Spoken Language Comprehension Research Articles

Determinants of spoken language comprehension in children with cerebral palsy

Purpose To identify determinants of spoken language comprehension (SLC) in children with cerebral palsy (CP). Materials and methods Cross-sectional data of 207 children with CP were included: 82 toddlers (18 months–3;11 years), 59 preschool children (4;0–5;11 years), and 66 schoolchildren (6;0–8;11 years), across all Gross Motor Function Classification System (GMFCS) levels. SLC was assessed using the Computer-Based instrument for Low motor Language Testing (C-BiLLT). Potential determinants were retrieved from medical files and through parental questionnaires. Per developmental stage, multivariable regression analyses were used to assess determinants of SLC. Results Fifty-nine percent of the children showed below average SLC. Significant determinants for SLC differed per developmental stage. In toddlers: age, motor type, functional communication and speech function (R 2 = 0.637); in preschool children: functional communication, speech function and language activities (R 2 = 0.820), and in schoolchildren: functional communication, intellectual functioning and arm-hand functioning (R 2 = 0.807). For all developmental stages, functional mobility was not a significant determinant. Conclusions A large proportion of children with CP across all GMFCS levels have SLC impairments. Findings indicate that SLC is strongly determined by functional communication classified with CFCS. We recommend standardized assessment and monitoring of SLC in all children with CP. IMPLICATIONS FOR REHABILITATION Children across all GMFCS levels can experience difficulties in spoken language comprehension. At all developmental stages, functional communication (classified with CFCS) is an important determinant of spoken language comprehension. Standardized assessment and monitoring of spoken language comprehension, language production, speech, and communication of all children with CP, is strongly recommended. When children show below average performances, especially in spoken language comprehension, intervening with speech and language therapy and guidance for parents, is advised.

Gesture and reference to objects in the here-and-now: Listeners' use of gesture cues in quiet and in noise.

In face-to-face interaction, speakers spontaneously produce manual gestures that can facilitate listeners' comprehension of spoken language. The present study explores the factors affecting the uptake and influence of gesture cues in situations where a speaker is referring to objects visible to the listener. In this context, the listener's attention must be distributed across various scene regions, potentially reducing the ability to draw on and apply gesture cues in real time. In two experiments, the instruction provided by a speaker (e.g., "pick up the candy") was accompanied by an iconic grasp gesture (produced alongside the verb) that reflected the size/shape of the intended target. Effects on listeners' comprehension were compared with a no-gesture condition. Experiment 1 (audiovisual gating task) showed that, under simplified processing circumstances, gesture cues allowed earlier identification of intended targets. Experiment 2 (eye tracking) explored whether this facilitation is found in real-time comprehension, and whether attention to gesture information is influenced by the acoustic environment (quiet vs. background noise). Measures of gaze position showed that although the speaker's gesturing hand was rarely fixated directly, gestures did facilitate comprehension, particularly when the target object was smaller relative to alternatives. The magnitude of the gesture effect was greater in quiet than in noise, suggesting that the latter did not provoke listeners to increase attention to gesture to compensate for the challenging auditory signal. Together, the findings clarify how situational factors influence listeners' attention to visual information during real-time comprehension. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Syllable inference as a mechanism for spoken language understanding

A classic problem in spoken language comprehension is how speech is perceived as comprised of discrete words. A Syllable Inference account of spoken word recognition and segmentation is proposed, according to which alternative hierarchical models of syllables, words, and phonemes are dynamically posited. Estimates of context speech rate are combined with generative models, such that over time, models which result in local minima in error between predicted and recently experienced signals give rise to perceptions of hearing words. Evidence for this account comes from experiments using the visual world eye-tracking paradigm. Materials were sentences that were acoustically ambiguous in numbers of syllables, words, and phonemes they contained. Time-compressing, or expanding, speech materials permitted determination of how temporal information at, or in the context of, each locus affected looks to, and selection of, pictures with a singular or plural referent. Supporting our account, listeners probabilistically interpreted identical chunks of speech as consistent with a singular or plural referent to a degree that was based on the chunk’s gradient rate in relation to its context. These results support the Syllable Inference account that arriving temporal information informs inferences about syllables, giving rise to perception of words separated in time.

