Word Scores Research Articles

Speech sound production, speech intelligibility, and oral-motor outcomes of preterm children: Are they different from full term children?

We studied the speech sound abilities of preterm (PT) children. Thirty-one PT and twenty-nine full term (FT) children were recruited. Speech abilities were assessed in single word, story retelling, oral-motor, and intelligibility. PT group had poorer outcomes (Mean = 25.77, SD = 17.19) than FT ones (Mean = 5.9, SD = 4.97) for single word (p < 0.001). They obtained poorer results (Mean = 9.65, SD = 7.85) than FT peers (Mean = 2.95, SD = 3.34) in story retelling (p = 0.002) and intelligibility (Man-Whitney U = 89.50, p = 0.02). They obtained lower values for diadochokesis/patuku/(p < 0.001), isolated (p = 0.001), and sequenced movements (p = 0.02) but not for diadochokesis/patukejk/(p = 0.12). Significant values of correlation were found among single word scores with birth weight (r = −.54, p < .001) and gestational age (r = −0.67, p < .001) and story retelling scores with birth weight (r = −0.40, p = .013) and gestational age (r = −0.64, p < .001). The associations of single word score and maternal (r = −0.02, p = .85) and paternal education (r = −0.10, p = .41) were not significant. No significant relationships were obtained between story retelling score and maternal (r = 0.16, p = .34) and paternal education (r = 0.09, p = .59). The significant values were obtained for associations of intelligibility with isolated (r = 0.54, p = .001), sequenced movements (r = 0.59, p < .001), and diadochokesis/patukejk/(r = 0.39, p = .016) but not significant for intelligibility and diadochokesis/patuku/(r = 0.25, p = .13). Findings implied that speech abilities are weaker in PT children.

Selection of the optimal first ear for sequential bilateral cochlear implantation in children.

When there is a difference in hearing on both ears, where to perform the first cochlear implantation (CI) becomes an important issue. The purpose of the study was to evaluate which ear should be chosen for the first implantation in sequential bilateral CI with a long inter-implant period. The study population consisted of 34 severe-to-profound sensorineural hearing loss pediatrics with the inter-implant period of ≥3 years between the first CI (CI-1) and the second CI (CI-2) before the age of 19 (mean of inter-implant period: 7.1-year). The patients were classified into Group A (CI-1 was performed on the ear with better hearing), Group B (CI-1 on the ear with worse hearing), or Group C (symmetrical hearing in both ears). Speech intelligibility test results were compared between the groups. The monosyllabic word scores of CI-1 were excellent in Groups A (91.7±7.9%) and B (92.5±3.6%) but slightly lower in Group C (85.7±14.9%) before the second implantation (P = .487). At 3 years after the second implantation, all groups demonstrated excellent scores in the bilateral CI condition (95.9±3.0% in Group A; 99.1±.8% in Group B; 97.5±2.9% in Group C, P = .600). However, when the patients were tested in using CI-2 only in Groups A and B after using bilateral CI for 3 years, the scores were inconsistent in Group A (79.6±23.9%; range: 22.2-94.4%), while those were higher and more constant in Group B (92.9±4.8%; 86.8-100.0%). The first CI is strongly recommended to perform on a worse hearing ear if they had different hearing levels between ears. Even with the first CI on a worse hearing ear, its performance never deteriorates. In addition, if they receive the second CI several years later, it will be likely that the second one functions better.

A Model for Estimating Tactile Sensation by Machine Learning Based on Vibration Information Obtained while Touching an Object

The tactile sensation is an important indicator of the added value of a product, and it is thus important to be able to evaluate this sensation quantitatively. Sensory evaluation is generally used to quantitatively evaluate the tactile sensation of an object. However, statistical evaluation of the tactile sensation requires many participants and is, thus, time-consuming and costly. Therefore, tactile sensing technology, as opposed to sensory evaluation, is attracting attention. In establishing tactile sensing technology, it is necessary to estimate the tactile sensation of an object from information obtained by a tactile sensor. In this research, we developed a tactile sensor made of two-layer silicone rubber with two strain gauges in each layer and obtained vibration information as the sensor traced an object. We then extracted features from the vibration information using deep autoencoders, following the nature of feature extraction by neural firing due to vibrations perceived within human fingers. We also conducted sensory evaluation to obtain tactile scores for different words from participants. We finally developed a tactile sensation estimation model for each of the seven samples and evaluated the accuracy of estimating the tactile sensation of unknown samples. We demonstrated that the developed model can properly estimate the tactile sensation for at least four of the seven samples.

