Characteristics of Lexical Stress in Hebrew-Speaking Children With Childhood Apraxia of Speech.

PURPOSE: The purpose of the present study was to explore the ability of Hebrew-speaking children with childhood apraxia of speech (CAS) to produce lexical stress. METHOD: A total of 36 children aged between 4 and 7 years, 18 children with CAS, and 18 typically developing (TD) children participated in the study. All children completed language and speech assessments. The children imitated 20 weak-strong and strong-weak target words within short sentences and in isolation. Acoustic analysis of the vowels in the stressed and unstressed syllables of the target words and perceptual judgment of the words by six speech-language pathologists were conducted. RESULTS: The acoustic analysis showed significant differences in duration, fundamental frequency, and amplitude between stressed and unstressed vowels in weak-strong and strong-weak words and in both groups of children. The total duration for both the stressed and weak syllables was longer in children with CAS compared to TD children. Rated on a Likert scale of 1-5, where 5 indicates correct production, the productions of lexical stress in the CAS group were judged as above 4 on average but were significantly worse compared to the TD group. The target productions of children with CAS were judged as including excessive, equal, or misplaced stress in 10.8% of the productions, whereas 5.8% of the target productions of the TD children were judged as having inappropriate stress. CONCLUSIONS: The present findings suggest that Hebrew-speaking children with CAS produce the acoustic characteristics of lexical stress similarly to their peers, and their productions are perceived as having relatively good lexical stress (above 4), although not as good as TD children.

Listening Preference for Child-Directed Speech Versus Time-Reversed Speech in Moderate-Preterm Infants Compared to Full-Term Infants.

PURPOSE: The purpose of the present study was to examine whether there is a listening preference for child-directed speech (CDS) over backward speech in moderate-preterm infants (MPIs). METHOD: Eighteen MPIs of gestational age of 32.0 weeks (range: 32-34.06 weeks), chronological age of 8.09 months, and maturation age of 6.48 months served as the experimental group. The two control groups consisted of a total of 36 infants-20 full-term infants matched for chronological age and 16 full-term infants matched for maturation age. The infants were tested using the central fixation procedure and were presented with 16 trials of CDS and backward speech. A follow-up was conducted 5 years after the initial experiment using a developmental and a five-item parent questionnaire. RESULTS: MPIs did not demonstrate a preference for CDS over backward speech, whereas both control groups demonstrated a listening preference for CDS over backward speech. MPIs showed a delayed use of first words and word combinations and lower scores on the five-item questionnaire compared to term infants. Twelve MPIs (67%) did not demonstrate a preference for CDS over backward speech. Four of them (33%) were later diagnosed with neurodevelopmental disorders. CONCLUSIONS: The lack of preference for CDS over backward speech in the MPIs group suggests delayed developmental pattern of speech processing compared to full-term peers. Delays in neurological maturation as well as listening experience in an unregulated environment outside the uterus during a sensitive period of brain development may affect the recognition of phonological and prosodic patterns that support listening preference for speech over backward speech.

An escalating continuum of learning and attention difficulties from premutation to full mutation in female carriers of FMR1 expansion.

Objective: Carriers of Fragile X premutation may have associated medical comorbidities, such as Fragile X-associated tremor and ataxia (FXTAS) and Fragile X-associated premature ovarian insufficiency (FXPOI). We examined the Fragile X premutation effect on cognition, and we assumed that there is a direct correlation between the continuous spectrum of specific learning and attention deficits to the number of CGG repeats on the FMR1 gene. Methods: A total of 108 women were referred to our center due to a related Fragile X syndrome (FXS) patient, 79 women carried a premutation of 56-199 repeats, and 19 women carried a full mutation of more than 200 CGG repeats on FMR1 gene. Genetic results of CGG repeats, demographic information, structured questionnaires for ADHD, learning disabilities of language and mathematics, and independence level were analyzed in women carrying the FMR1 premutation and compared to the group carrying the full mutation. Women with FXS and FXTAS were excluded. Results: When analyzed as a continuum, there was a significant increase in the following complaints which were associated with a higher number of repeats: specific daily function skills such as driving a car, writing checks, disorientation in directions, and also specific learning difficulties such as spelling and math difficulties. Additionally, when tested as a categorical independent variable, we observe that women with the full mutation were more likely to have ADHD or other learning disability diagnoses in the past than during premutation (<200 CGG repetitions). Conclusion: Specific learning and attention difficulties and resulting daily function difficulties correlate with an increased number of CGG repeats and are more likely to be associated as a common feature of premutation and full mutation in a female premutation carrier. Despite evidence of learning and attention difficulties, it is encouraging that most female carriers of the premutation and full mutation function well in most areas. Nevertheless, they face significant difficulties in specific areas of functioning such as driving, and confusion in times and schedules. Those daily function skills are mostly impacted by dyscalculia, right and left disorientation, and attention difficulties. This may aid to design specific interventions to address specific learning deficits in order to improve daily function skills and quality of life.