Expository discourse skills of students with reading comprehension difficulties

Purpose: The ability to produce expository discourse (the use of language to convey information) is important for classroom participation and access to the curriculum, particularly during the middle school years. This study investigated the spoken expository discourse skills of students with reading comprehension (RC) difficulties compared to their peers with average reading skills. Method: In this study, we administered a modified favourite game or sport (M-FGS) task developed by Heilmann and Malone to 48 students who were in their fifth year of schooling (9.33 − 11.11 years of age). Expository language samples were transcribed and analysed on measures of (a) microstructure: syntax (MLU in words) and vocabulary (number of different words [NDW]); and (b) macrostructure (Expository Scoring Scheme [ESS]). Result: Compared to their peers with average RC skills, students with RC difficulties demonstrated significant difficulties at the micro- and macro-structure levels. Subgroup analysis revealed the importance of spoken language comprehension proficiency (at text level) for expository discourse skills. Conclusion: The results from this small-scale investigation demonstrated the usefulness of the M-FGS task in describing challenges in expository discourse of students with RC difficulties, with clear implications for intervention.

The Validity and Reliability of the Language Battery in Comprehensive Aphasia Test-Turkish (CAT-TR)

Aphasia assessment is the initial step of a well-structured language therapy. Therefore, it is reasonable to underline that the assessment tools need to consider the typological and cultural characteristics of the language. A group of international researchers in the Collaboration of Aphasia Trialists have been adapting the Comprehensive Aphasia Test (CAT) into 14 languages spoken in Europe including Turkish. Thus, the aim of this study was to perform the validity and reliability analyses of the Language Battery section of CAT-TR to ensure the assessment of Turkish-speaking people with aphasia (PWA). The test included 21 sub-tests and yielded six modality scores (spoken language comprehension, written language comprehension, repetition, naming, reading, writing). Ninety PWA (Mean AGE = 61.07) and 200 controls (Mean AGE = 54.89) involved in the analyses. The participants were stratified into two education and three age groups. The analyses belonging to content, construct and criterion validity were performed, while the reliability analyses included internal consistency, test-retest and inter-rater reliability. Education influenced all the modality scores of the controls, while age-related differences were significant among all the modality scores except reading. It has to be underlined that Education did not hold any significant effects on the language performance of PWA, whereas those younger than 60 showed statistically better performance in the Spoken and Written Language Comprehension modality scores. The cut-off scores for each modality and Language Battery were presented with high sensitivity and specificity values. Compared to the psychometric characteristics of the adapted versions of CAT and aphasia tests utilized in Turkey, CAT-TR is an appropriate test for the language assessment of Turkish-speaking adults with aphasia.

The "two-brain" approach reveals the active role of task-deactivated default mode network in speech comprehension.

Exhibiting deactivation and anticorrelation with task-positive networks, the default mode network (DMN) has been traditionally thought to be suppressed to support externally oriented cognitive processes during spoken language comprehension. In contrast, recent studies examining listener-listener intersubject correlation (ISC) have proposed an active role of DMN in language comprehension. How can we reconcile those seemingly conflicting results? This study adopted a "two-brain" paradigm and combined "within-brain" and "across-brain" analyses to address this issue. We found, despite being deactivated and anticorrelated with the language network (LN) and executive control network (ECN), both the anterior and posterior DMN in the listeners' brains were temporally coupled with the homologous networks in the speaker's brain. Interestingly, the listener-speaker neural couplings persisted even after controlling for listener-listener ISC. Moreover, the coupling strength of posterior DMN positively correlated with the listeners' speech comprehension. Further dynamic causal modeling showed that the LN and ECN, the anterior DMN, and the posterior DMN occupied the bottom, intermediate, and top layers of a hierarchical system, respectively. We suggest the DMN may primarily serve as an internal module that cooperates with the externally oriented modules, potentially supporting the transformation of external acoustic signals into internal mental representations during successful language comprehension.

