development of the central auditory system in this age span among the children with CIs. Regarding MMN, there was an interaction between the duration deviant and time for the children with HA, also indicating a possible improvement over time among the HA children.

Conclusions: This three-year follow-up study shows neurophysiological differences between children with HL and children with NH. The results suggest a delay in the central auditory processing among the HA children compared to children with NH, but a possible catch-up, over time, and this potential may be worth to be utilized. Regarding the CI children, similar improvement in this age span is missing, meaning there are differences between the subgroups of children with HL, i.e. the children with HAs vs. CIs. The results highlight the importance of distinguishing between subgroups of children with HL in further research.