| 1. |
- Edvall, Niklas K., et al.
(författare)
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Alterations in auditory brain stem response distinguish occasional and constant tinnitus
- 2022
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Ingår i: Journal of Clinical Investigation. - : American Society for Clinical Investigation. - 0021-9738 .- 1558-8238. ; 132:5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND. The heterogeneity of tinnitus is thought to underlie the lack of objective diagnostic measures.METHODS. Longitudinal data from 20,349 participants of the Swedish Longitudinal Occupational Survey of Health (SLOSH) cohort from 2008 to 2018 were used to understand the dynamics of transition between occasional and constant tinnitus. The second part of the study included electrophysiological data from 405 participants of the Swedish Tinnitus Outreach Project (STOP) cohort.RESULTS. We determined that with increasing frequency of the occasional perception of self-reported tinnitus, the odds of reporting constant tinnitus after 2 years increases from 5.62 (95% CI, 4.83–6.55) for previous tinnitus (sometimes) to 29.74 (4.82–6.55) for previous tinnitus (often). When previous tinnitus was reported to be constant, the odds of reporting it as constant after 2 years rose to 603.02 (524.74–692.98), suggesting that once transitioned to constant tinnitus, the likelihood of tinnitus to persist was much greater. Auditory brain stem responses (ABRs) from subjects reporting nontinnitus (controls), occasional tinnitus, and constant tinnitus show that wave V latency increased in constant tinnitus when compared with occasional tinnitus or nontinnitus. The ABR from occasional tinnitus was indistinguishable from that of the nontinnitus controls.CONCLUSIONS. Our results support the hypothesis that the transition from occasional to constant tinnitus is accompanied by neuronal changes in the midbrain leading to a persisting tinnitus, which is then less likely to remit.
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| 2. |
- Engström, Elisabet, et al.
(författare)
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Auditory event-related potentials and mismatch negativity in children with hearing loss using hearing aids or cochlear implants : A three-year follow-up study
- 2021
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 140
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 3. |
- Engström, Elisabet, et al.
(författare)
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Computer-assisted reading intervention for children with hearing impairment using cochlear implants : Effects on auditory event-related potentials and mismatch negativity
- 2020
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 137
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The primary aim was to find out whether a computer-assisted reading intervention program with a phonic approach can affect event-related (ERPs) and mismatch negativity (MMN) in hearing impaired (HI) children using cochlear implants (CIs).METHODS: This study involved a test group of 15 HI children with CIs and a control group of 14 normal hearing (NH) children. The children were 4 years and 10 months to 8 years and 1 month old. ERPs were recorded immediately before and after 4 weeks of training with a computer-assisted reading intervention, GraphoGame. A multi-feature paradigm, Optimum-1, was used, i.e. a standard stimulus alternated with five different deviants: gap intensity, pitch, location and duration. MMN was calculated from the mean amplitude ERP of each deviant minus the standard stimulus response in a specific time interval, 80 - 224 ms. Repeated measures ANOVA was used for the statistical analysis.RESULTS: The results did not show any significant changes with the computerassisted training in the ERPs and MMNs among the HI children with CIs. The presence of both MMN and a positive mismatch response (pMMR), which might reflect an immaturity, complicates interpreting the results in this age group. Individually, there was a mix of MMNs and pMMRs among all participants, pre and post training, and the change of each deviant after intervention was not predictable.CONCLUSIONS: There are no significant changes in ERP or MMN after intervention, however lack of significances must be interpreted with caution. Besides the presence of both MMNs and pMMRs, only modest changes are to be expected on an individual basis and small samples hinder making statistical conclusions regarding the training's effects. The study contributes to some more descriptive pieces of ERPs and MMNs among the HI children with CIs. The issues of MMN and pMMR are highlighted.
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| 4. |
- Engström, Elisabet, et al.
(författare)
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Computer-assisted reading intervention for children with sensorineural hearing loss using hearing aids : Effects on auditory event-related potentials and mismatch negativity
- 2019
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 117, s. 17-25
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The primary aim was to investigate whether computer-assisted reading intervention somehow can affect event-related potentials (ERP) and mismatch negativity (MMN) in hearing impaired (HI) children with hearing aids (HAs) and normal hearing (NH) children.METHODS: The study included 15 HI children with sensorineural hearing loss (SNHL) using bilateral HAs and 14 NH children as a reference group; all children between the ages of 5 and 8. A multi-feature MMN-paradigm, Optimum-1, with a standard stimulus alternating with 5 different deviants was used. ERPs were recorded pre and post intervention, i.e. one month of repeatedly computer-assisted training (GraphoGame). MMN was calculated from the average ERP of each deviant minus standard. Data were based on samples within a specific time interval, 80-224 ms, and repeated measures ANOVA was used to analyze possible interactions.RESULTS: There was a significant difference between groups before training, though, the mean obligatory responses or MMN was not statistically significantly different before versus after training, neither among the NH nor the HI children. Further, the HI children did generally achieve lower levels in GraphoGame compared to the NH children. Altogether, our findings indicate differences between the groups and that training may affect the neurophysiological processing in the brain, gaining the HI children. Both MMN and positive mismatch response (pMMR) were seen among both the HA and NH children, irrespective to deviant type. Individually, changes of the MMN and pMMR after training seem unpredictable.CONCLUSION: There are statistically significant differences in both the obligatory responses in ERP and the MMNs between the NH and HI groups before the computer-assisted training. Though, these differences disappear after the intervention. This suggests possible training effects regarding the central auditory processing among the HI children.