Enhancing Theory-Informed Dictionary Approaches with “Glass-box” Machine Learning: The Case of Integrative Complexity in Social Media Comments

ABSTRACT Dictionary-based approaches to computational text analysis have been shown to perform relatively poorly, particularly when the dictionaries rely on simple bags of words, are not specified for the domain under study, and add word scores without weighting. While machine learning approaches usually perform better, they offer little insight into (a) which of the assumptions underlying dictionary approaches (bag-of-words, domain transferability, or additivity) impedes performance most, and (b) which language features drive the algorithmic classification most strongly. To fill both gaps, we offer a systematic assumption-based error analysis, using the integrative complexity of social media comments as our case in point. We show that attacking the additivity assumption offers the strongest potential for improving dictionary performance. We also propose to combine off-the-shelf dictionaries with supervised “glass box” machine learning algorithms (as opposed to the usual “black box” machine learning approaches) to classify texts and learn about the most important features for classification. This dictionary-plus-supervised-learning approach performs similarly well as classic full-text machine learning or deep learning approaches, but yields interpretable results in addition, which can inform theory development on top of enabling a valid classification.

Insertion Depth and Cochlear Implant Speech Recognition Outcomes: A Comparative Study of 28- and 31.5-mm Lateral Wall Arrays.

1) To compare speech recognition outcomes between cochlear implant (CI) recipients of 28- and 31.5-mm lateral wall electrode arrays, and 2) to characterize the relationship between angular insertion depth (AID) and speech recognition. Retrospective review. Tertiary academic referral center. Seventy-five adult CI recipients of fully inserted 28-mm (n = 28) or 31.5-mm (n = 47) lateral wall arrays listening with a CI-alone device. Cochlear implantation with postoperative computed tomography. Consonant-nucleus-consonant (CNC) word recognition assessed with the CI-alone at 12 months postactivation. The mean AID of the most apical electrode contact for the 31.5-mm array recipients was significantly deeper than the 28-mm array recipients (628° vs 571°, p < 0.001). Following 12 months of listening experience, mean CNC word scores were significantly better for recipients of 31.5-mm arrays compared with those implanted with 28-mm arrays (59.5% vs 48.3%, p = 0.004; Cohen's d = 0.70; 95% CI [0.22, 1.18]). There was a significant positive correlation between AID and CNC word scores (r = 0.372, p = 0.001), with a plateau in performance observed around 600°. Cochlear implant recipients implanted with a 31.5-mm array experienced better speech recognition than those with a 28-mm array at 12 months postactivation. Deeper insertion of a lateral wall array appears to confer speech recognition benefit up to ∼600°, with a plateau in performance observed thereafter. These data provide preliminary evidence of the insertion depth necessary to optimize speech recognition outcomes for lateral wall electrode arrays among CI-alone users.

Valence, Arousal and Concreteness Mediate Word Association.

Given the impact of lexical properties such as valence, arousal, and concreteness in language processing, recent computational methods have been designed to extrapolate these values from different sources, such as word co-occurrence or word association corpora. These methods have been proven to be particularly successful approaches to extract lexical features from word association data. Consequently, valence, arousal and concreteness seem to be represented in word association, and we hypothesize that they might in fact be critical mediators in the process. To test our hypothesis, we paired the cue and associate words from three databases in three different languages with their valence, arousal and concreteness values. We then conducted linear regression analyses to see if an associate's score in each dimension could be predicted by the scores of its cue word. The analyses showed that the score of the cue words in each of the three dimensions was a strong predictor of the scores of their associates in the same dimension. Furthermore, words that were more strongly associated tended to have more similar scores. We showed that across different languages, word association is mediated and can be predicted by concreteness, arousal and valence.

