Effects of Speech Cues on Acoustics and Intelligibility of Korean-Speaking Children With Cerebral Palsy.

PURPOSE: Reduced speech intelligibility is often a hallmark of children with dysarthria secondary to cerebral palsy (CP), but effects of speech strategies for increasing intelligibility are understudied, especially in children who speak languages other than English. This study examined the effects of (the Korean translation of) two cues, "speak with your big mouth" and "speak with your strong voice," on speech acoustics and intelligibility of Korean-speaking children with CP. METHOD: Fifteen Korean-speaking children with CP repeated words and sentences in habitual, big mouth, and strong voice conditions. Acoustic analyses were performed and intelligibility was assessed by means of 90 blinded listeners' ease-of-understanding (EoU) ratings and percentage of words correctly transcribed (PWC). RESULTS: In response to both cues, children's vocal intensity and utterance duration increased significantly and differentially, whereas their vowel space area gains did not reach statistical significance. EoU increased significantly in the big mouth condition at word, but not sentence, level, whereas in the strong voice condition, EoU increased significantly at both levels. PWC increases were not statistically significant. Considerable variability in children's responses to cues was noted overall. CONCLUSIONS: Korean-speaking children with CP modify their speech styles differentially when provided with cues aimed to increase their articulatory working space and vocal intensity. The results provide preliminary support for the use of the strong voice cue, in particular, to increase EoU. While the findings do not offer conclusive evidence of the intelligibility benefits of these cues, investigation with a larger sample size should provide further insight into optimal cueing strategies for increasing intelligibility in this population. Implications for language-specific versus language-independent treatment approaches are discussed. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25521052.

CD11b Deficiency Exacerbates Methicillin-Resistant Staphylococcus aureus-Induced Sepsis by Upregulating Inflammatory Responses of Macrophages.

Macrophages are important for the first line of defense against microbial pathogens. Integrin CD11b, which is encoded by Itgam, is expressed on the surface of macrophages and has been implicated in adhesion, migration, and cell-mediated cytotoxicity. However, the functional impact of CD11b on the inflammatory responses of macrophages upon microbial infection remains unclear. Here, we show that CD11b deficiency resulted in increased susceptibility to sepsis induced by methicillin-resistant Staphylococcus aureus (MRSA) infection by enhancing the pro-inflammatory activities of macrophages. Upon infection with MRSA, the mortality of Itgam knockout mice was significantly higher than that of control mice, which is associated with increased production of TNF-α and IL-6. In response to MRSA, both bone marrow-derived macrophages and peritoneal macrophages lacking CD11b produced elevated amounts of pro-inflammatory cytokines and nitric oxide. Moreover, CD11b deficiency upregulated IL-4-induced expression of anti-inflammatory mediators such as IL-10 and arginase-1, and an immunomodulatory function of macrophages to restrain T cell activation. Biochemical and confocal microscopy data revealed that CD11b deficiency augmented the activation of NF-κB signaling and phosphorylation of Akt, which promotes the functional activation of macrophages with pro-inflammatory and immunoregulatory phenotypes, respectively. Overall, our experimental evidence suggests that CD11b is a critical modulator of macrophages in response to microbial infection.

Bilateral cochlear implantation versus unilateral cochlear implantation in deaf children: Effects of sentence context and listening conditions on recognition of spoken words in sentences.

OBJECTIVES: Previous studies have investigated the efficacy of bilateral cochlear implants (CIs) in deaf children. The current study focused on the use of sentence-context information in different listening conditions to better explain the benefits of bilateral cochlear implantation. We compared the word recognition abilities of children with bilateral CIs and children with unilateral CIs in relation to sentence context and listening conditions. Additionally, we investigated whether sentence context- and listening condition-dependent word recognition scores can differentiate children with bilateral CIs from children with unilateral CIs. METHODS: Twenty children with bilateral CIs and 20 children with unilateral CIs participated in this study. All children were presented with semantically controlled sentences (high vs. low predictability) in quiet and noisy conditions and were asked to repeat the final words of each sentence. RESULTS: Children with bilateral CIs had significantly higher word recognition scores than children with unilateral CIs on words embedded in both high- and low-predictability sentences in noisy conditions. The two groups recognized more words in high-predictability sentences than in low-predictability sentences in noisy conditions. The scores on the high-predictability sentences in noisy conditions significantly differentiated children with bilateral CIs from children with unilateral CIs. CONCLUSION: Bilateral cochlear implantation is more advantageous than unilateral cochlear implantation at the auditory-linguistic processing level in complex listening conditions.

