the sound training study - cheri

The

Sound Training StudyPrinciple Investigators: Genevieve McArthur, Max Coltheart

Research Support: Danielle Ellis, Carmen Atkinson, Sarah Barry, Eliza Fraser

Technical Support: Craig Richardson, Rob Seiler, Noel Stephenson, Steve Saunders

Administrative Support: Suzanne Mendes, Katie Webb

Moral support: Romina Palermo, Steve Mondy, Martha Turner

Child support: Lyndsey Nickels, Sachicko Kinoshita, Karen Smith-Locke

External support

• CHW• Dr Pam Joy• Dr Natalie Silove

• CEO• Frederick Patchell• All special ed teachers

• Therapists• John Dyson • Jeanie Raffills• Joni Coleman• Trish Hurley• Samantha Barros• Jennie McLean

• Schools• Booragul Primary

School• St Catherine’s School

Waverley• Holy Spirit Primary

School• Mowbray Public School• Nepean District

Christian School• Special Education

Centre at Macquarie University

• All children and families

Introduction

• Specific language impairment (SLI)• unexplained failure to acquire spoken

language skills • grammar, phonology, semantics• ~ 5%

• Developmental dyslexia• unexplained failure to learn reading skills• ~ 5%

What causes SLI and dyslexia?• Heterogeneous conditions• No single cause• Multiple risk factors

• limited processing (SLI)• poor grammatical rule learning (SLI)• poor phonological short-term memory (SLI)• poor phonological processing (SLI and dyslexia)• poor automatisation (SLI and dyslexia)• poor visual processing (dyslexia)• low-level sound processing deficit (SLI and dyslexia)

How?Less able to process sounds

Less able the process speech sounds

Poor phonological representations

Poor receptive and expressive phonology

SLI

Poor phonological decoding

Dyslexia

What type?

• Rapid auditory processing• SLI: Tallal & Piercy (1973a)• Dyslexia: Tallal (1980)

• Frequency discrimination• SLI: McArthur & Bishop (2004)• Dyslexia: Baldeweg et al. (1999)

• Speech processing• Studdert-Kennedy & Mody (1995)

• Association does not mean causation

Does poor sound processing cause SLI or dyslexia?

• Tallal, Merzenich et al. (1996)• Training programme

• Frequency-modulated tones

• CV syllables• CVC syllables• Words• Phrases• Sentences

• 11 children SLI• Lab: 3 hours per day, 5 days a

week, for 1 month• Home: 1-2 hours per day, 7

days a week, for 1 month• Significant gains in spoken

language tests

• Claim: “The measured improvement in a child’s threshold for correctly segmenting and sequencing successive nonverbal auditory stimuli was significantly correlated with post-training outcome in on-line language processing”

• !!!!! Correlation does not mean causation!!!!

Fast ForWord• Claim: “Once a programme is found to be

effective, it is a reiterative process to determine what specific training components are most effective, so that the programme can be improved. It is anticipated that many future studies will address these issues.” (Tallal, 2000, p. 151).

• Where are they?• Does training low-level sound processing

improve spoken language or reading skills?

Questions• How many children with SLI or dyslexia

have a sound processing deficit?• What type do they have?• Can sound processing deficits be fixed?• Does this improve spoken language,

reading, spelling, or phonological processing?

Children Dyslexia SLI Control

N 66 28 38

Age (months) 82-183* 97-168* 86-148*

Non-verbal IQ (ss) 80-131* 80-126* 89-131**

Recalling Sentences (ss) 4-13** 1-13* 7-16***

Nonword Repetition (ss) 6-14** 3-13* 8-15***

TROG (ss) 60-120* 55-106**

BPVS (ss) 83-121* 68-108** CC Nonwords (z) -2.41-2.37* -2.41-0.01* -0.94-2.41**

CC Irregular words (z) -2.41-1.32* -2.41-0.57* -0.99-1.94** no reported sensory, neurological, physical, emotional, social problems

Good Bad

Pre-training tests

• Spoken language• Recalling sentences (Clinical Evaluation Language

Fundamentals -4)• Nonword repetition (NEPSY)

• Reading• Nonwords (Castles and Coltheart lists)• Irregular Words (Castles and Coltheart lists)

• Spelling• Regular words (Test of Written Spelling)• Irregular words (Test of Written Spelling)

• Phoneme Discrimination• Alliteration test with pictures (Phonological

Assessment Battery)

Pre-training tests

• Sound processing tests• Frequency discrimination• Rapid auditory processing• Vowel discrimination• Consonant-vowel discrimination