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| 5. |
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| 6. |
- Kallioinen, Petter, et al.
(författare)
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Semantic Processing in Deaf and Hard-of-Hearing Children : Large N400 Mismatch Effects in Brain Responses, Despite Poor Semantic Ability
- 2016
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Ingår i: Frontiers in Psychology. - London : Frontiers Media SA. - 1664-1078. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Difficulties in auditory and phonological processing affect semantic processing in speech comprehension for deaf and hard-of-hearing (DHH) children. However, little is known about brain responses related to semantic processing in this group. We investigated event-related potentials (ERPs) in DHH children with cochlear implants (CIs) and/or hearing aids (HAs), and in normally hearing controls (NH). We used a semantic priming task with spoken word primes followed by picture targets. In both DHH children and controls, cortical response differences between matching and mismatching targets revealed a typical N400 effect associated with semantic processing. Children with CI had the largest mismatch response despite poor semantic abilities overall; Children with CI also had the largest ERP differentiation between mismatch types, with small effects in within-category mismatch trials (target from same category as prime) and large effects in between-category mismatch trials (where target is from a different category than prime), compared to matching trials. Children with NH and HA had similar responses to both mismatch types. While the large and differentiated ERP responses in the CI group were unexpected and should be interpreted with caution, the results could reflect less precision in semantic processing among children with CI, or a stronger reliance on predictive processing.
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| 7. |
- Lyxell, Björn, et al.
(författare)
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Cognitive and communicative development in deaf and hearing-impaired children with cochlear implants and/or hearing-aids
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of the study was to examine neurophysiological, cognitive and linguistic development in deaf and hearing-impaired children (5–7 years of age) with CI and/or hearingaids and how a phonological intervention programme may influence this development. The deaf and hearing-impaired children were compared with age-matched hearing children. The results reveal that deaf and hearing-impaired children had equivalent or close to equivalent performance levels compared to hearing children for cognitive and linguistic tasks with relatively low demands on phonological processing, whereas there was a substantial and significant difference between the groups for cognitive tasks involving explicit phonological processing. The results indicate that there is a relationship between age at implant and neurophysiological, cognitive and linguistic development, where early implantation promotes faster development. The childrens´ cognitive performance increased as a function of phonological intervention.
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| 8. |
- Lyxell, Björn, et al.
(författare)
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Cognitive and communicative development in deaf and hearing-impaired children with cochlear implants and/or hearing-aids
- 2013
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of the study was to examine neurophysiological, cognitive and linguistic development in deaf and hearing-impaired children (5–7 years of age) with CI and/or hearingaids and how a phonological intervention programme may influence this development. The deaf and hearing-impaired children were compared with age-matched hearing children. The results reveal that deaf and hearing-impaired children had equivalent or close to equivalent performance levels compared to hearing children for cognitive and linguistic tasks with relatively low demands on phonological processing, whereas there was a substantial and significant difference between the groups for cognitive tasks involving explicit phonological processing. The results indicate that there is a relationship between age at implant and neurophysiological, cognitive and linguistic development, where early implantation promotes faster development. The childrens´ cognitive performance increased as a function of phonological intervention.
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| 9. |
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| 10. |
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| 11. |
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| 12. |
- Mackey, Allison R., et al.
(författare)
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Protocol and programme factors associated with referral and loss to follow-up from newborn hearing screening : a systematic review
- 2022
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Ingår i: BMC Pediatrics. - : BioMed Central (BMC). - 1471-2431. ; 22:1
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: An effective newborn hearing screening programme has low referral rate and low loss to follow-up (LTFU) rate after referral from initial screening. This systematic review identified studies evaluating the effect of protocol and programme factors on these two outcomes, including the screening method used and the infant group.METHODS: Five databases were searched (latest: April 2021). Included studies reported original data from newborn hearing screening and described the target outcomes against a protocol or programme level factor. Studies were excluded if results were only available for one risk condition, for each ear, or for < 100 infants, or if methodological bias was observed. Included studies were evaluated for quality across three domains: sample, screening and outcome, using modified criteria from the Ottawa-Newcastle and QUADAS-2 scales. Findings from the included studies were synthesised in tables, figures and text.RESULTS: Fifty-eight studies reported on referral rate, 8 on LTFU rate, and 35 on both. Only 15 studies defined LTFU. Substantial diversity in referral and LTFU rate was observed across studies. Twelve of fourteen studies that evaluated screening method showed lower referral rates with aABR compared to TEOAE for well babies (WB). Rescreening before hospital discharge and screening after 3 days of age reduced referral rates. Studies investigating LTFU reported lower rates for programmes that had audiologist involvement, did not require fees for step 2, were embedded in a larger regional or national programme, and scheduled follow-up in a location accessible to the families. In programmes with low overall LTFU, higher LTFU was observed for infants from the NICU compared to WB.CONCLUSION: Although poor reporting and exclusion of non-English articles may limit the generalisability from this review, key influential factors for referral and LTFU rates were identified. Including aABR in WB screening can effectively reduce referral rates, but it is not the only solution. The reported referral and LTFU rates vary largely across studies, implying the contribution of several parameters identified in this review and the context in which the programme is performed. Extra attention should be paid to infants with higher risk for hearing impairment to ensure their return to follow-up.