Executive Function and Working Memory Deficits in Females with Fragile X Premutation.

The Fragile X premutation is a genetic instability of the FMR1 gene caused by 55-199 recurrences of the CGG sequence, whereas there are only 7-54 repeats of the CGG sequence in the normal condition. While males with the premutation of Fragile X were found to have difficulties in executive functions and working memory, little data have been collected on females. This study is among the first to address executive functions and phonological memory in females with the Fragile X premutation. Twenty-three female carriers aged 20-55 years and twelve non carrier females matched in age and levels of education (in years) participated in this study. Executive functions and phonological memory were assessed using the self-report questionnaire The Behavior Rating Inventory of Executive Function (BRIEF) and behavioral measures (nonword repetitions, forward and backward digit span). Females who were carriers of the premutation of the FMR1 gene reported less efficient executive functions in the BRIEF questionnaire compared to the control group. In addition, a relationship was found between the number of repetitions on the CGG sequence of nucleotides, nonword repetitions, and forward digit span. The findings suggest that the premutation of Fragile X in females affects their performance of executive functions and may have impact on everyday functioning.

The validity of LENA technology for assessing the linguistic environment and interactions of infants learning Hebrew and Arabic.

The present study assessed LENA's suitability as a tool for monitoring future language interventions by evaluating its reliability, construct validity, and criterion validity in infants learning Hebrew and Arabic, across low and high levels of maternal education. Participants were 32 infants aged 3 to 11 months (16 in each language) and their mothers, whose socioeconomic status (SES) was determined based on their years of education (H-high or L-low ME-maternal education). The results showed (1) good reliability for the LENA's automatic count on adult word count (AWC), conversational turns (CTC), and infant vocalizations (CVC), based on the positive associations and fair to excellent agreement between the manual and automatic counts; (2) good construct validity based on significantly higher counts for HME vs. LME and positive associations between LENA's automatic vocal assessment (AVA) and developmental questionnaire (DA) and age; and (3) good concurrent criterion validity based on the positive associations between the LENA counts for CTC, CVC, AVA, and DA and the scores on the preverbal parent questionnaire (PRISE). The present study supports the use of LENA in early intervention programs for infants whose families speak Hebrew or Arabic. The LENA could be used to monitor the efficacy of these programs as well as to provide feedback to parents on the amount of language experience their infants are getting and their progress in vocal production. The results also indicate a potential utility of LENA in assessing linguistic environments and interactions in Hebrew- and Arabic-speaking infants with developmental disorders, such as hearing impairment and cerebral palsy.

The Myth of Women's Advantage in Using Child-Directed Speech: Evidence of Women Versus Men in Single-Sex-Parent Families.

PURPOSE: Differences between child-directed speech (CDS) by women and men are generally explained by either biological-evolutionary or gender-social theories. It is difficult to tease these two explanations apart for different-sex-parent families because women are usually also the main caregivers. Thus, this study aims to examine the influence of parental sex on CDS by investigating men and women who are in same-sex-parent families. METHOD: Twenty same-sex-parent families participated in the study-10 families in which the parents were two men and 10 families in which the parents were two women. The families were matched for toddler age (range: 9-24 months) and sex. CDS was recorded using the Language Environment Analysis (LENA) device for 16 hr during a day. Each parent was also audio-recorded during a 30-min play session with his or her child. RESULTS: No difference was found between men and women across all the LENA measures, namely, adult word count, conversational turns count, and child vocalization count. The analysis of speech samples during parent-child play showed no difference between men and women in mean length of utterance and number of nouns, verbs, and adjectives. Pragmatic speech acts of initiations, responses to infants' actions, or vocalizations were similar in both sexes. Women used more "teaching" utterances than men, and men who were main caregivers used more "teaching" utterances than men who were secondary caregivers. Across both sexes, secondary caregivers used more "requests for actions" compared to main caregivers. CONCLUSIONS: The present findings support a functional-social approach and not a biological approach for explaining the use of CDS by men and women. These findings have clinical implications on the involvement of men in early intervention programs.

