Language ENvironment Analysis Research Articles

Improving Parents’ Interactions with Children with Hearing Loss Using Data-based Feedback

ABSTRACT An AB single case design was used to measure the effect of data-based feedback for 6 children in a listening and spoken language early intervention (EI) programme in Australia. Changes in the number of parent-child conversational turns following feedback were measured using an automated language environment analysis system. The perceived value and practicality of the feedback model were also investigated. A functional relationship was demonstrated between the intervention and an increase in the number of conversational turns for 4 of the children. Therapists were able to implement the model with high fidelity and perceived the intervention to be effective in changing parent behaviours. Parents reported the feedback helped them to improve their verbal interactions with their children. This study has provided preliminary evidence that supports the feasibility and the positive impact of data-based feedback in a listening and spoken language EI programme.

Using Technology to Monitor Hearing Device Use and Linguistic Environments: Early Intervention Providers' Perspectives.

To improve outcomes for children with hearing loss, early intervention professionals must work with families to optimize children's hearing device use and the linguistic and auditory features of children's environments. Two technologies with potential use in monitoring these domains are data logging and Language Environment Analysis (LENA) technology. This study, which surveyed early intervention providers, had two objectives: (a) to determine whether providers' experiences, perspectives, and current practices indicated there was a need for tools to better monitor these domains, and (b) to gain a better understanding of providers' experiences with and perspectives on use of the two technologies. Most providers reported that they used informal, subjective methods to monitor functioning in the two domains and felt confident that their methods allowed them to know how consistently children on their caseloads were wearing their hearing devices and what their environments were like between intervention visits. Although most providers reported limited personal experience with accessing data logging information and with LENA technology, many reported receiving data logging information from children's audiologists. Providers generally believed access to the technologies could be beneficial, but only if coupled with proper funding for the technology, appropriate training, and supportive administrative policies.

Randomised control language intervention for infants of adolescent mothers.

Create a Language ENvironment Analysis (LENA)-based intervention to increase adolescent and infant speech and improve 12-month language outcomes. Randomised control trial of adolescent (15-19years) mother-infant pairs comparing language-motor (intervention) and motor (control) groups. Intervention included reviewing language-motor curriculums, formative feedback on 4 LENA recordings (baseline, post-curriculum, 4 and 12-months) and 16-weekly language-motor texts. Controls reviewed a motor curriculum, summative feedback of four recordings after study completion and 4-monthly motor texts. Primary outcome was 12-month MacArthur scores. Secondary outcomes were LENA counts and social impacts to language outcomes. A total of 108 infants were randomised. Groups had similar baseline characteristics and LENA counts. Both groups had low maternal Peabody Picture Vocabulary age-equivalents (14.2years). On post-curriculum recording, intervention infants had higher vocalisations (188 vs 109, P=.02) and conversations (49 vs 30, P=.005) than controls. Group 4-month and 12-month LENA counts and 12-month MacArthur scores were similar. In regression analyses, more people in the home and cohabiting with the infant's father were associated with higher MacArthur scores. Linguistic feedback and a simple curriculum resulted in short-term increased vocalisations and conversational turns for infants of adolescent mothers that were not sustained over time. Household characteristics provided protective effects on outcomes.

Accuracy of the Language Environment Analysis System Segmentation and Metrics: A Systematic Review.

Purpose The Language Environment Analysis (LENA) system provides automated measures facilitating clinical and nonclinical research and interventions on language development, but there are only a few, scattered independent reports of these measures' validity. The objectives of the current systematic review were to (a) discover studies comparing LENA output with manual annotation, namely, accuracy of talker labels, as well as involving adult word counts (AWCs), conversational turn counts (CTCs), and child vocalization counts (CVCs); (b) describe them qualitatively; (c) quantitatively integrate them to assess central tendencies; and (d) quantitatively integrate them to assess potential moderators. Method Searches on Google Scholar, PubMed, Scopus, and PsycInfo were combined with expert knowledge, and interarticle citations resulting in 238 records screened and 73 records whose full text was inspected. To be included, studies must target children under the age of 18 years and report on accuracy of LENA labels (e.g., precision and/or recall) and/or AWC, CTC, or CVC (correlations and/or error metrics). Results A total of 33 studies, in 28 articles, were discovered. A qualitative review revealed most validation studies had not been peer reviewed as such and failed to report key methodology and results. Quantitative integration of the results was possible for a broad definition of recall and precision (M = 59% and 68%, respectively; N = 12-13), for AWC (mean r = .79, N = 13), CVC (mean r = .77, N = 5), and CTC (mean r = .36, N = 6). Publication bias and moderators could not be assessed meta-analytically. Conclusion Further research and improved reporting are needed in studies evaluating LENA segmentation and quantification accuracy, with work investigating CTC being particularly urgent. Supplemental Material https://osf.io/4nhms/.