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| 13. |
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| 14. |
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| 15. |
- Nakeva von Mentzer, Cecilia, et al.
(författare)
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Computer-assisted intervention for children with hearing impairment : Cognitive factors and phonological change
- 2013
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Ingår i: CHSCOM2013. - : Linköping University Electronic Press.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Thirty-two children with hearing impairment (HI) using cochlear implants (CI) and/or hearing aids (HA), and sixteen with normal hearing (NH) participated in a computer-assisted intervention study that focused on perceiving and memorizing phonemic sounds. The first purpose was to study cognitive abilities in NH and HI children, how they related to phonological processing skills (PhPS) pre intervention and to phonological growth post intervention. The second purpose was to analyze children’s performance at different fine-grained levels of phonological processing, i.e. how they manipulated, stored and produced phonological entities of different size with or without semantic content. This was put in relation to children’s type of auditory stimulation (electrical; bilateral CI, bimodal: CI + HA and acoustical; bilateral HA). Results showed significant correlations between complex working memory and PhPS in children with HI but not in children with NH. This suggests different cognitive strategies in the children when dealing with phonological processing tasks. Poor phoneme discrimination was the strongest predictor of phonological growth in the children with HI as a function of training. Thus, the computer-assisted program was beneficial for HI children with weak initial phoneme discrimination skills. Children with CI showed reduced performance at fine-grained levels of receptive phonological processing but not on expressive phonological lexical tasks.
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| 16. |
- Nakeva von Mentzer, Cecilia, et al.
(författare)
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Computer-assisted intervention for Deaf and Hard of hearing (D/HH) children with cochlear implants or hearing aids : Cognitive factors and phonological change
- 2013
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: Study cognitive abilities; specifically working memory and lexical access in NH and DHH children, and their correlations to phonological processing skills (PhPS) pre intervention. Analyze how cognitive abilities related to phonological change post intervention. Material and Method: Tasks for lexical access, complex and visual working memory and Phpr were assessed pre and post intervention.Conclusion: DHH children performed at a lower level than NH children on lexical access but equally on complex and visual working memory. Significant correlations between complex working memory and PhPS were evident in DHH children but not in NH. This suggests that DHH children recruit more cognitive resources when performing PhPr tasks. Weak initial performance on a task for phonological representations (Phrep) was the only significant predictor of phonological change in DHH children. Weak PhRep was associated with a higher age at diagnosis, higher age at implant, and shorter usage-time with CI.
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| 17. |
- Nakeva von Mentzer, Cecilia, et al.
(författare)
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Computer-assisted reading intervention with a phonics approach for children using cochlear implants or hearing aids
- 2014
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Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 55:5, s. 448-455
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Tidskriftsartikel (refereegranskat)abstract
- The present study examined computer-assisted reading intervention with a phonics approach for deaf and hard of hearing (DHH) children in Sweden using cochlear implants or hearing aids, or a combination of both. The study included 48 children, 5, 6 and 7years of age. Sixteen children with normal hearing (NH) served as a reference group. The first purpose of the study was to compare NH and DHH children's reading ability at pre and post-intervention. The second purpose was to investigate effects of the intervention. Cognitive and demographic factors were analyzed in relation to reading improvement. Results showed no statistically significant difference for reading ability at the group level, although NH children showed overall higher reading scores at both test points. Age comparisons revealed a statistically significant higher reading ability in the NH 7-year-olds compared to the DHH 7-year-olds. The intervention proved successful for word decoding accuracy, passage comprehension and as a reduction of nonword decoding errors in both NH and DHH children. Reading improvement was associated with complex working memory and phonological processing skills in NH children. Correspondent associations were observed with visual working memory and letter knowledge in the DHH children. Age was the only demographic factor that was significantly correlated with reading improvement. The results suggest that DHH children's beginning reading may be influenced by visual strategies that might explain the reading delay in the older children.
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| 18. |
- Nakeva von Mentzer, Cecilia, 1968-, et al.
