Jennifer Vannest

Purpose: This preliminary investigation occurred across two studies and examined validity, discriminant accuracy, and feasibility of the Sentence Completion Expressive Language Task–Preschool (SCELT-P) for characterizing language production in a neuroimaging environment for typically developing (TD) preschoolers and those with developmental language disorder (DLD). Method: Two separate studies were completed. Study 1 (validity) included 82 preschoolers (50% female; 69 TD, 13 DLD) aged 4;0 (years;months) to 5;11 ( M _age = 4;7). All children were assessed using standardized language measures (e.g., Clinical Evaluation of Language Fundamentals Preschool–Second Edition), a play-based language sample (analyzed using Developmental Sentence Scoring), and the 30-item SCELT-P (outside the neuroimaging environment), later streamlined to 20 items (SCELT-P Revised [SCELT-PR]). Study 2 (feasibility) included 14 preschoolers ( M _age = 4;9, 43% female; nine TD, five with DLD) that were assessed using the SCELT-P (inside the neuroimaging environment) and functional magnetic resonance imaging using a sparse acquisition approach with a “listen” (passive) and “listen + speak” (active) condition implemented using DirectRT software. Results: In Study 1, the SCELT-P and SCELT-PR demonstrated high reliability, including interrater (intraclass correlation coefficient = .99), test–retest ( r = .86 and .80, respectively), and internal consistency (Cronbach's α > .86 and .83, respectively), and similar strong criterion validity ( r = . 53–.84). Area under the curve analyses (.91) revealed both versions also evidenced fair sensitivity (.88 and .87) and specificity (.85) rates with a cutoff score of 15.5 and 9.5, respectively. In Study 2, 89% of TD preschoolers and 60% of preschoolers with DLD successfully completed the SCELT-P/R inside the neuroimaging environment, with activation maps illustrating relatively similar neurobiological characteristics across preschoolers in some brain regions. Conclusion: The SCELT-P, including its streamlined version, the SCELT-PR, holds promise as a reliable and valid task for including 4- to 5-year-olds in the neuroimaging environment to inform neural and cognitive systems involved in language development. Supplemental Material: https://doi.org/10.23641/asha.34543209

Preterm birth is associated with increased risk for communication difficulties, yet early neural markers of later outcomes remain poorly understood. This study examined associations between structural and functional brain connectivity in infancy and communication skills at 24to 30 months in children born very preterm (≤32 weeks gestation). Participants (n = 180) MRI at term-equivalent age during natural sleep. Resting-state functional and diffusion data were used to derive structural and functional connectivity across regions implicated in communication. At follow-up, communication outcomes were assessed using Communication and Symbolic Behavior Scales (CSBS), which captures verbal, gestural, social-affective, and symbolic communication skills. We analyzed 22×22 functional and structural connectomes among selected ROIs, using a LASSO regression approach to identify connectivity associated with CSBS scores adjusting for demographic and medical covariates. Significant relationships were observed between both functional and structural connectivity and communication skills, differing by domain. Functional connectivity between left and right temporal regions was positively associated with overall communication scores, whereas several structural connections involving cortical, cerebellar, and subcortical regions showed negative associations. Distinct connectivity patterns were also associated with gestural, verbal, social-affective, and symbolic communication skills. These findings demonstrate that variability in early brain connectivity is associated with later communication outcomes in children born very preterm. We found both significant positive and negative associations after adjusting for relevant covariates; these patterns potentially reflect compensatory or atypical network organization. These results highlight the value of multimodal neuroimaging in identifying early neural correlates of communication in this high-risk population. Highlights: Early structural and functional brain connectivity is associated with communication outcomes at 2–3 years in children born very preterm. Distinct patterns of connectivity relate differently to verbal, gestural, social-affective, and symbolic communication skills. Both positive and negative connectivity–behavior relationships suggest complex and potentially compensatory neural developmental pathways. Multimodal neuroimaging may provide early biomarkers to support identification and intervention for communication risk in preterm populations.