Comparing Theory of Mind Development in Children with Autism Spectrum Disorder, Developmental Language Disorder, and Typical Development.

Background: Theory of mind (ToM) is the ability to recognize, comprehend, and consider oneself's and others' mental states and perspectives to predict and explain behaviors and motivations. It is widely accepted that children with autism spectrum disorder (ASD) experience difficulties with ToM. However, there are also findings suggesting that ToM abilities might also be compromised in children with Developmental Language Disorders (DLD). Purpose: To assess ToM abilities in three groups of children: 1. ASD with no language difficulties; 2. DLD, known for their language disorder; and 3. TD with no language issues. Materials and Methods: A total of 41 preschool children aged 5-to-6 were examined and assigned to one of the three groups based on previous clinical reports and a standardized Hebrew language assessment tool. Nonverbal IQ was established with a standardized test to verify within average range placement (>75 IQ). ToM skills were examined with a Hebrew version of the ToM Task Battery and parent's questionnaire (ToMI). Results: Children with ASD had significantly lower ToM scores compared to the children with DLD, and TD. The ToM scores of the children with DLD were similar to the scores of the TD children. According to the parents' questionnaires, both the ASD children and the DLD children had less developed ToM skills compared to their TD peers. Conclusion: The present findings suggest that children with ASD have a fundamental difficulty in ToM that is independent of their language abilities. Children with DLD show difficulties in everyday social interactions that involve ToM. It is possible that both ASD and language disorders influence ToM development, suggesting that different developmental routes affect the acquisition of ToM.

Identification and Comprehension of Narrow Focus by Arabic-Speaking Adolescents With Moderate-to-Profound Hearing Loss.

PURPOSE: Processing narrow focus (NF), the stressed word in the sentence, includes both the perceptual ability to identify the stressed word in the sentence and the pragmatic-semantic ability to comprehend the nonexplicit linguistic message. NF and its underlying meaning can be conveyed only via the auditory modality. Therefore, NF can be considered as a measure for assessing the efficacy of the hearing aid (HA) and cochlear implants (CIs) for acquiring nonexplicit language skills. The purpose of this study was to assess identification and comprehension of NF by HA and CI users who are native speakers of Arabic and to associate NF outcomes with speech perception and cognitive and linguistic abilities. METHOD: A total of 46 adolescents (age range: 11;2-18;8) participated: 18 with moderate-to-severe hearing loss who used HAs, 10 with severe-to-profound hearing loss who used CIs, and 18 with typical hearing (TH). Test materials included the Arabic Narrow Focus Test (ANFT), which includes three subtests assessing identification (ANFT1), comprehension of NF in simple four-word sentences (ANFT2), and longer sentences with a construction list at the clause or noun phrase level (ANFT3). In addition, speech perception, vocabulary, and working memory were assessed. RESULTS: All the participants successfully identified the word carrying NF, with no significant difference between the groups. Comprehension of NF in ANFT2 and ANFT3 was reduced for HA and CI users compared with TH peers, and speech perception, hearing status, and memory for digits predicted the variability in the overall results of ANFT1, ANFT2, and ANFT3, respectively. CONCLUSIONS: Arabic speakers who used HAs or CIs were able to identify NF successfully, suggesting that the acoustic cues were perceptually available to them. However, HA and CI users had considerable difficulty in understanding NF. Different factors may contribute to this difficulty, including the memory load during the task as well as pragmatic-linguistic knowledge on the possible meanings of NF.

The Bouba-Kiki Effect in Children With Childhood Apraxia of Speech.

PURPOSE: The bouba-kiki (BK) effect refers to associations between visual shapes and auditory pseudonames. Thus, when tested, people tend to associate the pseudowords bouba and kiki with round or spiky shapes, respectively. This association requires cross-modal sensory integration. The ability to integrate information from different sensory modalities is crucial for speech development. A clinical population that may be impaired in cross-modal sensory integration is children with childhood apraxia of speech (CAS). The purpose of this study was to examine the involvement of cross-modal sensory integration in children with (CAS). METHOD: The BK effect was assessed in participants with CAS (n = 18) and two control groups: One control group was composed of children with developmental language disorder (DLD), also termed specific language impairment (n = 15), and a second group included typically developing (TD) children (n = 22). The children were presented with 14 pairs of novel visual displays and nonwords. All the children were asked to state which shape and nonword correspond to one another. In addition, background cognitive (Leiter-3) and language measures (Hebrew PLS-4) were determined for all children. RESULTS: Children in the CAS group were less successful in associating between visual shapes and corresponding auditory pseudonames (e.g., associating the spoken word "bouba" with a round shape; the spoken word "kiki" with a spiky shape). Thus, children with CAS demonstrated a statistically significant reduced BK effect compared with participants with TD and participants with DLD. No significant difference was found between the TD group and the DLD group. CONCLUSIONS: The reduced BK effect in children with CAS supports the notion that cross-modal sensory integration may be altered in these children. Cross-modal sensory integration is the basis for speech production. Thus, difficulties in sensory integration may contribute to speech difficulties in CAS.