(författare)
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Computer-assisted training of phoneme-grapheme correspondence for children who are deaf and hard of hearing : Effects on phonological processing skills
- 2013
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - Amsterdam, Netherlands : Elsevier. - 0165-5876 .- 1872-8464. ; 77:12, s. 2049-2057
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Examine deaf and hard of hearing (DHH) children's phonological processing skills in relation to a reference group of children with normal hearing (NH) at two baselines pre intervention. Study the effects of computer-assisted phoneme-grapheme correspondence training in the children. Specifically analyze possible effects on DHH children's phonological processing skills.Methods: The study included 48 children who participated in a computer-assisted intervention study, which focuses on phoneme-grapheme correspondence. Children were 5, 6, and 7 years of age. There were 32 DHH children using cochlear implants (CI) or hearing aids (HA), or both in combination, and 16 children with NH. The study had a quasi-experimental design with three test occasions separated in time by four weeks; baseline 1 and 2 pre intervention, and 3 post intervention. Children performed tasks measuring lexical access, phonological processing, and letter knowledge. All children were asked to practice ten minutes per day at home supported by their parents.Results: NH children outperformed DHH children on the majority of tasks. All children improved their accuracy in phoneme-grapheme correspondence and output phonology as a function of the computer-assisted intervention. For the whole group of children, and specifically for children with CI, a lower initial phonological composite score was associated with a larger phonological change between baseline 2 and post intervention. Finally, 18 DHH children, whereof 11 children with CI, showed specific intervention effects on their phonological processing skills, and strong effect sizes for their improved accuracy of phoneme-grapheme correspondence.Conclusion: For some DHH children phonological processing skills are boosted relatively more by phoneme-grapheme correspondence training. This reflects the reciprocal relationship between phonological change and exposure to and manipulations of letters.
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| 19. |
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| 20. |
- Nakeva von Mentzer, Cecilia, et al.
(författare)
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Coputer based phonological intervention : Effects on phonological processing
- 2012
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Konferensbidrag (refereegranskat)abstract
- Children with mild to profound hearing impairment (HI) using cochlear implants (CI) and/or hearingaids (HA), and children with normal hearing (NH) participated in a phonological intervention study, bymeans of a computer‐based intervention program (Graphogame, Lyytinen et al., 2009). Children were 5,6 and 7 years of age. Thirty‐two of the children used CI and/or HA. 16 children with NH served as thecontrol group. The main design was a quasi‐experimental 3 x 3 design. Each test session was separatedin time with four weeks. All children were asked to practice 10 minutes per day at home supported bytheir parents, with an intervention program primarily developed to enhance phonemic differentiation.Results showed that the children with HI displayed a heterogeneous pattern of results, specifically withrespect to their performance on the phonological tasks. Approximately 20 percent performed within therange of NH children; these were all children with HA except one child with CI/HA. Children with CIdisplayed considerable difficulty with phonological working memory whereas children with HAshowed less knowledge in letter tasks. Intervention revealed positive effects on accuracy of phonemegraphemecorrespondence for all children and a significant positive change on phonological processingskills for children with weak initial phonological skills. Enhanced phoneme‐grapheme connections maybuild associations between the phonological lexicon and the sub‐lexical phonological representations,thereby improving underlying skills essential for word learning and the development of literacy. Implicationsof this are discussed within theoretical models of phonological and lexical processing (Goswami,2000; Ramus, 2001).
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| 21. |
- Nakeva von Mentzer, Cecilia, 1968-, et al.
(författare)
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Datorbaserad fonologisk intervention för barn med cochleaimplantat (CI) och/eller hörapparat (HA) : effekter på fonologiska färdigheter
- 2012
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Ingår i: Logopednytt. - Stockholm, Sweden : Svenska Logopedförbundet (SLOF). - 1102-500X. ; :3, s. 18-23
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Children with mild to profound hearing impairment 5, 6 and 7 years of age, thirty-two using cochlear implants and/or hearing aids, and sixteen normal hearing children participated in a computer based phonological intervention study.The main design was a quasi-experimental design with three test sessions separated in time with four weeks. Each test session included tasks for phonological skills and letter knowledge. All children were asked to practice 10 minutes per day.Results showed that children with HI displayed a heterogeneous pattern of results with respect to phonological skills. Only 20 percent performed within the range of NH children; these were children with HA, except one child with CI/HA.Group comparisons at the first and last test session revealed that children with CI displayed difficulty with phonological working memory whereas children with HA showed less letter knowledge. Intervention revealed positive effects on accuracy of phoneme-grapheme correspondence for all children and a significant positive change on phonological processing skills for children with weak initial phonological skills.
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| 22. |
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| 23. |
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| 24. |
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| 25. |
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| 26. |
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| 27. |
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| 28. |
- Nakeva von Mentzer, Cecilia, et al.
(författare)
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Predictors of phonological change in deaf and hard of hearing children who use cochlear implants or hearing aids
- 2014
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: The purpose of the present study was to examine cognitive abilities (i.e., working memory (WM), lexical access, phonological processing skills (PhPS), and letter knowledge) in deaf and hard of hearing (D/HH) children in relation to a reference group with normal hearing (NH) children pre intervention with a computer-assisted program that focused on phonological coding. A more specific purpose was to explore how cognitive abilities were associated to PhPS pre intervention and to phonological change post intervention in D/HH children in general, and specifically in D/HH children with weak initial PhPS.Methods: Participants were thirty-two children using cochlear implants or hearing aids, or both in combination, and sixteen children with NH 5, 6 and 7 years of age. Children practiced with phonological coding 10 min per day for 4 weeks with support by their parents. Cognitive abilities were examined pre and post intervention.Results: NH and D/HH children displayed a similar performance level on the majority of cognitive tasks, but the D/HH children demonstrated weaker lexical access and PhPS. A significant correlation between complex WM and PhPS pre intervention was only observed in D/HH children. Weak initial performance on one phonological processing task capturing both lower level and higher level auditory processing was the main significant predictor of phonological change in all D/HH children. In D/HH children with weak initial PhPS letter naming was associated with phonological change.Conclusions: The associations between complex working memory and PhPS in D/HH children and the lack of such associations in children with NH may indicate that phonological processing skills require more cognitive resources in the D/HH children. Letter knowledge can act as a driving force for phonological change following intervention in D/HH children with weak PhPS.