Cognitive impairment networks in Alzheimer's disease: Analysis of three double-blind randomized, placebo-controlled, clinical trials of donepezil

Psychometric network analysis is an alternative theoretically-driven analytic approach that has the potential to conceptualize cognitive impairment in Alzheimer's disease differently than was previously assumed and consequently detect unknown treatment effects. Based on individual participant data, extracted from three double-blind, randomized placebo-controlled clinical trials, psychometric networks were computed on observed Alzheimer's Disease Assessment Scale Cognitive Subscale scores at baseline (N=1,554) and on predicted change scores at 24 weeks of follow-up for participants who received donepezil (N=797) or placebo (N=484). A novel conceptualization of cognitive impairment in Alzheimer's disease was displayed through the baseline network, that had 90% (n=27) positive statistically significant (p<0.05) associations, and a most central aspect of ideational praxis. Following 24 weeks, treatment effects emerged via the differences between the change score networks. The donepezil network had more statistically significant (p<0.05) positive associations and a higher global strength (n=15; S=1.22; p=0.03), than the placebo network (n=8; S=0.57). This suggests that for those who were treated with donepezil compared with placebo, cognition is a more unified construct. The main aspects of change in cognitive impairment were comprehension of spoken language for the donepezil network and spoken language ability for the placebo network. Comprehension of spoken language apears to be most sensitive to psychopharmaceutical interventions and should therefore be closely monitored. Overall, our psychometric network analysis presents a new conceptualization of cognitive impairment in Alzheimer's disease, points to previously unknown treatment effects and highlights well-defined aspects of cognitive impairment that may translate into future treatment targets.

The VIDAS Data Set: A Spoken Corpus of Migrant and Refugee Spanish Learners.

The VIDAS data set (Verbal Interaction Dataset of Acquired Spanish) presents data from 200 participants from different countries and language backgrounds (50 Philippines with L1 Tagalog; 50 Ukrainians with L1 Ukrainian; 50 Moroccans with L1Arabic; 50 Romanians with L1 Romanian). They completed an oral expression and interaction test in the context of a Spanish certification exam for adult migrants. The aim of the VIDAS data set is to provide researchers in psycholinguistics and second language acquisition with a Spanish spoken corpus of traditionally marginalized and underrepresented learners, providing a compelling data set of oral interactions by migrants and refugees. The corpus contains more than 29 h of recordings of the oral interactions of the participants with trained interviewers, as well as background information about the participants (age, gender, maximum education level, years of residence, and language background). It furthermore contains the scores obtained by the participants in the oral expression and interaction exam. The VIDAS corpus allows for the development of studies on L2 spoken language comprehension and processing, as well as for comparative analyses of language acquisition between different L1 groups at different linguistic levels.

Hemispheric dissociations in regions supporting auditory sentence comprehension in older adults.

We investigated how the aging brain copes with acoustic and syntactic challenges during spoken language comprehension. Thirty-eight healthy adults aged 54 - 80 years (M = 66 years) participated in an fMRI experiment wherein listeners indicated the gender of an agent in short spoken sentences that varied in syntactic complexity (object-relative vs subject-relative center-embedded clause structures) and acoustic richness (high vs low spectral detail, but all intelligible). We found widespread activity throughout a bilateral frontotemporal network during successful sentence comprehension. Consistent with prior reports, bilateral inferior frontal gyrus and left posterior superior temporal gyrus were more active in response to object-relative sentences than to subject-relative sentences. Moreover, several regions were significantly correlated with individual differences in task performance: Activity in right frontoparietal cortex and left cerebellum (Crus I & II) showed a negative correlation with overall comprehension. By contrast, left frontotemporal areas and right cerebellum (Lobule VII) showed a negative correlation with accuracy specifically for syntactically complex sentences. In addition, laterality analyses confirmed a lack of hemispheric lateralization in activity evoked by sentence stimuli in older adults. Importantly, we found different hemispheric roles, with a left-lateralized core language network supporting syntactic operations, and right-hemisphere regions coming into play to aid in general cognitive demands during spoken sentence processing. Together our findings support the view that high levels of language comprehension in older adults are maintained by a close interplay between a core left hemisphere language network and additional neural resources in the contralateral hemisphere.

Prototyping Mobile Storytelling Applications for People with Aphasia.

Aphasia is a partial or total loss of the ability to articulate ideas or comprehend spoken language, resulting from brain damage, in a person whose language skills were previously normal. Our goal was to find out how a storytelling app can help people with aphasia to communicate and share daily experiences. For this purpose, the Aphasia Create app was created for tablets, along with Aphastory for the Google Glass device. These applications facilitate social participation and enhance quality of life by using visual storytelling forms composed of photos, drawings, icons, etc., that can be saved and shared. We performed usability tests (supervised by a neuropsychologist) on six participants with aphasia who were able to communicate. Our work contributes (1) evidence that the functions implemented in the Aphasia Create tablet app suit the needs of target users, but older people are often not familiar with tactile devices, (2) reports that the Google Glass device may be problematic for persons with right-hand paresis, and (3) a characterization of the design guidelines for apps for aphasics. Both applications can be used to work with people with aphasia, and can be further developed. Aphasic centers, in which the apps were presented, expressed interest in using them to work with patients. The Aphasia Create app won the Enactus Poland National Competition in 2015.