Loci of stuttering of English- and Korean-speaking children who stutter: Preliminary findings.

PURPOSE: The purpose of the study was to determine whether differences exist between young English- and Korean-speaking children who stutter (CWS) in the loci of stuttering. METHOD: Participants were 10 Korean-speaking and 11 English-speaking CWS between the ages of 3 and 7 years. Participants produced narratives while viewing various picture scenes and a wordless picture book. RESULTS: Findings indicated that Korean-speaking CWS stuttered more on content than function words whereas English-speaking CWS stuttered more on function than content words. Furthermore, both Korean- and English-speaking CWS tended to stutter more on utterance-initial words. These findings appear to be related to the differences in linguistic/syntactic structures between Korean and English. Specifically, in the Korean-speaking CWS's narratives, most utterance-initial words (73.60 %) were content words whereas in the English-speaking CWS's narratives, most utterance-initial words (83.57 %) were function words. CONCLUSION: These preliminary findings, although in need of replication with a larger sample size, seem to suggest that the word class (i.e., content/function words) contributions to stuttering loci are more language-specific whereas the word position (i.e., utterance-initial position) contributions to stuttering loci are more language-nonspecific. Given that the true characteristics of stuttering may be rather language-nonspecific than language-specific, further research may need to focus more on stuttering loci related to word position than word class.

Prosodic control in imitative speech of preschool-age children with cochlear implants.

This study aimed to (a) to investigate the acoustic characteristics of speech in preschool-age children with cochlear implants (CIs) compared to those in age-matched children with normal hearing (NH), (b) to identify which acoustic measures could differentiate children with CIs from children with NH, (c) to explore the relationships between child variables and the perceptually judged ability to control prosody in the CI group, and (d) to examine predictors of perceptually judged ability in children with CIs to control prosody. Study participants included 30 children with CIs (3-5.9 years old) and 30 age-matched children with NH. Children were asked to imitate 20 utterances, which were syntactically matched 10 statements and 10 questions. Fundamental frequency, intensity, and duration measures were obtained from the final word of each utterance. Ten adults rated the prosodic-contour appropriateness of the children with CIs using a 5-point scale. Children with CIs tended to produce less distinctive declarative and interrogative utterances compared to children with NH. The mean F0 significantly differentiated children with CIs from their NH peers. In children with CIs, perceptual ratings of prosodic-contour appropriateness were significantly correlated with age, duration of implant use, and percentage of consonants corrects. Duration of implant use was a significant factor predicting the ability to control prosody in children with CIs. These findings suggested that preschool-age children with CIs have difficulty in controlling pitch parameters, compared with the NH peers. The prosodic development in children with CIs was affected by the hearing experience via CIs.

Passive sentence comprehension difficulties and its related factors in children with cochlear implants.

OBJECTIVES: The purposes of this study were to investigate which syntactic structures, from active and passive sentences, sensitively differentiate children with cochlear implants (CIs) from children with normal hearing (NH), to explore the correlations among working memory (WM) and other factors for each group, and to examine predictors of the active and passive sentence scores for both groups. METHODS: Twenty deaf children with CIs and 20 children with NH, aged 8-14 years, were included in this study. Sentence comprehension skills were measured using the picture-pointing comprehension task, which consisted of active and passive sentences. The WM capacity was tested by the digit forward, digit backward, word forward, and word backward span tasks. RESULTS: Passive sentence type was a significant predictor to differentiate between the two groups (p < .05). In the CI group, passive sentence scores were significantly correlated with age, duration of an implant use, receptive vocabulary scores, and WM scores (all p values < .05). In the stepwise regression analysis, WM capacity was a significant factor in predicting the passive sentence scores of children with CIs (p < .05). CONCLUSION: Passive sentence type was a significant factor in distinguishing the CI group from the NH group. The WM capacity was an important predictor accounting for individual differences in processing complex sentence types for children with CIs. The results indicate that a complex syntactic form may serve as a clinically critical index in detecting higher-level cognitive and linguistic processing difficulties in good performers after implantation.

