The use and reliability of Tait video analysis in assessing preverbal language skills in profoundly deaf and normally hearing children under 12 months of age.

BACKGROUND: Assessment measures in evaluating preverbal skills and their progress in very young deaf children are lacking. However, their importance is highlighted by the recent trend of implanting children under 1 year of age. Tait video analysis is a technique for assessing preverbal communication behaviours in very young children with hearing impairment and has been found to be strongly related to speech discrimination and intelligibility outcomes post-implantation. AIM: To assess feasibility and inter-user reliability of Tait video analysis in assessing preverbal communication skills in children under 1 year of age. MATERIAL AND METHODS: Ten children (five profoundly deaf and five normally hearing) under 1 year of age were assessed by Tait video analysis. Three observers analysed the samples independently, according to the established protocol. RESULTS: There was complete agreement on 305 judgements and 8 discrepancies between observers over all the measures. Four of the discrepancies occurred in the samples of deaf children and four in the normally hearing samples. Statistical analysis revealed that the correlation coefficients between the different observers were extremely high ranging from 0.94 to 1 (perfect agreement). All of them were found to be statistically significant (p<0.01). CONCLUSION: The very high rate of inter-observer reliability suggests that the video recordings of children under 12 months can be scored consistently, and Tait video analysis is therefore a valid method of monitoring the development of vocal and auditory preverbal skills in very young deaf children, either following cochlear implantation or using acoustic hearing aids.

Age at implantation and development of vocal and auditory preverbal skills in implanted deaf children.

BACKGROUND: Preverbal vocal and auditory skills are essential precursors of spoken language development and they have been shown previously to predict later speech perception and production outcomes in young implanted deaf children. OBJECTIVES: To assess the effect of age at implantation on the development of vocal and auditory preverbal skills in implanted children. METHODS: The study assessed 99 children, 33 in each of three groups (those implanted between 1 and 2 years; 2 and 3 years; and 3 and 4 years). Preverbal skills were measured in three areas: turn taking, autonomy and auditory awareness of spoken language, using the Tait video analysis method. RESULTS: The youngest implanted group made an exceptional progress outperforming in all measures the two other groups (p<0.01), 6 and 12 months post-implantation, whereas there was no such difference before implantation. In the youngest group there was also significantly greater use of an auditory/oral style of communication: 85% of the group by 12 months post-implantation compared with 30% and 18% of the two older groups. CONCLUSIONS: Vocal and auditory preverbal skills develop much more rapidly in children implanted between 1 and 2 years in comparison with older implanted children and reach a significantly higher level by 6 and 12 months post-implantation. In addition, younger implanted children are significantly more likely by 12 months post-implantation to adopt an auditory/oral mode of communication. These findings favour cochlear implantation as early as between 1 and 2 years, provided that correct diagnosis and adequate hearing-aid trial have been achieved.

Agrammatic aphasic subjects' comprehension of subject and object extracted Wh questions.

This study attempted to replicate the unusual wh question comprehension pattern of Hickok and Avrutin's (1996) subjects who showed an expected subject/object extraction asymmetry for which NP questions, but not for who questions. We also examined comprehension of what and which one questions, which are similar to who and which NP questions, respectively, and we examined passivized wh questions in order to test predictions of Grodzinsky's (1995) restrictive theory of trace deletion, the Trace-Based Account (TBA). Results, using both a figurine manipulation task and a picture pointing task, showed that only one of four agrammatic (Broca's) aphasic subjects showed the pattern reported by Hickok and Avrutin and that this pattern extended to comprehension of what and which one questions. One of the subjects showed subject/object asymmetry for all wh questions tested, as would be predicted by the original trace deletion hypothesis (Grodzinsky, 1984), and two subjects showed neither pattern. None of our subjects demonstrated ability to comprehend passivized wh questions as predicted by the TBA. We discuss our findings in terms of the lack of homogeneity of wh question comprehension among individuals with agrammatic aphasia and we explore alternatives to the syntactic explanation for differences between who and which NP question comprehension advanced by Hickok and Avrutin.

Training and generalized production of wh- and NP-movement structures in agrammatic aphasia.

The present research examines production of "complex" sentences, which involve movement of noun phrases (NPs), in 2 agrammatic aphasic subjects. According to linguistic theory (Chomsky, 1991, 1993), such sentences are derived using one of two movement operations, either wh- or NP-movement, subsumed under the general rule "move alpha." In this experiment recovery of both wh- and NP-movement derived sentences was investigated using a treatment research paradigm. Subjects were sequentially trained to produce either wh-movement (i.e., who questions, object clefts) or NP-movement (i.e., passives, subject-raising structures) derived sentences. Throughout training, generalization to untrained sentences relying on both types of movement was tested. The influence of training on aspects of narrative discourse also was examined. Results showed generalization patterns constrained to type of movement. Training wh-movement structures resulted in generalized production of untrained wh-movement structures without influencing production of NP-movement structures. Similarly, training of NP-movement structures resulted in generalization only to other sentence types also relying on NP-movement. Aspects of sentence production in narrative contexts also was improved with treatment. These data indicate that movement to an argument (A) position as in NP-movement is distinct from movement to a non-argument (A-bar) position, required in wh-movement. The site where movement terminates in the s-structure of noncanonical sentences appears to influence sentence production. These findings show that linguistic properties of sentences influence sentence production breakdown and recovery in aphasia.

Training wh-question production in agrammatic aphasia: analysis of argument and adjunct movement.

The present research utilized aspects of the Principles and Parameters Approach (P&PA; Chomsky, 1991, 1993) in linguistic theory as well as findings from the psycholinguistic literature as a basis for examining sentence production in aphasic individuals. We examined the production of particular wh-movement constructions--wh-questions requiring movement of an argument noun phrase (i.e., who and what questions) and those which require adjunct movement (i.e., when and where questions). Using a single-subject experimental treatment paradigm, subjects were sequentially trained to produce these wh-questions and, throughout training, generalization to untrained wh-questions relying on similar wh-movement processes was tested. As well, the influence of training on aspects of narrative and conversational discourse was examined. Seven agrammatic aphasic subjects who evinced difficulty producing (and comprehending) "complex" sentences (e.g., passives, object relative clauses, wh-questions)--sentences that involve movement of noun phrases (NPs) out of their canonical positions, leaving behind a "trace" of that movement or "gap"--participated in the study. Subjects were trained to produce wh-questions by taking them through a series of steps emphasizing the lexical and syntactic properties (e.g., thematic role assignment, movement processes, and proper selection of wh-morpheme) of declarative sentence counterparts of target sentences. Results revealed improved sentence production abilities in all subjects under study in both constrained sentence production and, importantly, in discourse tasks. The argument/adjunct distinction was observed in the sentence production recovery patterns noted in six of the seven subjects. Three of the subjects evinced correct argument movement across trained and untrained question structures when wh-questions relying on argument movement were trained; similarly, for these subjects, training structures relying of adjunct movement resulted in improved adjunct movement. Three of the remaining four subjects who required additional treatment to alleviate their wh-morpheme selection deficits, too showed covariance between argument and adjunct movement structures with each type of movement emerging across structures in temporal sequence. We discuss these data in terms of the operations necessary to produce wh-questions, the importance of considering linguistic and psycholinguistic data when designing treatment programs for language disordered patients, and the contribution that detailed recovery data can make both to understanding the nature of sentence production deficits and to issues regarding normal sentence production.