A Comparative Study of Structural and Metabolic Brain Networks in Patients With Mild Cognitive Impairment.

Background: Changes in the metabolic and structural brain networks in mild cognitive impairment (MCI) have been widely researched. However, few studies have compared the differences in the topological properties of the metabolic and structural brain networks in patients with MCI.Methods: We analyzedmagnetic resonance imaging (MRI) and fluoro-deoxyglucose positron emission tomography (FDG-PET) data of 137 patients with MCI and 80 healthy controls (HCs). The HC group data comes from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. The permutation test was used to compare the network parameters (characteristic path length, clustering coefficient, local efficiency, and global efficiency) between the two groups. Partial Pearson’s correlation analysis was used to calculate the correlations of the changes in gray matter volume and glucose intake in the key brain regions in MCI with the Alzheimer’s Disease Assessment Scale-Cognitive (ADAS-cog) sub-item scores.Results: Significant changes in the brain network parameters (longer characteristic path length, larger clustering coefficient, and lower local efficiency and global efficiency) were greater in the structural network than in the metabolic network (longer characteristic path length) in MCI patients than in HCs. We obtained the key brain regions (left globus pallidus, right calcarine fissure and its surrounding cortex, left lingual gyrus) by scanning the hubs. The volume of gray matter atrophy in the left globus pallidus was significantly positively correlated with comprehension of spoken language (p = 0.024) and word-finding difficulty in spontaneous speech item scores (p = 0.007) in the ADAS-cog. Glucose intake in the three key brain regions was significantly negatively correlated with remembering test instructions items in ADAS-cog (p = 0.020, p = 0.014, and p = 0.008, respectively).Conclusion: Structural brain networks showed more changes than metabolic brain networks in patients with MCI. Some brain regions with significant changes in betweenness centrality in both structural and metabolic networks were associated with MCI.

Individual Differences in Political Ideology and Disgust Sensitivity Affect Real-Time Spoken Language Comprehension.

Individuals' moral views have been shown to affect their event-related potentials (ERP) response to spoken statements, and people's political ideology has been shown to guide their sentence completion behavior. Using pupillometry, we asked whether political ideology and disgust sensitivity affect online spoken language comprehension. 60 native speakers of English listened to spoken utterances while their pupil size was tracked. Some of those utterances contained grammatical errors, semantic anomalies, or socio-cultural violations, statements incongruent with existing gender stereotypes and perceived speaker identity, such as “I sometimes buy my bras at Hudson's Bay,” spoken by a male speaker. An individual's disgust sensitivity is associated with the Behavioral Immune System, and may be correlated with socio-political attitudes, for example regarding out-group stigmatization. We found that more disgust-sensitive individuals showed greater pupil dilation with semantic anomalies and socio-cultural violations. However, political views differently affected the processing of the two types of violations: whereas more conservative listeners showed a greater pupil response to socio-cultural violations, more progressive listeners engaged more with semantic anomalies, but this effect appeared much later in the pupil record.

Literacy can enhance syntactic prediction in spoken language processing.

Language comprehenders can use syntactic cues to generate predictions online about upcoming language. Previous research with reading-impaired adults and healthy, low-proficiency adult and child learners suggests that reading skills are related to prediction in spoken language comprehension. Here, we investigated whether differences in literacy are also related to predictive spoken language processing in non-reading-impaired proficient adult readers with varying levels of literacy experience. Using the visual world paradigm enabled us to measure prediction based on syntactic cues in the spoken sentence, prior to the (predicted) target word. Literacy experience was found to be the strongest predictor of target anticipation, independent of general cognitive abilities. These findings suggest that (a) experience with written language can enhance syntactic prediction of spoken language in normal adult language users and (b) processing skills can be transferred to related tasks (from reading to listening) if the domains involve similar processes (e.g., predictive dependencies) and representations (e.g., syntactic). (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Primary visual cortex is activated by spoken language comprehension

Primary visual cortex is activated by spoken language comprehension

Spoken Language Skills in Children With Bilateral Hearing Aids or Bilateral Cochlear Implants at the Age of Three Years.