CD11b regulates antibody class switching via induction of AID.

The integrin CD11b, which is encoded by the integrin subunit alpha M (ITGAM), is primarily expressed on the surface of innate immune cells. Genetic variations in ITGAM are among the strongest risk factors for systemic lupus erythematosus, an autoimmune disease characterized by the presence of autoantibodies. However, the regulatory function of CD11b in the antibody responses remains unclear. Here, we report the induction of CD11b in activated B2 B cells and define its unexpected role in immunoglobulin heavy chain class switch recombination (CSR). LPS-activated B cells lacking CD11b yielded fewer IgG subtypes such as IgG1 and IgG2a in vitro, and immunization-dependent CSR and affinity maturation of antibodies were severely impaired in CD11b-deficient mice. Notably, we observed the reduced expression of activation-induced cytidine deaminase (AID), an enzyme that initiates CSR and somatic hypermutation, and ectopic expression of AID was sufficient to rescue the defective CSR of CD11b-deficient B cells. LPS-induced phosphorylation of NF-κB p65 and IκBα was attenuated in CD11b-deficient B cells, and hyperactivation of IκB kinase 2 restored the defective AID expression and CSR, which implied that CD11b regulates the NF-κB-dependent induction of AID. Overall, our experimental evidence emphasized the function of CD11b in antibody responses and the role of CD11b as a vital regulator of CSR.

Disfluency characteristics of children with attention-deficit/hyperactivity disorder symptoms.

The purpose of the current study was to investigate the characteristics of speech disfluency in 15 children with attention-deficit/hyperactivity disorder (ADHD) symptoms and 15 age-matched control children. Reading, story retelling, and picture description tasks were used to elicit utterances from the participants. The findings indicated that children with ADHD symptoms produced significantly more stuttering-like disfluencies (SLD) and other disfluencies (OD) when compared to the control group during all three tasks. Further statistical analysis showed that children with ADHD symptoms produced more OD during the story retelling task than the other two tasks, whereas no significant differences in OD were observed among the three tasks in the control children. Finally, children with ADHD symptoms exhibited a higher proportion of SLD in total disfluencies (TD) than the control children. These results are consistent with previous studies that children with ADHD are disfluent in their verbal production. Furthermore, children with ADHD symptoms seem to be more vulnerable to a speaking task that places greater demands on their attentional resources for language production, resulting in increased speech disfluencies.

Rapamycin-resistant and torin-sensitive mTOR signaling promotes the survival and proliferation of leukemic cells.

The serine/threonine kinase mTOR is essential for the phosphoinositide 3-kinases (PI3K) signaling pathway, and regulates the development and function of immune cells. Aberrant activation of mTOR signaling pathway is associated with many cancers including leukemia. Here, we report the contributions of mTOR signaling to growth of human leukemic cell lines and mouse T-cell acute leukemia (T-ALL) cells. Torin, an ATP-competitive mTOR inhibitor, was found to have both cytotoxic and cytostatic effects on U-937, THP-1, and RPMI-8226 cells, but not on Jurkat or K-562 cells. All cells were relatively resistant to rapamycin even with suppressed activity of mTOR complex 1. Growth of T-ALL cells induced by Notch1 was profoundly affected by torin partially due to increased expression of Bcl2l11 and Bbc3. Of note, activation of Akt or knockdown of FoxO1 mitigated the effect of mTOR inhibition on T-ALL cells. Our data provide insight on the effect of mTOR inhibitors on the survival and proliferation of leukemic cells, thus further improving our understanding on cell-context-dependent impacts of mTOR signaling.

Effects of listeners' working memory and noise on speech intelligibility in dysarthria.

The purpose of this study was to investigate the effects of listeners' working memory (WM), types of noise and signal to noise ratios (SNRs) on speech intelligibility in dysarthria. Speech intelligibility was judged by using a word transcription task. A three-way mixed design (2 × 3 × 2) was used with the WM group (high/low group) as a between-subject factor and the types of noise (multi-talker babble/environmental noise) and SNRs (0, +10 and +20 dB) as within-subject factors. The dependent measure was the percentage of correctly transcribed words. The results revealed that the high WM group performed significantly better than the low WM group and listeners performed significantly better at higher levels of SNRs on the speech intelligibility test. The findings of this study suggested that listeners' cognitive abilities and SNRs should be considered as important factors when evaluating speech intelligibility in dysarthria.

