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Perceptual Development and Sequencing Skills in Children with a History of Ear Infections

Perceptual Development and Sequencing Skills in Children with a History of Ear Infections. Margaret Adair University of Arkansas mladair@uark.edu. Overview. Why? Early identification of children who are at risk for learning disorders How?

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Perceptual Development and Sequencing Skills in Children with a History of Ear Infections

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  1. Perceptual Development and Sequencing Skills inChildren with a History of Ear Infections Margaret Adair University of Arkansas mladair@uark.edu

  2. Overview • Why? • Early identification of children who are at risk for learning disorders • How? • Looking at perceptual asynchrony across multiple physical systems • Comparing language skills across children with or without one or multiple asynchronic systems

  3. Literature Review • Gibson’s(1966) foundation • Individual sensory units (e.g., vision, hearing, touch) have to function as an active and interactive system • The working combination of senses– the “perceptual organ” • This idea sets the foundation for thinking of the interactive senses as being vital to perceptual development of children

  4. Literature Review • Senses as Systems– more recent studies • Stein & Meredith (1993)– senses merge with each other during processing • Kemeny et al. (2006)– fMRI study showed interaction of visual, auditory & articulatory-perceptual systems during formulation & production of language

  5. Literature Review • Development, Sensory Systems, & Perceptual Deficiencies • Perception via vision, hearing, and oral-tactile systems • Common feature: require coordinated motor action– time/space motor issues frequently cited in literature on learning disabilities • Likely that these motor issues would be a common feature for all physical modalities rather than just for a single sensory system (Getchell, McMenamin, & Whitall, 2005)

  6. Literature Review • Integrated Sensory Systems • Different forms of sensory specific perception depend on each other for complete understanding– McGurk effect (Thesen, Vibell, Calvert, & Osterbauer, 2004) • Insufficient coordination of visual, auditory, and oral-motor modalities are highly suspect for children with learning disorders, which are linked to spoken, heard, and seen symbol systems (Rosner, 1975; Hagstrom, 2003)

  7. Literature Review • PE Tube Controversy • Longitudinal Pennsylvania study– placement versus non-placement of PE tubes DID NOT correlate with the development of language skills or with school failure (Neighmond, 2007) • Is there more to it than JUST the PE tubes? • What if there are more deficient sensory systems than just the ear’s?

  8. Literature Review • How do we identify oral-motor sensory-perceptual problems in preschool children? • Until recently, there has not been an formal measure. • The Preschool Repetition Test is a newly developed oral-motor test for children as young as two years of age (Chait & Roy, 2007)

  9. Purpose of the Study To investigate one particular subset of pre-school children, i.e., those with a history of ear infections, in order to determine if differences in oral-motor functioning co-existed for these young children

  10. Participants 37 Participants Age range: 23 -59 months 6 10 5 16 Ear Status: No Ear Infections: n=9 History of Ear Infections & No Tubes: n=17 History of Ear Infections + Tubes: n=11

  11. Materials • Developmental History Form • Preschool Repetition Test (Chiat & Roy, 2007) • MacArthur-Bates Communicative Development Inventories– measure of language acquisition (Fenson et. al, 2007)

  12. Procedures • Children sought in Preschools throughout Northwest Arkansas • Parents completed Developmental History and MacArhur-Bates Communicative Development Inventories (Vocabulary sections only) prior to data collection • Preschool Repetition Test administered to children

  13. Question 1: Did children with a history of ear infections have poorer language skills than children without a history of ear infections? No History of Ear Infections History of Ear Infections History of Ear Infections & Tubes

  14. Question 2: Do children with oral-motor asynchrony have poorer language skills than children without oral-motor asynchrony? 79% 82% 75% 14% 17% 9% 9% 7% 8% Above age expected Vocabulary Scores Age expected Vocabulary Scores Below age expected Vocabulary Scores

  15. Question 3: Did children with a history of ear infections who also displayed oral-motor asynchrony have poorer language skills? Above and within age expected total Repetition score Below age expected total Repetition score

  16. Question 4: Did children with a history of ear infections who received PE tube have better language skills than children with ear infections who did not received PE tubes or children with no history of ear infections if oral-motor asynchrony was also present? History of Ear Infections, Plus Tubes History of Ear Infections; No Tubes

  17. Discussion • On the surface, same results as Pennsylvania study but variation suggests further research • Two of the four children with oral-motor asynchrony (& ear infections) had poorer vocabulary scores • One child was an exception: history of ear infections & PE tubes and oral-motor asynchrony but above age-expected vocabulary • Only children with a history of ear infections had oral-motor asynchrony

  18. Conclusions • Suggests that combined ear infections and oral-motor asynchrony may provide sufficient reason to evaluate a child’s linguistic development • This may be an issue for a small subset of children • Other factors may contribute to perceptual developmental delay in addition to ear infections and oral-motor asynchrony (i.e., visual focusing)

  19. Limitations & Future Directions • Limited number of participants • Unable to study children in depth • No participants with oral-motor asynchrony and without a history of ear infections • Demographics • Vocabulary inventory alone used to assess language