Objectives:Early hearing aid (HA) fitting and cochlear implants (CIs) aim to reduce the effects of hearing loss (HL) on spoken language development. The goals of this study were (1) to examine spoken language skills of children with bilateral HAs and children with bilateral CIs; (2) to compare their language skills to the age-norms of peers with normal hearing (NH); and (3) to investigate factors associated with spoken language outcomes.Design:Spoken language results of 56 Finnish children with HL were obtained from a nationwide prospective multicenter study. Children with HL comprised two groups: children with mild-to-severe HL who used bilateral HAs (BiHA group, n = 28) and children with profound HL who used bilateral CIs (BiCI group, n = 28). Children’s spoken language comprehension, expressive and receptive vocabulary, and phonological skills were compared with normative values of children with NH at the age of three years. Odds ratio (OR) was calculated to compare proportions of children below age-norms in BiHA and BiCI groups. Factors associated with spoken language outcomes were modeled with analysis of covariance.Results:At the age of 3 years, 50%–96% of children with HL performed 1 SD or more below the mean of the normative sample of age-peers with NH in spoken language skills, depending on the language domain. Receptive vocabulary and phonological skills were the most vulnerable language domains. In receptive vocabulary, 82% of the children in the BiHA group and 50% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 4.4 times more likely to have poorer receptive vocabulary than the BiCI group. In phonological skills, 96% of children in the BiHA group and 60% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 18.0 times more likely to have poorer phonological skills than the BiCI group. The analysis of covariance models showed that unaided pure-tone average, PTA0.5–4 kHz, had a significant effect on spoken language comprehension in the BiHA group. For the BiCI group, age at HL diagnosis and age at CI activation had a significant effect on expressive vocabulary. High maternal level of education had a significant effect on language comprehension and expressive vocabulary and female gender on phonological skills.Conclusions:At the age of 3 years, especially receptive vocabulary and phonological skills caused difficulties for children with HL showing also considerable individual variation. Children with bilateral HAs seemed to be more likely to have poorer receptive vocabulary and phonological skills than children with bilateral CIs. A variety of factors was associated with outcomes in both groups. Close monitoring of spoken language skills of children with HL is important for ensuring similar opportunities for all children with HL and timely intervention, when needed.

The cortical organization of listening effort: New insight from functional near-infrared spectroscopy

Everyday challenges impact our ability to hear and comprehend spoken language with ease, such as accented speech (source factors), spectral degradation (transmission factors), complex or unfamiliar language use (message factors), and predictability (context factors). Auditory degradation and linguistic complexity in the brain and behavior have been well investigated, and several computational models have emerged. The work here provides a novel test of the hypotheses that listening effort is partially reliant on higher cognitive auditory attention and working memory mechanisms in the frontal lobe, and partially reliant on hierarchical linguistic computation in the brain's left hemisphere. We specifically hypothesize that these models are robust and can be applied in ecologically relevant and coarse-grain contexts that rigorously control for acoustic and linguistic listening challenges. Using functional near-infrared spectroscopy during an auditory plausibility judgment task, we show the hierarchical cortical organization for listening effort in the frontal and left temporal-parietal brain regions. In response to increasing levels of cognitive demand, we found (i) poorer comprehension, (ii) slower reaction times, (iii) increasing levels of perceived mental effort, (iv) increasing levels of brain activity in the prefrontal cortex, (v) hierarchical modulation of core language processing regions that reflect increasingly higher-order auditory-linguistic processing, and (vi) a correlation between participants’ mental effort ratings and their performance on the task. Our results demonstrate that listening effort is partly reliant on higher cognitive auditory attention and working memory mechanisms in the frontal lobe and partly reliant on hierarchical linguistic computation in the brain's left hemisphere. Further, listening effort is driven by a voluntary, motivation-based attention system for which our results validate the use of a single-item post-task questionnaire for measuring perceived levels of mental effort and predicting listening performance. We anticipate our study to be a starting point for more sophisticated models of listening effort and even cognitive neuroplasticity in hearing aid and cochlear implant users.

