Retest reliability of the Wechsler Preschool and Primary Scale of Intelligence restandardized in Iran

Executive functions in Persian-speaking preschool children with speech sound disorders and comparison with their typically developing peers

This study aimed to compare working memory, inhibitory control, and cognitive flexibility, the core components of executive functions, among two prevalent subtypes of preschool children with speech sound disorder, i.e., phonological delay (n = 16) and consistent phonological disorder (n = 15), and a group of typically developing children (n = 18). The correlation between executive function components and the accuracy of speech sound production were also investigated. Nonword repetition task and syllable repetition task were used to evaluate the phonological loop of working memory. Backward digit span was administered to examine the central executive of working memory. Cognitive flexibility was assessed using the second selection of the flexible item selection task and inhibitory control using Stroop-like and Go/No-Go tasks. The percentage consonants correct was applied to calculate the accuracy of speech sound production. Results of a one-way multivariate analysis of covariance revealed statistically significant differences between groups in the combined dependent variables after controlling for age (F(14, 80) = 17.289, p < .001, Pillai's trace = 1.503, partial ηƞ² = .752). Typically developing children outperformed in all measurements of executive functions than both speech sound disorder subgroups. Moreover, children with phonological delay performed better in nonword repetition and corrected responses of Stroop-like than consistent phonological disorder group. All executive function measurements also correlated with speech sound production. The results of the present study highlight the importance of including domain-general cognitive skills in current assessment protocols for children with phonological delay and consistent phonological disorders.

The Development of a New Test for Consecutive Assessment of Narrative Skills in Iranian School-Age Children

BACKGROUND

The assessment of narrative skills in young children is essential for early identification of potential learning and literacy-related difficulties. The present study aimed to develop a validated and reliable test for consecutive assessment of narrative skills in Iranian school-age children.

METHODS

To elicit story retelling by the children, 14 pictures (each a discrete test) were developed based on which 14 stories were scripted in accordance with the Stein and Glenn model. The pictures were presented to 50 typically developing (TD) children and seven children with autism spectrum disorder (ASD) in Kerman, Iran, 2018. The recorded audio of retold stories by the children was transcribed and analyzed using the monitoring indicator of scholarly language (MISL) instrument. The SPSS software (Version: 18.0) was used to analyze the data with the significance level set at 0.05.

RESULTS

A high correlation between the total MISL score of each test and each MISL item (r>0.5) confirmed the construct validity of our test. A comparison of the mean total MISL score between the TD and ASD groups showed significant differences (P<0.001) for all pictures. The internal consistency coefficient was >0.7 between all the MISL items and the intraclass correlation coefficient between the test and retest scores was >0.96 for all pictures. The repeated measures ANOVA did not indicate significant differences (P=0.15) between the total MISL scores of the pictures.

CONCLUSION

The validity and reliability of the developed test were confirmed, suggesting it can be used for consecutive assessment and monitoring of the narrative skills in school-aged children.

Relationship between working memory and comprehension and expression of grammar in Farsi-speaking children with cochlear implants

OBJECTIVES

Grammar is one of the most fundamental components of language and working memory (WM) is one of the most important cognitive features. These two skills play a vital role in learning, literacy and communication. Children with cochlear implants (CIs) experience delays in both of these skills. The aim of this study was to investigate the relationship between these two skills in children with CIs.

SUBJECTS AND METHODS

The sample consisted of 20 Farsi-speaking children with CIs. WM was estimated by forward and backward auditory digit spans (FBS and BDS) from the Persian (Farsi) version of the Wechsler Intelligence Scale for Children, 4th edition. The comprehension of grammar by participants was evaluated using the Persian Syntax Comprehension Test. Grammar expression was assessed using the Photographic Expressive Persian Grammar Test. Pearson's correlation and simple linear regression were used for data analysis.

RESULTS

The results of linear regression and correlation showed a strong correlation between comprehension of grammar and FDS (r = 0.61; p = 0.004) was obtained, between BDS and comprehension of grammar (r = 0.161; p = 0.080). FDS and expression of grammar (r = 0.163; p = 0.222) showed a positive but insignificant correlation.

CONCLUSION

The results indicate that WM decisively effects grammar. Enhancement of the phonological loop can improve grammar, especially comprehension of grammar. The effect of the central executive in grammar requires further research.