  20. References Chait, S. & Roy, P. (2007). The Preschool Repetition Test: An evaluation of performance in typically developing children and clinically referred children. Journal of Speech, Language and Hearing Research, 50, 429-443. Desjardins, R. N. & Werker, J. F. (2004). Is the integration of heard and seen speech mandatory for infants? Developmental Psychobiology, 45, 187-203. Ear infections and language development. [Pamphlet]. (2001). Rockville, MD:ASHA. Fenson, L., Marchman, V. A., Thal, D., J., Dale, P.S., Reznick, J. S., & Bates, E., (2007). MacAurthur –Bates Communicative Development Inventories. Baltimore, MD: Paul H. Brookes Publishing. Fletcher, S. G. (1993). Articulation: A physiological approach. New York: Grune & Stratton. Fulk, G. W., & Gross, D. A. (2001). Relationship between refractive status and teacher evaluations of school achievement. Journal of Optometric Vision Development,32(3), 80-82. Getchell, N., McMenamin, S., & Whitall, J. (2005). Dual motor task coordination in children with and without learning disabilities. Adapted Physical Activity Quarterly, 22(1), 21. Gibson, J. J. (1966). The senses considered as perceptual systems. Boston, MA: Houghton Mifflin. Hagstrom, F. (2003). Unpublished manuscript. Kemmeny, S., Xu, J., Park, G. H., Hosey, L. A., Wettig, C. M., & Braun, A. R. (2006). Temporal dissociation of early lexical access and articulation using a delayed naming task — An fMRI study. Cerebral Cortex, 16(4), 587-595. Klein, S. & Rapin, I. (1992). Intermittent conductive hearing loss and language development. In D. Bishop and K. Mogford (Eds.). Language development in exceptional circumstances (pp. 96-109). Hillsdale, NJ: Erlbaum. Kelso, S. J. (1997). Dynamic patterns: the self-organization of brain and behavior. Cambridge, MA: The MIT Press. Loritz, D. (1999). How the brain evolved language. New York, NY: Oxford University Press. Neighmond, P. (2007). Ear tubes in children may be over-prescribed. Retrieved February 23, 2007, from http://www.npr.org Norrix, L. W., Plante, E., & Vance, R. (2006). Auditory–visual speech integration by adults with and without language-learning disabilities. Journal of Communication Disorders, 39(1), 22-36. Paradise, J.L., Feldman, H.M., Campbell, T.F, et al. (2001) Effect of early or delayed insertion of tympanostomy tubes for persistent otitis media and developmental outcomes at the age of 3 years. The New England Journal of Medicine, 344(11), 79-87.

  21. References Continued Paradise, J.L., Feldman, H.M., Campbell, T.F, et al. (2007). Tympanostomy tubes and developmental outcomes at 9 to 11 years of age. The New England Journal of Medicine, 356(3), 248-261. Paul, R. (2007). Language Disorders from Infancy through Adolescence. St. Louis, MO: Mosby. Polka, L., & Rvachew, S. (2005). The impact of otitis media with effusion on infant phonetic perception. Infancy, 8, 101-117. Roberts, J. (2004). Otitis media, hearing loss, and language learning: Controversies and current research. Journal of Development and Behavioral Pediatrics, 25, 110-122. Roland, P., & Brown, O. (1990). Tympanostomy tubes: A rational clinical treatment for middle ear disease. Topics in Language Disorders, 11(1), 23-28. Rosner, J. (1975). Helping children overcome learning difficulties. Oxford: Walker. Rosner J. (1990). Spatial awareness assessment program. Austin, TX: Pro-Ed. Rosner, J. (1999). Symposium on vision and learning. Journal of optometric vision development, 30(3), 116-121. Rosner, J., Hagstrom, F., & Dunkelberger, M. (2001). Parent and teacher’s guide to understanding and treating children with puzzling school learning problems: dyslexia, ADD, learning disabilities. Houston: University of Houston College of Optometry. Sams, M., Mottonen, R. & Sihvonen, T. (2005). Seeing and hearing others and oneself talk. Cognitive Brain Research, 23, 429-435. Sigmundsson, H., Hansen, P. C., & Talcott, J. B. (2003). Do ‘clumsy’ children have visual deficits. Behavioral Brain Research, 139(1/2), 123. Smith, A. & Zelaznik H. N. (2004). Development of functional synergies for speech motor coordination in childhood and adolescence. Developmental Psychobiology, 45, 22-33. Smits-Engelsman, B.C.M., Wilson, P.H., Westenberg, Y., & Duysens, J. (2003). Fine motor deficiencies in children with developmental coordinating disorder and learning disabilities: An underlying open-loop control deficit. Human Movement Science, 22(4-5), 495-513. Stein, B.E. & Meredith, M. A. (1993). The merging of the senses. Cambridge, MA: MIT Press. Thensen, T., Vibell, J. F., Calvert, G. A., & Osterbauer, R. A. (2004). Neuroimaging of multisensory processing in vision, audition, touch, and olfaction. Cognitive Processing, 5(2), 84-93.

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