Deficient sensory and cognitive processing in children with cochlear implants: An event-related potential study

Compared with children having normal hearing (NH), those with cochlear implants (CIs) perform poorly in spoken language comprehension which involves both low-level acoustic encoding and higher-level cognitive processing. Here, we performed an electroencephalography study to portray this brain dynamics of speech perception in CI children. We presented a Mandarin Chinese monosyllable or four-syllable idiom to CI and NH children, and infrequently varied its lexical tone to form a novel monosyllable or pseudo-idiom in an oddball paradigm. The tone contrast embedded in the monosyllables evoked similar mismatch negativities (MMNs) in CI and NH children at an early stage (~200 ms). However, the amplitude of the MMN evoked by the tone contrast in the idiom context was significantly lower in CI children than in NH children. Furthermore, robust late discriminative negativity (LDN) at a late stage (~500 ms) was found only in NH children, but not in CI children. The MMN and LDN findings indicate deficits of low-level acoustic encoding in a complex context (such as an idiom) and higher-level cognitive processing in CI children, respectively. Both deficient sensory and cognitive processing may contribute to the speech perception difficulties in CI children.

Discourse Markers Activate Their, Like, Cohort Competitors

ABSTRACT Speech in everyday conversations is riddled with discourse markers (DMs), such as well, you know, and like. However, in many lab-based studies of speech comprehension, such DMs are typically absent from the carefully articulated and highly controlled speech stimuli. As such, little is known about how these DMs influence online word recognition. The present study specifically investigated the online processing of DM like and how it influences the activation of words in the mental lexicon. We specifically targeted the cohort competitor (CC) effect in the Visual World Paradigm: Upon hearing spoken instructions to “pick up the beaker,” human listeners also typically fixate—next to the target object—referents that overlap phonologically with the target word (cohort competitors such as beetle; CCs). However, several studies have argued that CC effects are constrained by syntactic, semantic, pragmatic, and discourse constraints. Therefore, the present study investigated whether DM like influences online word recognition by activating its cohort competitors (e.g., lightbulb). In an eye-tracking experiment using the Visual World Paradigm, we demonstrate that when participants heard spoken instructions such as “Now press the button for the, like … unicycle,” they showed anticipatory looks to the CC referent (lightbulb)well before hearing the target. This CC effect was sustained for a relatively long period of time, even despite hearing disambiguating information (i.e., the /k/ in like). Analysis of the reaction times also showed that participants were significantly faster to select CC targets (lightbulb) when preceded by DM like. These findings suggest that seemingly trivial DMs, such as like, activate their CCs, impacting online word recognition. Thus, we advocate a more holistic perspective on spoken language comprehension in naturalistic communication, including the processing of DMs.

Visual Sequence Repetition Learning is Not Impaired in Signing DHH Children.

The auditory scaffolding hypothesis states that early experience with sound underpins the development of domain-general sequence processing abilities, supported by studies observing impaired sequence processing in deaf or hard-of-hearing (DHH) children. To test this hypothesis, we administered a sequence processing task to 77 DHH children who use American Sign Language (ASL) and 23 hearing monolingual children aged 7-12years and found no performance difference between them after controlling for age and nonverbal intelligence. Additionally, neither spoken language comprehension scores nor hearing loss levels predicted sequence processing scores in the DHH group, whereas ASL comprehension scores did. Our results do not indicate sequence processing deficits in DHH children and do not support the auditory scaffolding hypothesis; instead, these findings suggest that factors related to experience with and/or proficiency in an accessible language during development may be more important determinants of sequence processing abilities.

Comparing in-Person and Telepractice Service Delivery for Spoken Language Production and Comprehension Using the National Outcomes Measurement System.

The American Speech-Language-Hearing Association (ASHA) developed the National Outcomes Measurement System for aggregating standardized patient outcomes. Outcomes are standardized using Functional Communication Measures (FCM), scales designed to describe communicative function across specific areas of clinical need. This investigation compared in-person and telepractice service delivery for children in elementary school settings who received treatment targeting the FCM categories of either “spoken language production” or “spoken language comprehension.” De-identified cases were secured from ASHA's NOMS database and the database of a private e-learning provider that implemented the NOMS format. There were minimal significant differences in the median change scores between the traditional and telepractice interventions. These results support comparable treatment outcomes between in-person service delivery and telepractice for treatment of children exhibiting impaired spoken language production or spoken language comprehension in an elementary school setting.