From the Editors

In a recent survey study by Finestack and Sutterland (2018), formal language sample analysis (LSA) was reportedly used frequently to evaluate child language outcomes by less than a third of speech-language pathologists who provided early intervention services or who worked with elementary-aged children. The respondents indicated they most often employed mean length of utterance and type-token ratio as outcome measures when using language sampling as an evaluation tool for their clients. These survey results, along with results from other such surveys (e.g., Pavelko, Owens, Ireland, & Hahs-Vaughn, 2016; Westerveld & Claessen, 2014), were the impetus for this issue of Topics in Language Disorders, edited by Dr. Cheryl Scott. The group of articles in this issue addresses the potential for LSA to help identify spoken and written language difficulties, determine important therapeutic goals, and effectively monitor treatment progress when working with individuals who are at risk for or have been identified with a language disorder. These articles also shed light on many shortcomings of conventional LSA and associated measures (such as those mentioned earlier), while offering suggestions for overcoming at least some of these shortcomings using novel approaches and measures. We hope that these articles will inspire more practitioners and researchers to use formal LSA in their work on behalf of children and adults with language impairments and to think “outside the box” about the possibilities of LSA as a vital diagnostic and outcomes assessment tool. We suspect in the next decade or so, as efforts to deploy automation (e.g., the LENA [Language Environment Analysis] system) and artificial intelligence in linguistic applications (e.g., machine learning and natural language processing) continue to accelerate and improve, that the collection, transcription, and extraction of data from contextual language samples will be afforded without great effort or much time on the part of the clinician or researcher. The coupling of new and neglected clinical applications and measures discussed in this collection of articles with advances in technology and computing pose exciting future prospects for LSA, but as we see in this issue, LSA has much to offer even now. —Gary A. Troia, PhD, CCC-SLP Co-Editor —Sarah E. Wallace, PhD, CCC-SLP Co-Editor

Couple relationship quality and the infant home language environment: Gender-specific findings.

Couple relationship quality is known to drop significantly across the transition to parenthood (Ahlborg & Strandmark, 2001; Doss, Rhoades, Stanley, & Markman, 2009), yet individual differences in the amount of parent-to-infant talk have rarely been studied in relation to variation in couple relationship quality. Addressing this gap, the current study of 93 first-time parents with 4-month-old infants included multimeasure reports of couple relationship quality from both mothers and fathers and examined associations between couple relationship quality and the home language environment, assessed via the Language Environment Analysis (LENA), when infants were approximately 7 months old. LENA consists of a wearable talk pedometer that records a full day of naturalistic parent-infant talk and is coupled to software that provides automated analysis. Given the covariation between depression and both couple relationship quality and parental infant-directed talk, both maternal and paternal depression were controlled for in all analyses. Results showed that, for mothers of sons, frequency of infant-directed talk was inversely related to couple relationship quality. Consistent with family systems theory, this finding provides partial support for the compensation hypothesis. However, variation in couple relationship quality was unrelated to infant-directed speech in fathers or in mothers of daughters. Together, these findings demonstrate that the gender composition of the parent-infant dyads plays a moderating role on the association between couple relationship quality and parent-infant talk.

How many words are Australian children hearing in the first year of life?