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| 29. |
- Nakeva von Mentzer, Cecilia, et al.
(författare)
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Reading Ability and Working Memory in School-Age Children Who Are Deaf and Hard of Hearing Using Cochlear Implants and/or Hearing Aids : A 3-Year Follow-Up on Computer-Based Phonics Training
- 2020
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Ingår i: Perspectives of the ASHA Special Interest Groups. - : American Speech-Language-Hearing Association. - 2381-473X. ; 5:6, s. 1388-1399
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe aim of the current study was to investigate reading ability in children who are deaf and hard of hearing (DHH) using cochlear implants (CI) or hearing aids (HA) 3 years after computer-assisted phonics intervention. Reading ability was examined in relation to cognitive and audiological aspects and compared to a reference group of children with typical hearing (TH).MethodParticipants were 73 Swedish primary school children (Mdn = 9 years). Fifty-five of the children were TH, and 18 children were DHH using CI (n = 10) or HA (n = 8). Twenty-seven of the children (all children who were DHH and nine of the children with TH) had participated in computer-based phonics intervention 3 years earlier. Children were assessed on word and nonword decoding, reading comprehension, and three working memory (WM) tasks. Age at diagnosis, age of amplification, and duration of unaided hearing loss formed the audiological variables.ResultsComparable word decoding skills and reading comprehension were observed in all three groups (CI, HA, and TH). Children with CI showed strong and significant correlations between two aspects of WM capacity (phonological and complex WM) and all aspects of reading. For children with TH, similar but weaker correlations as in children with CI was observed, and correlations with visual WM were also evident. In children with HA only, complex WM correlated strongly and significantly with nonword decoding. Duration of unaided hearing loss was the single audiological variable that was significantly associated with reading.ConclusionsThis 3-year follow-up showed overall positive reading results at the group level in children who are DHH. However, some children still lag behind their peers with TH. Early hearing experience and intervention are stressed as crucial factors in preventing negative outcomes in these children.
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| 30. |
- Nakeva von Mentzer, Cecilia, et al.
(författare)
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Segmental and suprasegmental properties in nonword repetition : An explorative study of the associations with nonword decoding in children with normal hearing and children with bilateral cochlear implants
- 2015
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Ingår i: Clinical Linguistics & Phonetics. - London, UK : Informa Healthcare. - 0269-9206 .- 1464-5076. ; 29:3, s. 216-235
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Tidskriftsartikel (refereegranskat)abstract
- The present study explored nonword repetition (NWR) and nonword decoding in normalhearing (NH) children and in children with cochlear implants (CIs). Participants were 11 children with bilateral CIs, 5:0-7:11 years (M = 6.5 yrs.), and 11 NH children, individually age-matched to the children with CIs. The purpose was twofold; to thoroughly describe aspects of repetition and decoding of novel words and to study possible associations between them. All children were assessed after having practiced with a computer-assisted reading intervention with a phonics approach during four weeks. Results showed that NH children outperformed children with CIs on the majority of aspects of NWR. The analysis of syllable length in NWR revealed that children with CIs made more syllable omissions than did the NH children, and predominantly in prestressed positions. Additionally, the consonant cluster analysis showed significantly more consonant omissions and substitutions in children with CIs suggesting that reaching fine- grained levels of phonological processing was particularly difficult for these children. No significant difference was found for decoding accuracy between the groups, as measured by percent nonwords and percent phonemes correctly decoded, but differences were observed regarding error patterns. Further, phoneme deletions and lexicalizing of nonwords occurred more often in children with CIs than in those with NH. The correlation analysis revealed that the ability to repeat consonant clusters in NWR had the strongest associations to nonword decoding in both groups.
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| 31. |
- Nakeva von Mentzer, Cecilia, et al.