The effects of narrative-based language intervention (NBLI) on spoken narrative structures in Persian-speaking cochlear implanted children: A prospective randomized control trial

BACKGROUND

Previous research has shown that narrative-based language intervention (NBLI) is a feasible approach increasing the narrative skills of hearing-impaired children.

OBJECTIVE

In the present study, the efficacy of NBLI on the macrostructure and microstructure components of the spoken narrative of children with cochlear implants (CI) was evaluated in an experimental study.

MATERIALS AND METHODS

Thirty-six CI children between the ages of 5.5 and 7 years were randomly divided in three groups of equal size. Group 1 attended 24 1-h sessions of NBLI group therapy. Group 2 participants each attended 24 1-h private sessions of NBLI instruction. Group 3 attended 24 1-h conventional speech therapy (CST) sessions. The subjects' storytelling skills were prompted using pictures from the Persian version of the Language Sample Analysis test. The results were assessed before treatment (T0), after treatment (T1) and two months after treatment (T2) as follow-up.

RESULTS

Groups 1 and 2 showed significantly better results over Group 3 on all microstructure components of spoken narrative at the T1 (p ≤ 0.04) and T2 (p ≤ 0.04) levels in comparison with T0, but no differences were observed between the NBLI approaches (p > 0.05). All three intervention programs significantly improved the macrostructure of the spoken narrative in CI children.

CONCLUSION

Improvements in spoken narrative structures were observed in CI children that support the efficacy of NBLI over CST for the hearing-impaired population.

Spoken and Written Narrative in Persian-Speaking Students Who Received Cochlear Implant and/or Hearing Aid

OBJECTIVES

To compare narrative skills between fourth and fifth grades of Persian-speaking students with hearing impairments and typical hearing students of the same grade and also to evaluate the effects of group, sex, hearing age, and educational grade of the students on their spoken/written narrative performance.

METHODS

The subjects were 174 students aged 10-13 years, 54 of whom wore cochlear implants, 60 suffered from moderate to severe hearing losses and wore hearing aids, with the remaining 60 students being typical hearing in terms of the sense of hearing. The micro- and macrostructure components of spoken and written narrative were elicited from a pictorial story (The Playful Little Elephant) and then scored by raters.

RESULTS

Compared to the typical hearing, the students with hearing impairments had significantly lower scores in all of the microstructure components of narratives. However, the findings showed no significant difference among different groups in macrostructure components of narratives. It was also revealed that the students had equal performance in spoken and written narrative. Finally, factor analysis manifested that group, sex, hearing age, and educational level of children might alter the outcome measures in various interactions.

CONCLUSION

Although cochlear implantation was more effective than hearing aid on spoken and written narrative skills, the Persian-speaking students with hearing impairments were seen to need additional trainings on microstructure components of spoken/written narrative.

Assessment of narrative writing by Persian-speaking students with hearing impairments

OBJECTIVE

Previous studies have highlighted that narrative skill is critical to the development of the literacy skills by children. Children with cochlear implants (CI) and hearing aids (HA) may have problems in narrative development compared to peers with healthy hearing (HH). There is no exact data about the narrative writing ability of Persian-speaking students who are hearing-impaired. This study was undertaken to compare the microstructure and macrostructure scores for narrative writing of Persian-speaking students who are hearing-impaired and peers with HH.

DESIGN

This was a cross-sectional descriptive-analytical study.

SETTING

The subjects were recruited from elementary schools in the city of Tehran.

PARTICIPANTS

A total of 144 elementary school students were participated.

OUTCOME MEASURES

The written narratives were elicited using a wordless pictorial storybook story. Three-way ANOVA with post hoc adjusted Bonferroni test was applied to determine the main effects and interactions of grounded variables on the microstructure and macrostructure components of narrative writing.

RESULTS

No significant differences were observed in the macrostructure components of narrative writing between hearing-impaired and HH students. Factors analysis showed that the 4th grade HH students had significantly the highest scores, and the 3rd grade HA students had significantly the lowest scores in microstructure components of narrative writing.

CONCLUSION

The findings revealed that hearing-impaired students similarly to their HH peers can transmit the main idea (macrostructure) of narrative writing, but show critical difficulties when using complete grammatical elements (microstructures) to form sentences to convey the idea in the narrative.

Working memory span in Persian-speaking children with speech sound disorders and normal speech development

OBJECTIVES

The aim of this study was to compare working memory span in Persian-speaking preschool children with speech sound disorder (SSD) and their typically speaking peers. Additionally, the study aimed to examine Non-Word Repetition (NWR), Forward Digit Span (FDS) and Backward Digit Span (BDS) in four groups of children with varying severity levels of SSD.