Challenges Surrounding the Diagnosis of Autism in Children.

This comprehensive thematic review aims to highlight and familiarize readers with the challenges and pitfalls encountered in differential diagnosis of autism spectrum disorders (ASD) in children to facilitate the process of accurate identification by stakeholders. Accordingly, articles that best answer our questions and highlight our concerns were chosen from well-established publishers with prime peer reviewed journals. Included are studies showing alternate views of the issues so as to point readers to other possibilities. ASD, a complex dynamic biological-neurodevelopmental disorder, is underscored by its heterogeneous symptomology, severity, and phenotypes - all characterized by social communication deficits and presence of restricted interests and repetitive behaviours (RRBs), the core symptoms in ASD. Language and intellectual capacities do not form ASD core symptoms although vary considerably. Accurate identification is challenging as ASD is often enmeshed with other neurodevelopmental disorders, and medical comorbidities, a situation now recognized as the rule rather than the exception in child psychiatry and developmental medicine. ASD is a disorder with varying performance and severity of symptoms over time, including unexpected loss of early skills, and lost diagnosis in some children following treatment. The review reiterates the urgency in accurate diagnosis in face of the rapid rise in ASD prevalence globally, and risk-increase in delayed or denied treatment with undesirable life-long consequences for most of the affected children. In addition, a call for change is advised to circumvent the ethical dilemma posed by the present "deficit model" in ASD diagnosis. Here, ASD prevalence is presented first, followed by emphasis on importance of accurate early diagnosis, and challenges in its accomplishment due to flaws in diagnostic instruments and other contributing factors. Next follow the required criteria for accurate identification, and its difficulties attributed to comorbid conditions, gender differences, and socio-economic and cultural influences. The conclusion includes future directions and a take away message.

Infants' Preference for Child-Directed Speech Over Time-Reversed Speech in On-Channel and Off-Channel Masking.

Purpose This study aims to examine the development of auditory selective attention to speech in noise by examining the ability of infants to prefer child-directed speech (CDS) over time-reversed speech (TRS) presented in "on-channel" and "off-channel" noise. Method A total of 32 infants participated in the study. Sixteen typically developing infants were tested at 7 and 11 months of age using the central fixation procedure with CDS and TRS in two types of noise at +10 dB signal-to-noise ratio. One type of noise was an "on-channel" masker with a spectrum overlapping that of the CDS (energetic masking), and the second was an "off-channel" masker with frequencies that were outside the spectrum of the CDS (distractive masking). An additional group of sixteen 11-month-old infants were tested in quiet and served as controls for the "off-frequency" masker condition. Results Infants preferred CDS over TRS in both age groups, but this preference was more pronounced with "off-channel" masker regardless of age. Also, older infants demonstrated longer looking time for the target stimuli when presented with an "off-channel" masker compared to the "on-channel" masker. Looking time in quiet was similar to looking time in the "off-channel" condition, and looking time for CDS was longer in quiet compared to the "on-channel" condition. Conclusions These findings support the notion that (a) infants as young as 7 months of age are already showing preference for speech in noise, regardless of type of masker; (b) by 11 months of age, listening with the "off-channel" condition did not yield different results than in quiet. Thus, by 11 months of age, infants' cognitive-attentional abilities may be more developed.

Functional Communication Profiles of Children and Youth with Autism: A Roadmap to Therapeutic and Educational Interventions.