Phonological processing skills and its relevance to receptive vocabulary development in children with early cochlear implantation.

OBJECTIVES: The purposes of this study were to investigate phonological processing skills for children with cochlear implants (CIs) in comparison with children with normal hearing (NH), and to assess whether phonological processing skills can explain variance in receptive vocabulary scores in children with CIs. METHODS: Twenty-five deaf children who received a CI before 2 years of age were included in this study, and they ranged from 4 years to 6 years 11 months. Twenty-five children with NH as a control group were matched to children with CIs on the basis of chronological age with 3 months. Phonological processing skills were measured by the phonological awareness (PA), nonword repetition (NWR), and rapid automatized naming (RAN) tasks. Receptive vocabulary skills were also tested by the Peabody Picture Vocabulary Test - Korean version. RESULTS: Children with CIs performed significantly lower than children with NH on PA (p<.05) and NWR (p<.001) tasks. Children with CIs showed slower naming speed than children with NH, which did not reach the significant level (p>.05). Among phonological processing skills, PA contributed significant amount to receptive vocabulary skills in children with CIs (p<.001). CONCLUSIONS: Children with early implantation receive substantial benefits for developing lexical access skills. However, children with CIs showed delays in PA and NWR in comparison with age-matched children with NH. For children with CIs, PA among phonological processing skills plays an important role of developing receptive vocabulary skills.

Lateralization of cognitive functions in aphasia after right brain damage.

PURPOSE: The lateralization of cognitive functions in crossed aphasia in dextrals (CAD) has been explored and compared mainly with cases of aphasia with left hemisphere damage. However, comparing the neuropsychological aspects of CAD and aphasia after right brain damage in left-handers (ARL) could potentially provide more insights into the effect of a shift in the laterality of handedness or language on other cognitive organization. Thus, this case study compared two cases of CAD and one case of ARL. MATERIALS AND METHODS: The following neuropsychological measures were obtained from three aphasic patients with right brain damage (two cases of CAD and one case of ARL); language, oral and limb praxis, and nonverbal cognitive functions (visuospatial neglect and visuospatial construction). RESULTS: All three patients showed impaired visuoconstructional abilities, whereas each patient showed a different level of performances for oral and limb praxis, and visuospatial neglect. CONCLUSION: Based on the analysis of these three aphasic patients' performances, we highlighted the lateralization of language, handedness, oral and limb praxis, visuospatial neglect and visuospatial constructive ability in aphasic patients with right brain damage.

An acoustic study of the temporal characteristics of nasalization in children with and without cleft palate.

OBJECTIVE: The purpose of this study was to measure the oral and nasal cavity acoustic energies to determine whether temporal patterns of nasalization differentiate children with and without cleft palate and the extent to which vowel context contributes to these temporal differences. DESIGN: Nasal onset interval, nasal offset interval, and total nasalization duration measures were obtained from acoustic waveforms, spectrograms, and energy contours acquired using the Computerized Speech Lab (Kay Elemetrics, Lincoln Park, NJ). In addition to absolute temporal values, proportional durations of nasalization were measured to obtain information regarding the relative duration of nasalization. PARTICIPANTS: Fifteen children with cleft palate exhibiting mild hypernasality and 15 children without cleft palate participated in the study. Children in both groups were between 4 and 7 years of age. RESULTS: Each of the three absolute measures was significantly different between the two groups of subjects and within the three vowel contexts. Children with cleft palate showed longer temporal characteristics than children without cleft palate in all three absolute measures. The three temporal variables of the high vowel contexts were generally longer than those of low vowel contexts. Regarding proportional measures, nasal offset interval ratio, and total nasalization ratio showed significant differences between the two groups. CONCLUSIONS: Nasalization, as reflected by acoustic signals, showed different timing characteristics between children with cleft palate and without cleft palate and across vowel contexts. This suggests that the duration of nasalization reflecting temporal patterns of the oral-nasal acoustic impedance may have an influence on the perception of hypernasality.