• Threshold scores• If produced abnormal score on first run then

did again to check that score was valid

• Target impaired sound processing• Frequency Discrimination• Rapid auditory processing• Vowels• Consonant vowels

• Home training• Laptop• ½ hour per day• 4 days per week• 6 weeks

Training

Post-training tests• Spoken language

• Recalling sentences (Clinical Evaluation Language Fundamentals -4)

• Nonword repetition (NEPSY)• Reading

• Nonwords (Castles and Coltheart lists)

• Irregular Words (Castles and Coltheart lists)

• Spelling• Regular words (Test of Written

Spelling)• Irregular words (Test of Written

Spelling)• Phonological awareness

• Alliteration test with pictures (Phonological Assessment Battery)

• Sound processing tests• Frequency discrimination• Rapid auditory processing• Vowel discrimination• Consonant-vowel

discrimination

Delayed tests• Spoken language

• Recalling sentences (Clinical Evaluation Language Fundamentals -4)

• Nonword repetition (NEPSY)• Reading

• Nonwords (Castles and Coltheart lists)

• Irregular Words (Castles and Coltheart lists)

• Spelling• Regular words (Test of Written

Spelling)• Irregular words (Test of Written

Spelling)• Phonological awareness

• Alliteration test with pictures (Phonological Assessment Battery)

• Sound processing tests• Frequency discrimination• Rapid auditory processing• Vowel discrimination• Consonant-vowel

discrimination

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How many children with SLI or dyslexia have a sound processing deficit?

Dyslexia SLI Control

F(2, 131) = 9.69, p < .001)

individual’s mean threshold for all 4 tasks

22/66 14/2833% 50%

Limit of normal scores

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Frequency Discrimination

What type?

Dyslexia SLI Control22/66 9/2833% 32%


F(2, 131) = 6.49, p = .002)

F(2, 130) = 5.92, p = .003)

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Consonant-vowel Discrimination

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Vowel Discrimination

What type?


Dyslexia SLI Control12/66 8/2818% 29 %

F(2, 129) = 3.26, p = .04) F(2, 131) = 2.82, p = .02)

FD RAP Vowel CV FD RAP Vowel CV

Can frequency discrimination be trained?

1: Mean improvement from pre-tests to immediate post-tests for FD trainees

No training effect = 00

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Impr

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(t)Mean improvement from pre- to post-testing

95% CI; if falls over 0 then no sig change

SLI/dyslexia FD trained Untrained controlsN = 19 N = 38

Frequency Discrimination

Can rapid auditory processing be trained?

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SLI/dyslexia RAP train Untrained controlsN = 3 N = 38

Rapid Auditory Processing

Can vowel discrimination be trained?

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SLI/dyslexia V trained Untrained controlsN = 3 N = 38

Vowel Discrimination

Can consonant-vowel discrimination be trained?

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SLI/dyslexia CV trained Untrained controlsN = 10 N = 38

Consonant-vowel Discrimination

Does this improve spoken language?

Recalling Sentences Nonword repetition

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Imm Del Imm Del Imm

Dyslexia SLI Controls

Imm Del Imm Del Imm


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Does this improve reading?

Phonological Decoding Sight word reading

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Imm Del Imm Del Imm


Does this improve spelling?

Regular words Irregular words

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Imm Del Imm Del Imm


Does this improve phoneme discrimination?

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Imm Del Imm Del ImmDyslexia SLI Controls

Answers• How many children have a sound processing

deficit?• Dyslexia: 33%• SLI: 50%

• What type do they have?• FD>Vowel=CV>RAP

• Can sound processing deficits be fixed?• Yes

• Does this improve spoken language, reading, spelling, or phonological processing?• No

Why do we look so cheerful?

Fast ForWord• “Once a programme is found to be effective, it is a

reiterative process to determine what specific training components are most effective, so that the programme can be improved. It is anticipated that many future studies will address these issues.” (Tallal, 2000, p. 151).

• Fast ForWord• Frequency-modulated tones • CV syllables• CVC syllables• Words• Phrases• Sentences

• 2 hours per day, 5 days a week, for 6 to 8 weeks• Focus training on tasks that might work (good for FFW)• Halve the amount of training (good for kids)

Confirmation

• We are all on the same page• Research so far supports current speech,

language, and reading practice• Hit the problem at the level of the problem:

spoken language and reading

These kids can learn

• But they need much more practice• Not enough time, money, or therapists• Children can be persuaded to practice with

1000s of boring sounds using software• What could be done if you could use

software to get them to practice with 1000s of trials of relevant spoken and written verbal stimuli?

Thank you

the sound training study - cheri

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