(författare)
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The Phonics Approach in Swedish Children using Cochlear Implants or Hearing Aids : Inspecting Phonological Gain
- 2014
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Ingår i: Journal of Communication Disorders, Deaf Studies & Hearing Aids. - : OMICS Publishing Group. - 2375-4427. ; 2:3
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Tidskriftsartikel (refereegranskat)abstract
- The present study investigated cognitive abilities (i.e. Phonological Processing Skills (PhPS), lexical access, complex and visual Working Memory (WM), and letter knowledge) in Deaf and Hard of Hearing children (DHH) 5, 6 and 7 years of age using cochlear implants or hearing aids. Children with Normal Hearing (NH) served as a reference group. All children took part of a computer-assisted intervention with a phonics approach for 4 weeks aimed to support PhPS. The first aim of the study was to examine associations between cognitive abilities and Phonological Processing Skills (PhPS) pre intervention in DHH and NH children respectively. The second aim was to examine cognitive predictors of phonological gain post intervention. Finally, the influence of background variables on phonological gain was examined in NH and DHH respectively and in DHH children with weak PhPS particularly. Results showed comparable performance level in NH and DHH children on the majority of cognitive tasks, but weaker PhPS and lexical access in the DHH children. A significant association between PhPS and complex WM was only evident in DHH children. This finding suggests that DHH recruit more cognitive resources in phonological processing. A phonological representation task was the single predictor of phonological gain in DHH children. Children with initial weak performance on this task but had letter-naming skills, displayed relatively more phonological gain from the phonics training. Children with difficulties with the phonological representation task were older when diagnosed and had an older age at amplification. Further, these children displayed broader cognitive difficulties, suggesting that reduced access to auditory stimulation may have wide ranging effects on cognitive development.
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| 32. |
- Schwarz, Iris-Corinna, 1976-, et al.
(författare)
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Pupil dilation indicates auditory signal detection - towards an objective hearing test based on eye-tracking
- 2016
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Konferensbidrag (refereegranskat)abstract
- Purpose: The long-term objective of this project is to develop an objective hearing threshold test that can be used in early infancy, using pupildilation as an indicator of hearing. The study purposes are 1) to identify relevant time-windows for analysis of pupillary responses to various auditory stimuli in adults, and 2) to evaluate a trial-minus-baseline approach to deal with unrelated pupillary responses in adults. Method: Participants’ pupil size is recorded using a Tobii T120 Eye-tracker. In the first test, participants fixate on a blank screen while sound stimuli are presented. From this data, typical pupillary responses and the relevant analysis time-window is determined and used in future tests. In the second test, participants watch movie clips while sound stimuli are presented. Visually identical sound and no-sound trials will be compared in order to isolate the pupillary changes tied to hearing sound from those related to changes in brightness in the visual stimuli. Results and conclusion: Data is currently being collected. Results from the pilot study indicate that the pupillary response related to sound detection occurs at around 900 ms after stimulus onset, and that a trial-minus-baseline approach is a viable option to eliminate unrelated pupillary responses.
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| 33. |
- Schwarz, Iris-Corinna, 1976-, et al.
(författare)
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Towards a contingent anticipatory infant hearing test using eye-tracking
- 2014
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Ingår i: Proceedings from FONETIK 2014. - Stockholm : Department of Linguistics, Stockholm University. - 9789163756627 - 9789163756634 ; , s. 35-40
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Early identification of infant hearing impairment is imperative to prevent developmental language difficulties. The current diagnostic method is Visual Reinforcement Audiometry (VRA) in which infant response to sound isobserved to establish hearing thresholds. Together with the Karolinska Institute, we are developing an observer-independent contingent anticipatory infant hearing test using eye-tracking to increase reliability and significance levels of the current clinical practice. The present pilot study addresses in particular the first phase of the test in which the eye response is conditioned to occur at sound detection. The aim is to establish how well 6.5-month-olds associate the presence of sound to a certain location via a visual reward.
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| 34. |
- Seijsing, Johan, 1986-
(författare)
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Rational and Combinatorial Engineering of Affinity Proteins Towards Therapeutical Applications
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Protein engineering has had an immense impact on the development of biological drugs, including replacement therapies with engineered versions of insulin or factor VIII to treat diabetes or bleeding disorders, and monoclonal antibodies to treat cancer and various other malignancies. Now, with the next generation of treatment modalities coming up, including monoclonal reagents based on alternative scaffolds, gene and cell therapies, the importance of protein engineering to tailor-make these treatments is likely to increase further.The neonatal Fc receptor (FcRn) is widely expressed in the body. One of the receptor's interesting functions is to rescue immunoglobulin G (IgG) and serum albumin (SA) from degradation by cells in contact with blood. When serum proteins are endocytosed by a cell, they are transported via the endosome to the lysosome for degradation. However, IgG and SA associate with the FcRn already at the slightly acidic pH of the endosome followed by transport back to the cell surface. There the complex encounters the neutral pH of the blood, at which the binding affinity to FcRn is lost, and IgG and SA are released back into circulation. In the main part of this thesis, efforts are described aiming to take use of, or block, the FcRn recycling mechanism to control the serum circulation half-life of proteins.In the first study (Study I), a robust expression strategy for human FcRn was designed and evaluated. The extracellular domain was produced in the human SKOV3 cell-line after facile lentiviral delivery of the expression cassettes. This lead to continuous expression of secreted protein that could be purified to homogeneity by a single affinity chromatographic step, using the intrinsic pH-dependent interaction between FcRn and IgG, where the latter was