BackgroundThere is evidence that parents from more socioeconomically disadvantaged backgrounds engage in fewer verbal interactions with their child than more advantaged parents. This leads to the so-called, ‘30 million-word gap’. This study aims to investigate the number of words children hear and the number of vocalizations children produce in their first year of life and examines whether these aspects of the early language home environment differ by maternal education.MethodsMothers were recruited into a five-year prospective cohort study and categorized into either high or low maternal education groups. Data was derived from the first two waves of the study, when the children were six and twelve months old. At both waves, children were involved in day-long audio recordings using the Language Environment Analysis software that provided automatic counts of adult words spoken to the child, child vocalizations and conversational turns. Descriptive results are presented by maternal education groups.ResultsThere was large variation within each maternal education group, with the number of adult words spoken to the child ranging from 2958 to 39,583 at six months and 4389 to 45,849 at twelve months. There were no meaningful differences between adult words, child vocalizations or conversational turns across maternal education groups at either wave of data collection.ConclusionsThese results show that a word gap related to maternal education is not apparent up to twelve months of age. The large variability among both maternal education groups suggests that universal interventions that encourage all parents to talk more to their child may be more appropriate than interventions targeted towards disadvantaged families during the first year of life.

Investigation of the effectiveness of a community-based parent education program to engage families in increasing language interactions with their children

The home language environment (HLE) is robustly associated with children's later language and literacy abilities. The present study used a quasi-experimental comparison design to examine the changes in LENA (Language ENvironment Analysis) estimates of the HLE for participants who completed a community-based parent-education program relative to participants who regularly visit the library, but did not participate in the program. Twenty-eight caregivers and their 0- to 30-month-old children made up the comparison sample. They were matched on key control variables using propensity score matching techniques to participants in the intervention sample. The intervention sample was 28 caregivers and their children drawn from the larger sample of participants who completed the educational program. Using longitudinal growth curve modeling, we found significant growth in weekly estimates in adult language input to children, conversational turn-taking, and child vocalizations for the intervention group, but not for the comparison group. Community-delivered interventions have the potential to engage caregivers to provide enriching language environments that lead to children's healthy language development.

What do bilingual infants actually hear? Evaluating measures of language input to bilingual-learning 10-month-olds.

Examining how bilingual infants experience their dual language input is important for understanding bilingual language acquisition. To assess these language experiences, researchers typically conduct language interviews with caregivers. However, little is known about the reliability of these parent reports in describing how bilingual children actually experience dual language input. Here, we explored the quantitative nature of dual language input to bilingual infants. Furthermore, we described some of the heterogeneity of bilingual exposure in a sample of French-English bilingual families. Participants were 21 families with a 10-month-old infant residing in Montréal, Canada. First, we conducted language interviews with the caregivers. Then, each family completed three full-day recordings at home using the Language Environment Analysis recording system. Results showed that children's proportion exposure to each language was consistent across the two measurement approaches, indicating that parent reports are reliable for assessing a bilingual child's language experiences. Further exploratory analyses revealed three unique findings: (a) there can be considerable variability in the absolute amount of input among infants hearing the same proportion of input, (b) infants can hear different proportions of language input when considering infant-directed versus overheard speech, (c) proportion of language input can vary by day, depending on who is caring for the infant. We conclude that collecting naturalistic recordings is complementary to parent-report measures for assessing infant's language experiences and for establishing bilingual profiles.

Accuracy of the language environment analysis (LENA) speech processing system for detecting communicative vocalizations of young children

Automated audio processing systems, such as the Language Environment Analysis (LENA) system, are useful tools for understanding developmental language behaviors for clinical and basic research purposes. However, it is still unclear how accurate they may be in comparison to the traditional gold standard of evaluation by trained human listeners. In our study, human coders identified starts and ends of communicative vocalizations of children and adults from sampled audio in day-long LENA recordings of 23 families with a child with variable hearing status; accuracy of LENA was then determined for each recording by comparing LENA and human-derived labels for 100-ms frames of sampled audio. Preliminary analysis suggests that LENA accurately identified communicative vocalizations of the target child wearing the device as being produced by that target child 65% of the time (35% error); accuracy ranged from 49%—79% across recordings. When any child vocalization was correctly identified, LENA accurately distinguished whether this belonged to the target child or another child 75% of the time (25% error); accuracy, however, ranged from 7%—96%. These accuracy levels suggest caution is needed in applying popular speech processing systems like LENA to clinical and scientific questions in absence of additional validation measures.