Language difficulties are common in school-age children but their etiology is often unknown. Although neural underpinnings of language have been well-studied in neurotypical individuals, functional connectivity differences between children with language difficulties and their typically-developing peers have not. There is little evidence regarding patterns of neural connectivity for children with language difficulties. Differences in neural networks related to degree of language difficulties and subtype of language skills (structural or pragmatic) are unclear. We examined expressive and receptive language networks, and an executive function network, in school-age children (8–12 years, n = 81) relative to their caregiver-reported language skills. We hypothesized that children with poorer structural and pragmatic language skills would have decreased connectivity in these networks. Participants were separated into groups by structural and pragmatic language scores: those with structural language difficulties (SLD), pragmatic language difficulties (PLD), and combined language difficulties (CLD, consisting of some participants in both SLD and PLD). The remainder of participants were in the typical language (TL) group. Results showed trends toward increased cross-hemispheric connectivity in age-matched controls relative to those with poorer language skills. Specifically, connectivity between bilateral inferior frontal gyri and areas including bilateral supplementary motor areas, cerebellar regions, and bilateral frontal gyri was associated with higher structural and pragmatic language scores. Connectivity among additional regions including bilateral superior temporal gyri and Heschl’s gyrus showed both positive and negative correlation with both language scores. This suggests that reduced connectivity between regions involved in language processing may contribute to language difficulties in school-age children.

Objective To investigate neural mechanisms underlying speech-in-speech listening in adolescents with listening difficulties (LiD). Methods Neural speech tracking (NST) was assessed using magnetoencephalography (MEG) in 21 adolescents with LiD and 25 typically developing (TD) peers, all with audiometrically normal hearing. Participants performed a cocktail party task involving target speech presented alone or alongside competitor speech streams differing in talker identity and spatial location. NST was quantified using theta-band (4–8 Hz) inter-event phase coherence (IEPC) to acoustic edges. Results Adolescents with LiD demonstrated significantly reduced NST of target speech relative to TD peers, whereas NST of competitor speech was comparable between groups. Theta-band IEPC correlated with caregiver-reported listening difficulties in both groups, indicating clinical relevance. The presence of both talker and spatial cues synergistically enhanced NST of target speech, an effect more pronounced in TD adolescents and absent for competitor streams. Conclusions LiD is characterized by impairment in processing attended speech rather than enhanced competitor processing or generalized auditory disengagement. Reduced cue integration observed in adolescents with LiD may contribute to their listening challenges. Significance These findings suggest targeted therapeutic interventions enhancing selective auditory attention and multimodal cue integration may effectively address listening difficulties in adolescents with LiD. Highlights Adolescents with listening difficulty showed selective speech-tracking deficits in attended speech. Spatial and talker cues synergistically enhance neural tracking of attended speech. Neural speech tracking measures correlate with caregiver-reported listening difficulties.

Purpose: The lack of appropriate assessments affects populations presumed to be most at risk for speech and language concerns, one of them being children with a history of preterm birth. This study aims to examine whether cultural bias is present in two currently available language tests for Black children under 3 years of age: the Communication and Symbolic Behavior Scales (CSBS) and the MacArthur-Bates Communicative Development Inventories (CDI). Method: This study uses data from the Early Development of NICU Graduates' Study, a National Institutes of Health–funded, ongoing prospective, multicenter cohort investigation of very preterm (VPT) infants. A total of 54 (18 Black, 36 White) children born VPT were included in this study. The outcome measures were the Black and White children's CSBS cluster scores and their CDI: Words and Gestures (WG) scores. T tests and a mixed-model approach were used to compare the scores of the CSBS and CDI:WG based on matched pairs. Spearman rank correlation was used to examine the relationship between the CSBS and CDI:WG scores. Results: There was no significant difference between CSBS scores of Black and White children. There were no significant differences between the Black and White children's total scores on the CDI:WG based on the parent responses. There was a weak correlation between the CSBS and the CDI:WG subtest scores for the total group and a moderate correlation for Black children. Conclusions: The comparison of scores on the CSBS and the CDI:WG showed no significant difference between the Black and White children, indicating that there may not be evidence to support cultural bias for the premature children in this study. The correlation between the gestural subtest of the CSBS and the CDI:WG showed that direct observation by clinicians was similar to the observations of the parents.