immobilized in a column. The amount of purified protein was 1.4 mg per liter medium. The protein was characterized by SDS-PAGE, western blotting, circular dichroism spectroscopy, ELISA, surface plasmon resonance and a temperature stability assay. The results suggested a fully functional and stable protein of high purity. In addition, the gene encoding full-length FcRn as a fusion to eGFP was delivered to HeLa cells utilizing the same lentiviral system. Subsequent analysis by flow cytometry and confocal fluorescence microscopy indicated a wide distribution of eGFP/FcRn expression among the cells. Binding of IgG and HSA was found to correlate well with the amount of eGFP/FcRn expressed by the cells.In a following study (Study II), the goal was to generate affinity proteins interacting with human FcRn in a pH-dependent manner similar to that of FcRn's natural ligands. The affinity proteins used are denoted affibody molecules, a class of small alternative scaffold proteins with a three-helical structure. Affibody molecules were selected from a combinatorial library displayed on phage where binding took place at pH 5.5 and elution was performed at pH 2.2 or 8.0. Selected variants were characterized by developed in vitro and cell based assays, and some were found to have the desired pH-dependent binding to FcRn. In vivo studies in mice showed that the serum half-life of a model protein, genetically fused to the FcRn binding affibody molecules, was extended up to almost three-fold compared to a control protein (from 33 to 91 hours).In a subsequent study (Study III), the use of a FcRn binding affibody molecule to reduce, rather than prolong, the serum half-life of proteins was explored. Here, the rationale was to investigate if injection of a FcRn binding affibody could hinder endogenous IgG from being rescued by FcRn, which could lead to depletion of IgGs by lysosomal degradation. In autoimmune diseases, such depletion of IgG would include also pathogenic IgG and could thus mitigate the symptoms of the disease. Using cell based assays, it was found that one affibody molecule, selected in Study II, could readily block IgG from binding both human and murine FcRn. A following in vivo study in mice showed that systemic injection of the molecule reduced the amount of endogenous IgG by 39%.In a fourth study (Study IV), the goal was to use a different class of affinity proteins to regulate the level of an enzyme in the brain. More specifically, artificial zinc finger-based transcription factors regulating the level of GAD67, which is the rate-limiting enzyme in synthesis of gamma-aminobutyric acid (GABA), were designed. Imbalances in GABA-signaling is involved in different diseases, including Parkinson's disease and epilepsy, and regulation of GAD67 at particular sites in the brain might be a route to ameliorate symptoms associated with such diseases. ELISA-based investigation showed that one of the designed zinc fingers, denoted G3, bound selectively to its intended target DNA sequence. A construct encoding G3 fused to a general transcriptional activator (VP64) was delivered to PC12-cells, using a lentivirus-based gene delivery system, resulting in a significant up-regulation of endogenous GAD67 expression. The same construct was subsequently delivered to the striatum of rats, with an induced disease model of Parkinson's disease. Western blot of striatal samples showed a significant up-regulation of GAD67 expression in lesioned striatum compared to intact striatum, and a tendency towards up-regulation compared to lesioned striatum.Taken together, the protein engineering efforts described in this thesis concerning affinity proteins binding other proteins or DNA, has the potential to find use in drug development and may benefit patients in the future.
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| 35. |
- Tonnquist-Uhlén, Inger
(författare)
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Topography of auditory evoked cortical potentials in children with severe language impairment
- 1996
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Development of normal speech and language functions is closely related to normal hearing. However, most children with delayed or disturbed speech development show normal tone thresholds and here the investigation has to include higher levels in the auditory system. There is evidence for a connection between language impairment and a central auditory processing disorder, but the underlying mechanisms are not well understood. There is also a need for objective diagnostic methods of central auditory function. In the present study, a computerised method of mapping the scalp topography of long-latency (cortical) auditory evoked potentials (LAEP) was used for assessment of the function in central auditory pathways . Topographic mapping of the LAEP component NI, in adults and normal children, showed reproducible and valid results. In adults, a focal negativity, focus of NI (FNI), with a frontocentral position and contralateral to the stimulated ear was observed. The NI maps in normal children showed a pattern similar to that in adults, but with some age-related changes. The Nl latencies declined significantly with age in normal children and reached adult values at the ages of 14-16 years. The topography of the LAEP components NI, P2, N2 and the T complex was investigated in 20 children with severe language impairment (LI). The study also included auditory brainstem responses (ABR), electroencephalography (EEG), quantitative EEG (qEEG) and magnetic resonance imaging (MRI). Twenty normal children served as controls (C). A similar topographic pattern was found in the LI and the C children, but with a higher proportion of deviating and non-focal maps in the LI group. The latencies of all components were significantly longer in the LI than in the C children. The diagnostic value of LAEP topography, latency and amplitude was estimated with a scoring system, whereby significantly higher scores were found in the LI group than in the C group. With all three parameters together the sensitivity was 65%, with a specificity of 90%. There was a high degree of pathological EEGs in the LI group. ABR abnormalities were seen in some LI subjects. MRI was normal in all but two LI children. There was no significant correlation between the results of EEG, ABR, MRI and the total score of LAEP, but some LI children showed a wide pathological pattern. In 17 of the 20 LI subjects a pathological result was obtained in one or more of the investigations. In conclusion, our results may indicate that language impairment has a dual pathophysiology, a specific auditory disorder (LAEP, ABR) and a non-specific general cerebral disturbance (EEG, MRI). The highly varying results among the present LI children, with specific and/or non-specific deviations, may be due to heterogeneity of the group with different aetiologies of their language impairment, or to a general developmental disturbance with a varying distribution and penetrance. The scoring system of LAEP proved to be the most sensitive method in separating the LI children from the controls. This may be a promising model for individual diagnostic criteria and for classification of language impairment.