The CREATE study: Pilot testing Cumulative Personal Environmental Exposure and Educational Readiness Assessments in Pre-school Children (ages 3-4)

TPS 731: Neurological effects in children, Exhibition Hall, Ground floor, August 26, 2019, 3:00 PM - 4:30 PM Background: Preschool is a critical time for neurological growth and development in children. Few studies have attempted to measure personal air pollution exposure simultaneously with family and home characteristics such as verbal language exposure, important predictors of future educational outcomes. The Cumulative Risks, Early Development and Academic Trajectories (CREATE) pilot study aims to assess personal, home and school exposure with growth and development data among 3-4 year old preschool children. Methods: Small backpacks were equipped with personal air monitors and t-shirts designed with Language EnviroNment Analysis system (LENA) technology to collect air and language data for two consecutive 24-hour periods. Plug-in air pollution monitors were also stationed in each child’s home and school. Collection time, percent missing, and percent of time fine particulate matter (PM2.5) > 35 µg/m3 along with minimum, maximum, and average PM2.5 were calculated in R version 3.5.2 for each location, timepoint, day, and child combination and compared across location and day graphically and statistically. A urine collection protocol was also tested. Results: Missing data arose from unintentional unplugging of air monitors. However, few significant differences in air pollution summary measures across location or day were observed (p>. 05). Technical challenges in the school environment suggest home and personal measurement may be more valid and reliable metrics of child personal exposures compared to school. Maternal, paternal and other adult language also varied by location and time of day. Over 85% of 3-4 year olds were compliant with the first 24 hours of air monitoring and day one urine collection, which dropped to 50% on day two. Conclusions: It is possible to collect personal air exposure and language environment data in preschool children’s home and school environments. Future studies may not require multi-location or multi-day collection for establishing a baseline, rather repeat measurement should occur at longer intervals.

Sequences of toddler negative emotion and parent-toddler verbal communication during a waking day.

Although the second year of life is characterized by dramatic changes in expressive language and by increases in negative emotion expression, verbal communication and emotional communication are often studied separately. With a sample of twenty-five one-year-olds (12-23months), we used Language Environment Analysis (LENA; Xu, Yapanel, & Gray, 2009, Reliability of the LENA™ language environment analysis system in young children's natural home environment. LENA Foundation) to audio-record and quantify parent-toddler communication, including toddlers' vocal negative emotion expressions, across a full waking day. Using a multilevel extension of lag-sequential analysis, we investigated whether parents are differentially responsive to toddlers' negative emotion expressions compared to their verbal or preverbal vocalizations, and we examined the effects of parents' verbal responses on toddlers' subsequent communicative behavior. Toddlers' negative emotions were less likely than their vocalizations to be followed by parent speech. However, when negative emotions were followed by parent speech, toddlers were most likely to vocalize next. Post hoc analyses suggest that older toddlers and toddlers with higher language abilities were more likely to shift from negative emotion to verbal or preverbal vocalization following parent response. Implications of the results for understanding the parent-toddler communication processes that support both emotional development and verbal development are discussed.

Use of the LENA Autism Screen with Children who are Deaf or Hard of Hearing.

Background and Objectives: This systematic review reports the evidence from the literature concerning the potential for using an automated vocal analysis, the Language ENvironment Analysis (LENA, LENA Research Foundation, Boulder, CO, USA) in the screening process for children at risk for autism spectrum disorder (ASD) and deaf or hard of hearing (D/HH). ASD and D/HH have increased comorbidity, but current behavioral diagnostic and screening tools have limitations. The LENA Language Autism Screen (LLAS) may offer an additional tool to disambiguate ASD from D/HH in young children. Materials and Methods: We examine empirical reports that use automatic vocal analysis methods to differentiate disordered from typically developing children. Results: Consensus across the sampled scientific literature shows support for use of automatic methods for screening and disambiguation of children with ASD and D/HH. There is some evidence of vocal differentiation between ASD, D/HH, and typically-developing children warranting use of the LLAS, but additional empirical evidence is needed to better understand the strengths and weaknesses of the tool. Conclusions: The findings reported here warrant further, more substantive, methodologically-sound research that is fully powered to show a reliable difference. Findings may be useful for both clinicians and researchers in better identification and understanding of communication disorders.