Purpose: The purpose of this project was to determine the feasibility of employing a functional magnetic resonance imaging (fMRI) task that captured activation associated with overt, unscripted (or free) discourse of people with aphasia (PWA), using a continuous scan paradigm. Method: Seven participants (six females, ages 48-70 years) with chronic poststroke aphasia underwent two fMRI scanning sessions that included a discourse fMRI paradigm that consisted of five 1-min picture description tasks, using personally relevant photographs, interspersed with two 30-s control periods where participants looked at a fixation cross. Audio during the continuous fMRI scan was collected and marked with speaking times and coded for correct information units. Activation maps from the fMRI data were generated for the contrast between speaking and control conditions. In order to show the effects of the multi-echo data analysis, we compared it to a single-echo analysis by using only the middle echo (echo time of 30 ms). Results: Through the implementation of the free discourse fMRI task, we were able to elicit activation that included bilateral regions in the planum polare, central opercular cortex, precentral gyrus, superior temporal gyrus, middle temporal gyrus, superior temporal gyrus, Crus I of the cerebellum, as well as bilateral occipital regions Conclusions: We describe a new tool for assessing discourse recovery in PWA. By demonstrating the feasibility of a natural language paradigm in patients with chronic, poststroke aphasia, we open a new area for future research.

Unaddressed maternal psychological distress within the first year postpartum is known to have numerous negative consequences on the child’s developmental outcomes, including language acquisition. This study examined the relationship between early maternal psychosocial factors and the language outcomes of children born very preterm (VPT; ≤32 weeks gestational age). It used data from the Cincinnati Infant Neurodevelopment Early Prediction Study, an ongoing National-Institutes-of-Health-funded prospective, multicenter cohort investigation of VPT infants. A total of 243 (125 boys; 118 girls) children born VPT (M = 29.03 weeks of gestation; SD = 2.47) and their corresponding 207 mothers (34 with multiple infants) were included in this study. We did not find an association between maternal depression or anxiety and Bayley-III (M = 92.3, SD = 18.9) language scores. Additionally, maternal grit and self-efficacy did not modify the relationship between depression and anxiety and language scores. A higher level of maternal education and infant female sex were significantly associated with higher language scores. While preterm birth typically results in higher rates of depression and anxiety for parents, the findings suggest that maternal depression, anxiety, and grit and the self-efficacy of the mothers in this sample did not relate to the language development of their children, independent of maternal education and infant female sex.

Background and Objectives: High-intensity interval training (HIIT) is a promising strategy for improving gait and fitness after stroke, but optimal parameters remain unknown. We tested the effects of short vs long interval type and over-ground vs treadmill mode on training intensity. Methods: Using a repeated measures design, 10 participants with chronic hemiparesis performed 12 HIIT sessions over 4 weeks, alternating between short and long-interval HIIT sessions. Both protocols included 10 minutes of over-ground HIIT, 20 minutes of treadmill HIIT and another 10 minutes over-ground. Short-interval HIIT involved 30 second bursts at maximum safe speed and 30–60 second rest periods. Long-interval HIIT involved 4-minute bursts at ~90% of peak heart rate (HR_peak) and 3-minute recovery periods at ~70% HR_peak. Results: Compared with long-interval HIIT, short-interval HIIT had significantly faster mean overground speeds (0.75 vs 0.67 m/s) and treadmill speeds (0.90 vs 0.51 m/s), with similar mean treadmill HR (82.9 vs 81.8%HR_peak) and session perceived exertion (16.3 vs 16.3), but lower overground HR (78.4 vs 81.1%HR_peak) and session step counts (1481 vs 1672). For short-interval HIIT, training speeds and HR were significantly higher on the treadmill vs. overground. For long-interval HIIT, the treadmill elicited HR similar to overground training at significantly slower speeds. Conclusions: Both short and long-interval HIIT elicit high intensities but emphasize different dosing parameters. From these preliminary findings and previous studies, we hypothesize that overground and treadmill short-interval HIIT could be optimal for improving gait speed and overground long-interval HIIT could be optimal for improving gait endurance.