BACKGROUND: Autism spectrum disorder (ASD) entails varied developmental pathways along the entire lifespan, demanding early and ongoing diverse and responsive interventions to children's needs. This study examined in situ education and development attained by children and youth with ASD in a school with a therapeutic and educational curriculum. OBJECTIVES: (1) Construct individual communication profiles in educational and developmental aspects. (2) Examine for associations between variables. (3) Demonstrate the clinical and educational utility of including cognitive-linguistic integrative variables. (4) Showcase how the profiles guide interventions tailored to students' individual needs. METHODS: Functional communication profiles (FCPs) of 21 students, aged 5.0-16.8 years, mostly from bilingual middle-high socioeconomic status families, were constructed with input from their educational and therapeutic staff. Students' performance was examined with an array of instruments and tasks, including person and clock drawings, false belief, and bouba-kiki metaphor screens. Qualitative and quantitative analyses were performed to uncover associations, weaknesses, and strengths. RESULTS: The profiles revealed associations between cognitive, linguistic, social, and educational abilities, indicating that some abilities from different domains tend to co-occur. CONCLUSIONS: Including cognitive linguistic integrative variables was a novelty that revealed additional aspects of the children's abilities. Staff feedback confirmed the utility of FCPs in providing "a roadmap" to needed individual and common curriculum adjustments.

Associations and Dissociations among Phonological Processing Skills, Language Skills and Nonverbal Cognition in Individuals with Autism Spectrum Disorder.

AIMS: The purpose of this study was to examine the nature of phonological processing in individuals with autism spectrum disorder (ASD) as it pertains to their nonverbal cognitive and linguistic abilities. METHODS: Twenty-one participants between the ages of 9 and 21 years were administered a nonverbal cognitive assessment (Raven test), a language measure that requires receptive and expressive knowledge of semantics, syntax and morphology, as well as the integration across these language domains (CELF-4), and a measure of phonological processing (CTOPP). RESULTS: Results show that performance on nonword repetition (NWR) that reflects an aspect of phonological memory was significantly low, whereas performance on phoneme reversal, phoneme elision, blending words and memory for digits was within the normal range. Hierarchical regressions with age, nonverbal intelligence (Raven test) and receptive language (CELF) as predictors showed that for NWR and phoneme elision the receptive part of the CELF was the main significant -predictor, after controlling for age. For phoneme reversal and memory for digits, however, the Raven score was the significant predictor, suggesting that cognitive nonverbal ability is the main factor explaining variability in these tasks. CONCLUSIONS: A deficit in phonological memory characterizes individuals in the autistic population. This deficit may influence language acquisition in this population consistent with other populations of children with language impairments. Other tasks of phonological awareness, however, might be preserved especially when they do not involve memory for long phonological sequences and when the cognitive abilities are within the norm.

Robust effects of stress on early lexical representation.

This study aims to elucidate the factors that affect the robustness of word form representations by exploring the relative influence of lexical stress and segmental identity (consonant vs. vowel) on infant word recognition. Our main question was which changes to the words may go unnoticed and which may lead the words to be unrecognizable. One-hundred 11-month-old Hebrew-learning infants were tested in two experiments using the Central Fixation Procedure. In Experiment 1, 20 infants were presented with iambic Familiar and Unfamiliar words. The infants listened longer to Familiar than to Unfamiliar words, indicating their recognition of frequently heard word forms. In Experiment 2, four groups of 20 infants each were tested in each of four conditions involving altered iambic Familiar words contrasted with iambic Unfamiliar nonwords. In each condition, one segment in the Familiar word was changed-either a consonant or a vowel, in either the first (unstressed) or the second (stressed) syllable. In each condition, recognition of the Familiar words despite the change indicates a less accurate or less well-specified representation. Infants recognized Familiar words despite changes to the weak (first) syllable, regardless of whether the change involved a consonant or a vowel (conditions 2a, 2c). However, a change of either consonant or vowel in the stressed (second) syllable blocked word recognition (conditions 2b, 2d). These findings support the proposal that stress pattern plays a key role in early word representation, regardless of segmental identity.

Orthographic, Phonological, and Semantic Dynamics During Visual Word Recognition in Deaf Versus Hearing Adults.

Purpose Studies on reading in individuals with severe-to-profound hearing loss (deaf) raise the possibility that, due to deficient phonological coding, deaf individuals may rely more on orthographic-semantic links than on orthographic-phonological links. However, the relative contribution of phonological and semantic information to visual word recognition in deaf individuals was not directly assessed in these studies. The aim of the present study, therefore, was to examine the interplay between orthographic, phonological, and semantic representations during visual word recognition, in deaf versus hearing adults. Method Deaf and hearing participants were asked to perform a visual lexical decision task in Hebrew. The critical stimuli consisted of three types of Hebrew words, which differ in terms of their relationship between orthography, phonology, and semantics: unambiguous words, homonyms, and homographs. Results In the hearing group, phonological effects were more pronounced than semantic effects: Homographs (multiple pronunciations) were recognized significantly slower than homonyms or unambiguous words (one pronunciation). However, there was no significant difference between homonyms (multiple meanings) and unambiguous words (one meaning). In contrast, in the deaf group, there was no significant difference among the three word types, indicating that visual word recognition, in these participants, is driven primarily by orthography. Conclusion While visual word recognition in hearing readers is accomplished mainly via orthographic-phonological connections, deaf readers rely mainly on orthographic-semantic connections.