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| 36. |
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| 37. |
- Uhlén, Inger, et al.
(författare)
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Eye tracking for establishing hearing thresholds in infants - evaluation of a new methodology
- 2010
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Hearing test in small children is a challenge during the first 1-2 years and in children with other disabilities even longer. With neonatal hearing screening hearing aids can be fitted as early as two months of age. Programming of the hearing aid then has to be based on ABR thresholds until the child is old enough to give a distinct behavioral response, typically at 4-6 months. However, ABR is not frequency specific and it requires a quite or sleeping child. Visual reinforcement audiometry (VRA). is based upon the head-turn paradigm and involves that the infant builds up an association between the presence of a sound stimulus and a reward display. This behavioral observation test suffers from poor reliability, lengthy test times across several sessions, heavy experimenter bias, and interpretative ambiguity of the broad variety of possible infant responses.This presentation describes a new method to objectively, automatically and adaptively determine reactions to sound stimuli. With an eye tracker and a computer based set-up the infants response, in anticipation towards a reward at the noted presence of an auditory stimulus (similar to VRA), can be registered, using eye movements instead of head turns. High test reliability and experimenter independence are achieved by the program´s automatic detection of infant response and adaptation of the next stimulus level. Result objectivity is improved by increasing the number of test trials for each frequency and hearing level, as well as by providing a significance level for each tested frequency depending on the number of trials.
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| 38. |
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| 39. |
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| 40. |
- Uhlen, Inger, et al.
(författare)
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Using a multi-feature paradigm to measure mismatch responses to minimal sound contrasts in children with cochlear implants and hearing aids
- 2017
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Ingår i: Scandinavian Journal of Psychology. - Oxford, UK : Blackwell Publishing. - 0036-5564 .- 1467-9450. ; 58:5, s. 409-421
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Tidskriftsartikel (refereegranskat)abstract
- Our aim was to explore whether a multi-feature paradigm (Optimum-1) for eliciting mismatch negativity (MMN) would objectively capture difficulties in perceiving small sound contrasts in children with hearing impairment (HI) listening through their hearing aids (HAs) and/or cochlear implants (CIs). Children aged 5-7 years with HAs, CIs and children with normal hearing (NH) were tested in a free-field setting using a multi-feature paradigm with deviations in pitch, intensity, gap, duration, and location. There were significant mismatch responses across all subjects that were positive (p-MMR) for the gap and pitch deviants (F(1,43) = 5.17, p = 0.028 and F(1,43) = 6.56, p = 0.014, respectively) and negative (MMN) for the duration deviant (F(1,43) = 4.74, p = 0.035). Only the intensity deviant showed a significant group interaction with MMN in the HA group and p-MMR in the CI group (F(2,43) = 3.40, p = 0.043). The p-MMR correlated negatively with age, with the strongest correlation in the NH subjects. In the CI group, the late discriminative negativity (LDN) was replaced by a late positivity with a significant group interaction for the location deviant. Children with severe HI can be assessed through their hearing device with a fast multi-feature paradigm. For further studies a multi-feature paradigm including more complex speech sounds may better capture variation in auditory processing in these children.
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| 41. |
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| 42. |
- Wass, Malin, et al.
(författare)
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Orthographic learning in children with hearing impairment
- 2011
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Ingår i: First International Conference on Cognitive Hearing Science for Communication. ; , s. 126-126
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Early in reading development, children generally read by using phonological decoding strategies where words are read letter by letter. Later in reading development, orthographic decoding strategies are generally used by most readers. This means that whole words are recognized directly through a process of comparing written words to mental orthographic representations, i.e. long-term memories of written words.This strategy is quicker and more efficient for reading familiar words.The process of building up a mental orthographic lexicon in long term memory is often referred to as orthographic learning (e.g. Share, 2004). In children with normal hearing and typical development, those who are better at phonological decoding also become better at constructing their orthographic lexicon. Children with cochlear implants (CI) have demonstrated relatively high reading skills despite less favorable cognitive prerequisites in terms of phonological representations, phonological working memory, phonological skills and lexical access (Asker-Árnason et al., 2007, Wass et al., 2010).The present study explores the acquistion orthographic representations in children who use CI and children who have moderate hearing impairments and use hearing aids (HA). The performance of each group was compared to that of hearing children matched for grade, nonverbal intelligence and gender.The results indicated that the children with CI did not have significantly different orthographic learning ability than their comparison group but had slightly poorer reading comprehension. The children with HA performed significantly poorer than their comparison group on orthographic learning but had similar reading skills as their comparison group on all measures of reading.
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