Assessment of a Parent-Child Interaction Intervention for Language Development in Children

Parent-child interactions are critical for language development in early life. To test whether a clinic-based intervention was associated with improved home language environment and language development. A pre-post study of a multifaceted clinic-based intervention called Talk It Up was conducted for 61 English- or Spanish-speaking families with children aged 2 to 12 months. Enrollment took place at a single urban pediatric clinic from January to November 2017, with follow-up data collection through May 2018. Analyses took place from June to August 2018. The 6-month multifaceted intervention consisted of delivering Language Environment Analysis word counts with clinician feedback, coaching, and twice-weekly pushes of brief instructional videos via a commercially available smartphone application. Baseline and follow-up z scores for adult word counts, parent-child conversational turns, and child vocalizations and language development as measured by the Developmental Snapshot score were compared and adjusted for confounders. Among 61 families, the mean (SD) child's age at baseline was 5.9 (3.3) months. English was the primary language spoken in the home for 54 families (89%). At follow-up, Talk It Up was associated with significant improvements in adult word counts (mean z score, 0.30; 95% CI, 0.05-0.55), parent-child conversational turns (mean z score, 0.29; 95% CI, 0.002-0.59), and Developmental Snapshot score (mean, 6.59; 95% CI, 0.95-12.23), but there were no improvements in child vocalizations (mean z score, -0.13; 95% CI, -0.49 to 0.24). A multifaceted clinic-based approach to promote parent-child interactions holds some promise. Future, larger studies are warranted.

Reliability of the Language Environment Analysis Recording System in Analyzing French-English Bilingual Speech.

Purpose This study examined the utility of the Language ENvironment Analysis (LENA) recording system for investigating the language input to bilingual infants. Method Twenty-one French-English bilingual families with a 10-month-old infant participated in this study. Using the LENA recording system, each family contributed 3 full days of recordings within a 1-month period. A portion of these recordings (945 minutes) were manually transcribed, and the word counts from these transcriptions were compared against the LENA-generated adult word counts. Results Data analyses reveal that the LENA algorithms were reliable in counting words in both Canadian English and Canadian French, even when both languages are present in the same recording. While the LENA system tended to underestimate the amount of speech in the recordings, there was a strong correlation between the LENA-generated and human-transcribed adult word counts for each language. Importantly, this relationship holds when accounting for different-gendered and different-accented speech. Conclusions The LENA recording system is a reliable tool for estimating word counts, even for bilingual input. Special considerations and limitations for using the LENA recording system in a bilingual population are discussed. These results open up possibilities for investigating caregiver talk to bilingual infants in more detail.

Remote Microphone System Use at Home: Impact on Child-Directed Speech.

Purpose The impact of home use of a remote microphone system (RMS) on the caregiver production of, and child access to, child-directed speech (CDS) in families with a young child with hearing loss was investigated. Method We drew upon extant data that were collected via Language ENvironment Analysis (LENA) recorders used with 9 families during 2 consecutive weekends (RMS weekend and no-RMS weekend). Audio recordings of primary caregivers and their children with hearing loss obtained while wearing and not wearing an RMS were manually coded to estimate the amount of CDS produced. The proportion of CDS that was likely accessible to children with hearing loss under both conditions was determined. Results Caregivers produced the same amount of CDS when using and when not using the RMS. However, it was concluded that children with hearing loss, on average, could potentially access 12% more CDS if caregivers used an RMS because of their distance from their children when talking to them. Conclusion Given our understanding of typical child language development, findings from this investigation suggest that children with hearing loss could receive auditory, speech, and language benefits from the use of an RMS in the home environment.

Automated Measures to Understand Communication Opportunities for Young Children With Autism in the Community: A Pilot Study.