International Survey of Speech-Language Pathologists' Practices in Working with Children with Autism Spectrum Disorder.

OBJECTIVE: Autism spectrum disorder (ASD) is a complex neurodevelopmental impairment. To better understand the role of speech-language pathologists (SLPs) in different countries in supporting children with ASD, the International Association of Logopedics and Phoniatrics (IALP) Child Language Committee developed a survey for SLPs working with children or adolescents with ASD. Method and Participants: The survey comprised 58 questions about background information of respondents, characteristics of children with ASD, and the role of SLPs in diagnosis, assessment, and intervention practices. The survey was available in English, French, Russian, and Portuguese, and distributed online. RESULTS: This paper provides a descriptive summary of the main findings from the quantitative data from the 1,114 SLPs (representing 35 countries) who were supporting children with ASD. Most of the respondents (91%) were experienced in working with children with ASD, and the majority (75%) worked in schools or early childhood settings. SLPs reported that the children's typical age at diagnosis of ASD on their caseload was 3-4 years, completed mostly by a professional team. CONCLUSIONS: The results support positive global trends for SLPs using effective practices in assessment and intervention for children with ASD. Two areas where SLPs may need further support are involving parents in assessment practices, and supporting literacy development in children with ASD.

Comprehension of "Narrow Focus" by Adolescents in the Autism Spectrum.

OBJECTIVE: The study compared the performance of adolescents with autistic spectrum disorder (ASD) to that of age-matched peers with typical development (TD) and cognitive language-matched peers with TD on measures of identification and comprehension of "narrow focus." PARTICIPANTS: Forty-nine participants, 17 autistic, 17 TD peers matched for age and sex, and 15 TD children matched for expressive vocabulary participated in the study. METHOD: The Hebrew Narrow Focus Test (HNFT) was used. The HNFT includes 3 subtests. The first subtest (A) required identification of the stressed word in the sentence based on psychoacoustic abilities alone. The second (B) and third (C) subtests required understanding the meaning of focused stress in different contexts. In subtest B, the meaning of "narrow focus" was to contrast other possibilities related to the lexical-grammatical role of the stressed word in the sentence, whereas in subtest C, the meaning was to indicate a mistake. RESULTS: ASD participants showed reduced performance compared to peers across all the subtests of the HNFT, but similar performance compared to TD children in subtests A and B and better performance on subtest C. A significant correlation was found between the Raven test for assessing nonverbal intelligence and subtests B and C of the HNFT in the group of adolescents with ASD. CONCLUSIONS: Comprehension of narrow focus in adolescents with ASD who study in a special educational system is related to their cognitive-linguistic abilities and not to the autistic condition by itself or to its severity.

Recognition and Comprehension of "Narrow Focus" by Young Adults With Prelingual Hearing Loss Using Hearing Aids or Cochlear Implants.

Purpose: The stressed word in a sentence (narrow focus [NF]) conveys information about the intent of the speaker and is therefore important for processing spoken language and in social interactions. The ability of participants with severe-to-profound prelingual hearing loss to comprehend NF has rarely been investigated. The purpose of this study was to assess the recognition and comprehension of NF by young adults with prelingual hearing loss compared with those of participants with normal hearing (NH). Method: The participants included young adults with hearing aids (HA; n = 10), cochlear implants (CI; n = 12), and NH (n = 18). The test material included the Hebrew Narrow Focus Test (Segal, Kaplan, Patael, & Kishon-Rabin, in press), with 3 subtests, which was used to assess the recognition and comprehension of NF in different contexts. Results: The following results were obtained: (a) CI and HA users successfully recognized the stressed word, with the worst performance for CI; (b) HA and CI comprehended NF less well than NH; and (c) the comprehension of NF was associated with verbal working memory and expressive vocabulary in CI users. Conclusions: Most CI and HA users were able to recognize the stressed word in a sentence but had considerable difficulty understanding it. Different factors may contribute to this difficulty, including the memory load during the task itself and linguistic and pragmatic abilities. Supplemental Material: https://doi.org/10.23641/asha.5572792.