Reddit use in the LIS community

This study examined online communications within library and information science (LIS)-related subreddits through the perspectives of social identity theory and social media engagement. A total of 17,049 Reddit posts from three major LIS-related subreddits were harvested through Pushshift by Python. Manual and computational coding methods were used to identify linguistic characteristics of the posts as well as the topicality of the content. Multiple logistic regressions were used to analyze the relationship between psychological and emotional characteristics of the posts and user engagement. Results showed that the majority of posts did not mention a specific type of LIS organization; of the subset that did, public libraries and academic libraries were most frequently referenced. “Library services and usage” was the topic most mentioned within LIS-related subreddits, followed by “librarians and jobs.” Various psychological features of posts including emotional tone score, authentic score, clout score, analytic score, and usage of words related to affective processes, anxiety, social processes, causation, and time were significantly related to user engagement. This study contributes to further understanding of social identity theory and social media engagement within the online communication context of LIS community. Key topics and issues in the LIS field and practical suggestions for strategies to improve social media engagement across LIS community were discussed.

Influence of the GABA Receptor Subunit Gene Polymorphism and Childhood Sexual Abuse on Processing Speed in Major Depression and Suicide Attempt.

Background: Suicide is moderately heritable and also more common in those who report childhood abuse. Previously, it was found that allele A of GABRG2 (GABA A receptor subunit gamma2) polymorphism rs211034 was protective in a suicide attempt (SA). Hence, it was proposed that rs211034 may interact with childhood trauma to influence cognitive deficits related to SA or depression risk. Genetic variants may predict the benefits of certain cognitive treatments.Methods: A total of 52 individuals who had attempted suicide, 59 individuals with major depressive disorder (MDD) or bipolar depression who had not previously attempted suicide, and 90 healthy volunteers were subjected to the modified Suicide Stroop task and were clinically assessed using the Childhood Trauma Questionnaire (CTQ) and Hamilton Depression Scale-24 items (HAMD-24). rs211034 was genotyped using Sanger sequencing.Results: After correcting for covariates, depressed participants displayed longer reaction times for all emotional conditions, including suicide-related words, compared with healthy controls. Depressed suicide attempters displayed longer reaction times for negative words than depressed non-attempters. Depressed non-attempters displayed higher interference scores for negative words compared with healthy controls. There was an interaction between rs211034 risk allele and the effects of reported childhood sexual abuse (CSA) on reaction time for all emotional words and suicide-related words. Carriers of the rs211034 risk allele A exhibited shorter reaction times, but the protective effects of this allele were eliminated in those exposed to reported CSA.Conclusion: Only limited results were found regarding effects of a past suicide attempt on response times to emotional and suicide-related words, but there was an overall effect of major depression on slower response time. Protective genetic effects of the rs211034 A allele on this slowing were eliminated in those with a history of sexual abuse during childhood. Further research is needed to better characterize the mechanisms underlying the effects of childhood trauma on these genetic effects.

The Impact of Age on Noise Sensitivity in Cochlear Implant Recipients.

