The changing role of gesture in linguistic development: a developmental trajectory and a cross-cultural comparison between British and Finnish children.

We studied how gesture use changes with culture, age and increased spoken language competence. A picture-naming task was presented to British (N = 80) and Finnish (N = 41) typically developing children aged 2-5 years. British children were found to gesture more than Finnish children and, in both cultures, gesture production decreased after the age of two. Two-year-olds used more deictic than iconic gestures than older children, and gestured more before the onset of speech, rather than simultaneously or after speech. The British 3- and 5-year-olds gestured significantly more when naming praxic (manipulable) items than non-praxic items. Our results support the view that gesture serves a communicative and intrapersonal function, and the relative function may change with age. Speech and language therapists and psychologists observe the development of children's gestures and make predictions on the basis of their frequency and type. To prevent drawing erroneous conclusions about children's linguistic development, it is important to understand developmental and cultural variations in gesture use.

Symphony orchestra musicians' use of hearing protection and attenuation of custom-made hearing protectors as measured with two different real-ear attenuation at threshold methods.

Despite a high level of sound exposure and a fairly large selection of earplugs available, musicians have often been reported to use personal hearing protectors only seldom. For better hearing conservation, it is important to identify and eliminate the causes for the low motivation to use hearing protection. We explored the usage rate of custom-molded musician's earplugs (ER-15) among 15 symphony orchestra musicians with a questionnaire, and measured the attenuation properties of their earplugs with a Real-Ear Attenuation at Threshold (REAT) procedure in a sound field. Earplug use was found to be low, and the musicians reported that earplugs hampered listening to their own and their colleagues' playing; earplugs affected either timbre or dynamics, or both. Additionally, several reasons related to discomfort of use were itemized, but the musicians who consistently used their earplugs did so in spite of problems with use. The REAT values obtained in sound field were relatively close to the manufacturer's nominal specifications, being 13.7 dB, on average. In the frequency range studied (0.125-8 kHz), individual variation in REAT was, however, up to 15 dB across the measured frequencies. Fluctuation in attenuation might be related to low use of hearing protectors, and REAT measured at fixed center frequencies may be too robust a method to uncover it. We therefore tested 10 additional subjects to find out whether a sweeping signal used in Bιkιsy audiometry would bring more detailed information on earplug attenuation. Mean attenuation was found to be somewhat closer to the nominal attenuation of the ER-9 and ER-15 earplugs up to about 1 kHz, whereas REAT measurements in sound field revealed more even attenuation at frequencies between 1 and 6 kHz. No significant association was found between earplug attenuation properties and earplug use. It was concluded that support and determination to get accustomed to hearing protector use are important factors in hearing conservation.

Phonological development in 4-6-year-old moderately hearing impaired children.

The acquisition of clear phonological rules is of utmost importance for a child when he/she is learning to decode and convey meanings using spoken language. Fifteen Finnish-speaking children, five normally hearing (NH) 3-year-olds and 10 moderately hearing impaired (HId) 4-6-year-olds were studied here. Speech samples consisting of 62 words were collected from each child during a picture naming task. Frequent phonetic (articulation) errors together with normal (but delayed) and deviant phonological processes of HId children were found in this study. The frequency and quality of the processes seemed to be related more to the grade of HI than, for example, the age of the child. Implications for speech therapy are briefly discussed.

Long-term outcome of early childhood hearing impairments in northern Finland.

Early childhood hearing impairment (HI) may have a marked negative effect on educational outcome and employment status in adulthood. The late outcome of 51 Finnish mildly to profoundly HId children born in the period 1965-1979 was studied using a questionnaire posted to the subjects. Subjects included in the study had an early childhood sensorineural, non-syndromal hearing impairment with no known associated handicaps. The response rate to the inquiry was as high as 88% (45/51). The subjects had qualified educationally at a somewhat lower level than their age peers according to nationwide statistics; 48% of the respondents belonging to the labour force were currently unemployed (versus 15% of all the 25-to 29-year-olds in Finland in 1997), but their employment status was not associated with the HI grade. In particular, the severely and profoundly HId often had needed special support from the employment authorities to find work.

On the construction of a Finnish audiometric sentence test.

To respond to the demands of clinical practice and the needs of rehabilitation, a Finnish audiometric sentence test is being developed. The test consists of 10 sets of 10 sentences, each set serving as an independent test. The test is scored by words (50 per set). Homogeneity between the sets was guaranteed by a number of linguistic and phonetic criteria, controlled by using the Virko Sentence Analyzer, a programme especially constructed for the purpose. Recognition tests for the validation of the sentence sets were made with young normally hearing adults (n = 70; age group 18-25 years). Psychometric recognition properties of the test are described. The selection process of the final 10 sentence sets is illustrated.

Cochlear implant patients and quality of life.

During the last two decades, cochlear implants have been available for profoundly hearing-impaired patients who do not benefit from conventional hearing aids. The quality of life of these implantees has not been extensively studied, and has not been studied at all in Finland. To assess their quality of life, the Nottingham Health Profile questionnaire was sent to all adult implanted patients in Finland. Implantees tended to have more favourable average pain, emotional reaction and mobility indexes in each age group studied than the average population. Social-isolation seemed to be more common in the youngest and oldest age groups of implantees. Apparently, implantees are physically healthier than the average population. However, a bias caused by the strict selection of implant candidates cannot be excluded.

Cochllear implants and GSM phone.

Use of a telephone and GSM phones, in particular, was assessed by means of a postal interview sent to all adult Finnish implantees. The response rate was very high (87%). Fifty-one of the 61 respondents used a telephone and 27/61 also used a mobile phone, usually a digital phone. Two GSM phone models from Nokia (3110 and 6110) were tested with three different cochlear implant systems used by nine patients. Definite differences between the processors were found. Nucleus Spectra (two implantees) could not be used with any of the GSM phones under any test condition. Nucleus SPrint was incompatible with both GSM phone models in a poor field, while GSM phone model 6110 could be used in a good field. The Med-El Combi 40+ processor was compatible with both GSM models tested under any condition.

Educational needs of speech and language therapists in the field of audiology.

Speech and language therapists have rather diverse educational backgrounds globally. Their qualifications vary from a 1 to 2-year diploma or certificate programme in a non-university educational setting, to a 6-year university graduate education. Although speech and language therapy is generally considered an interdisciplinary profession, both in education and in clinical practice, in some countries the main emphasis may still be on special education, medicine (mainly medical audiology) or, because of a joint qualification, psychology. This article discusses the requirements for audiological education in proper assessment and (re)habilitation of hearing impairments. Future challenges of both the profession and the discipline of speech and language therapy are also highlighted.