METHODS

The participants in this study comprised 35 children with SSD and 35 typically developing (TD) children -matched for age and sex-as a control group. The participants were between the age range of 48 and 72 months. Two components of working memory including phonological loop and central executive were compared between two groups. We used two tasks (NWR and FDS) to assess phonological loop component, and one task (BDS) to assess central executive component. Percentage of correct consonants (PCC) was used to calculate the severity of SSD.

RESULTS

Significant differences were observed between the two groups in all tasks that assess working memory (p < 0.001). In addition, the comparison of the phonological loop of working memory between the various severity groups indicated significant differences between different severities of both NWR and FDS tasks among the SSD children (p < 0.001). Nevertheless, comparison of the central executive between various severity groups, which was assessed with the BDS task, did not show any significant differences (p > 0.05). The result showed that PCC scores in TD children were associated with NWR (p < 0.001), FDS (p = 0.001), and BDS (p < 0.001). Furthermore, PCC scores in SSD children were associated with NWR and FDS (p < 0.001), but not with BDS (p > 0.05).

CONCLUSION

The working memory skills were weaker in SSD children, in comparison to TD children. In addition, children with varying levels of severity of SSD differed in terms of NWR and FSD, but not BDS.

Intellectual and Developmental Status in Children With Hyperphenylalaninemia and PKU Who Were Screened in a National Program

BACKGROUND

Hyperphenylalaninemia (HPA) and Phenylkeonuria (PKU) are metabolic errors caused by deficiency of phenylalanine hydroxylase enzyme, which results in increased level of phenylalanine. This increase is toxic to the growing brain.

OBJECTIVES

The purpose of this study was to compare the intellectual and developmental status in HPA and PKU children with normal population in national screening program.

PATIENTS AND METHODS

In a historical cohort study, 41 PKU patients who had the inclusion criteria and 41 healthy children were evaluated. Wechsler preschool and primary scale of intelligence-3rd edition (WPPI-3) was used in order to assess the intellectual status of children 4 years and older and Ages and stages questionnaire (ASQ) was used to assess the developmental status of children 5 years and younger.

RESULTS

In intellectual test comparison, the two groups showed significant difference in Wechsler's performance intelligence score and some performance subscales (P-value < 0.01). In comparison of developmental status, no significant difference was observed between the two groups (P-value > 0.05).

CONCLUSIONS

Even with early diagnosis and treatment of PKU patients, these children show some deficiencies intellectually compared to normal children. This study emphasizes on necessity for screening intellectual and developmental status of PKU patients so that effective medical or educational measures can taken in case of deficiencies.

Working memory in Farsi-speaking children with normal development and cochlear implant

AIM AND BACKGROUND

Working memory has an important role in language acquisition and development of cognition skills. The ability of encoding, storage and retrieval of phonological codes, as activities of working memory, acquired by audition sense. Children with cochlear implant experience a period that they are not able to perceive sounds. In order to assess the effect of hearing on working memory, we investigated working memory as a cognition skill in children with normal development and cochlear implant.

METHODS

Fifty students with normal hearing and 50 students with cochlear implant aged 5-7 years participated in this study. Children educated in the preschool, the first and second grades. Children with normal development were matched based on age, gender, and grade of education with cochlear implant. Two components of working memory including phonological loop and central executive were compared between two groups. Phonological loop assessed by nonword repetition task and forward digit span. To assess central executive component backward digit span was used. The developmental trend was studied in children with normal development and cochlear implant as well. The effect of age at implantation in children with cochlear implants on components of working memory was investigated.

RESULTS

There are significant differences between children with normal development and cochlear implant in all tasks that assess working memory (p < 0.001). The children's age at implantation was negatively correlated with all tasks (p < 0.001). In contrast, duration of usage of cochlear implant set was positively correlated with all tasks (p < 0.001). The comparison of working memory between different grades showed significant differences both in children with normal development and in children with cochlear implant (p < 0.05).

CONCLUSION

These results implied that children with cochlear implant may experience difficulties in working memory. Therefore, these children have problems in encoding, practicing, and repeating phonological units. The results also suggested working memory develops when the child grows up. In cochlear implant children, with decreasing age at implantation and increasing their experience in perceiving sound, working memory skills improved.