Community participation is vital to children's development and provides opportunities to practice social communication skills. Although previous studies suggest that young children with autism spectrum disorders (ASD) experience decreased community participation, there is little empirical evidence on the precise patterns of participation that may influence social communication opportunities. Therefore, this pilot study investigated the communication among families of children with ASD ( n = 5) versus typical development (TD; n = 5) across various community locations. We used automated, objective measures: the Language ENvironmental Analysis (LENA) system™ to measure the amount of communication and integrated this with a Global Positioning System (GPS; that is, Qstarz™) to measure community location. Results showed that families of children with ASD and TD spent a similar amount of time in community locations; however, there were differences in the amount of adult talk directed toward children with ASD versus TD across community locations. Findings suggest that automated measures may be successfully integrated to quantify social communication during community participation.

Understanding acoustic-phonetic environments of prelingual children with cochlear implants: Challenges, tools, and insights

Variability in auditory and linguistic environments experienced by prelingual children with cochlear implants (CIs) potentially helps explain variation in their language outcomes. Here, results are presented from several studies from our lab investigating early acoustic-phonetic environments of children with CIs. One collaborative study conducted over 10 years investigated individual differences in acoustic-phonetic quality of maternal speech as predictors of language outcomes in children with CIs. Results showed that properties of maternal speech recorded in the lab—as indexed in part by measures derived from vowel formants and fundamental frequency—significantly predicted infants’ language outcomes and growth on multiple standardized assessments two years after cochlear implantation. Other work has examined the usefulness of a widely adopted commercial automatic speech processing technology—the Language ENvironment Analysis (LENA) system—for investigating individual differences in auditory environments. Results from our study suggested considerable variability across samples in LENA’s accuracy at identifying adult speech, limiting LENA’s value for investigating individual differences in acoustic-phonetic input to children with CIs. Finally, an update is provided on current work using combined signal processing and hand-coding approaches aimed at investigating variability in acoustic input to children with CIs in their home environments. [Work supported by NIH grant R01DC008581.]

A Cross-cultural Mixed Methods Investigation of Language Socialization Practices.

This embedded mixed methods study explores how cultural differences in language socialization practices influence parent-child verbal interactions. The Language ENvironment Analysis (LENA) System audio recorded families of children who are and are not deaf and hard of hearing in Canada and Vietnam. Software automatically calculated an average conversational turn count. Canadian families participated in more turns than Vietnamese families regardless of hearing status. Interviews with the children's caregivers provided context for these results. Within Vietnamese families, the language socialization practice "Intelligence" results in reduced opportunities for turn-taking, while the Canadian focus on creating personal "Identity" encouraged them. "Intelligence" encompasses Vietnamese participants' desire to ensure their children are learning and "Identity" expresses the Canadian participants' appeal to encourage individuality in their children. The findings suggest directions for the adaptation of intervention. It is the first known study to incorporate LENA results into a mixed methods design.

A Naturalistic Study of Child and Family Screen Media and Mobile Device Use.

Parental mediation of screen media (e.g., television, video games) is associated with better outcomes for children. Although much research has examined parental mediation of television (TV), there is a dearth of research examining communication about mobile media (e.g., Smartphones, tablets) in the digital age. This study seeks to identify themes of family communication around media and mobile devices using naturalistic observational methodology. The sample consisted of 21 toddlers (ages 12-24-months old), 31 preschool-age children (3-5 years old), and 23 school-age (10-13 years old) children and their families. Children wore Language ENvironment Analysis (LENA) audio recording devices, which recorded vocalizations and other sounds proximal to the child wearing the device in the home environment, as well as audible screen media use. ATLAS.ti was used to transcribe dialogue from the audio recordings that pertained to screen media. Experts from the fields of communication, clinical child psychology, and developmental-behavioral pediatrics independently analyzed the transcripts to identify common themes. Five main themes emerged. First, parental mediation of screen media was primarily restrictive, reactive, and focused on technology functionality. Second, active mediation was child-driven. Third, siblings played a more dominant role in mediation than parents. Fourth, parents and children negotiated screen time limits. Finally, parallel family media use was common. Multiple family members engaged with their own mobile devices while simultaneously being exposed to background screen media (i.e., media multitasking). Assessing media use in the naturalistic home environment elucidated current patterns of family media use and communication about media in the digital age.