To evaluate the impact of different open set sentence recognition tests in quiet, +10 dB signal to noise ratio (SNR), and +5 dB SNR in adult cochlear implant (CI) recipients above and below 65 years of age. Multi-institution, prospective, non-randomized, single-subject repeated measures design. Ninety six adults more than or equal to 18 years old with postlingual bilateral sensorineural hearing loss. Participants received a CI532 in one ear. Speech perception measures were evaluated before and 6-months after activation. Subjects completed consonant-nucleus-constant (CNC) words in quiet and AzBio sentences in noise using +10 and +5 dB SNR, and Montreal Cognitive Assessment (MOCA). Ninety six adult patients were enrolled (n = 70 older [≥65 yr], n = 26 younger [<65 yr]). There was no difference in CNC scores (CI alone 58.4% versus 67.5%, p = 0.0857; best aided 66.7% versus 76.1%, p = 0.3357). Older adults performed worse on AzBio +10 dB SNR compared with younger patients (CI alone 37.4% versus 56.9%, p = 0.0006; best aided 51.4% versus 68.2%; p = 0.01), and in AzBio +5 dB SNR (CI alone 7.7% versus 11.2%, p = 0.0002; best aided 15.3% versus 22.3%, p = 0.0005). The magnitude of change in AzBio +10 dB SNR was significantly less in older adults in CI alone (15.3% versus 22.3%; p = 0.0493) but not best aided (21.5% versus 31.3%; p = 0.105). The magnitude of change was drastically worse in AzBio +5 dB SNR for older adults (CI alone 6.7% versus 22.1%, p = 0.0014; best aided 9.5% versus 21.5%; p = 0.0142). There was no significant difference in MOCA between the two age groups. While both older and younger patients have similar outcomes with respect to CNC word scores in quiet, the addition of noise disproportionally impacts older patients. Caution should be exercised testing the elderly in noise; testing in noise may disproportionally impact performance expectations and should be more carefully considered when used for candidacy criteria and counseling. Future studies need to further investigate the disproportionate effect of noise on candidacy testing and its impact on how elderly patients are qualified.

Using ideal binary masking based on signal-to-noise ratio of temporal amplitude envelope to improve the intelligibility of speech in noise

Ideal Binary Masking (IBM), using prior information, improves speech intelligibility by attenuating noisy components with a scaling factor applied to the noise. The main challenge is to construct an appropriate decision-making model to identify noise- or speech- dominant components. In this study, we utilized the signal-to-noise ratio (SNR) of the temporal amplitude envelope in the frequency-time domain. We firstly divided the noisy speech from 200 Hz to 6 kHz, processed by MATLAB, into 16 contiguous subbands each with bandwidth approximately 1.5 times an equivalent rectangular bandwidth. The subband envelopes were produced by means of the absolute value of the signal. SNRs of the temporal envelope were calculated for 40 ms windows. The mask was unity when the SNR was greater than −5dB; otherwise, it was 0.5. We evaluated the performance of the proposed IBM on word scores obtained with different speech in speech-spectrum shaped noise SNR values of −2, −4, −6, and −8 dB. Sixteen native speakers (age 28 ± 3 years) with normal hearing were recruited for the study and underwent the Modified Rhyme Test to assess intelligibility. Statistically significant increases of up to 20% in mean word scores were obtained by this IBM. [Work supported by NIOSH.]

The summating potential in human electrocochleography: Gaussian models and Fourier analysis.

In recent electrocochleographic studies, the amplitude of the summating potential (SP) was an important predictor of performance on word-recognition in difficult listening environments among normal-hearing listeners; paradoxically the SP was largest in those with the worst scores. SP has traditionally been extracted by visual inspection, a technique prone to subjectivity and error. Here, we assess the utility of a fitting algorithm [Kamerer, Neely, and Rasetshwane (2020). J Acoust Soc Am. 147, 25-31] using a summed-Gaussian model to objectify and improve SP identification. Results show that SPs extracted by visual inspection correlate better with word scores than those from the model fits. We also use fast Fourier transform to decompose these evoked responses into their spectral components to gain insight into the cellular generators of SP. We find a component at 310 Hz associated with word-identification tasks that correlates with SP amplitude. This component is absent in patients with genetic mutations affecting synaptic transmission and may reflect a contribution from excitatory post-synaptic potentials in auditory nerve fibers.

Speech Intelligibility evaluation in the presence of speech masker of cochlear implant in a reverberant room

In this report, we investigated the performance of a cochlear implant (CI) in a reverberant room with the presence of a competing speech masker. We compared Short-Time Objective Intelligibility (STOI) and Perceptual Speech Quality (PESQ) to represent the objective, to percent correct word (PCW) and Mean Opinion Score (MOS) as subjective evaluations, respectively. The target and the masker speech were convoluted with 0.4- and 0.7-s reverberation time, respectively, then processed with a 14-channel vocoder. We set the target to the masker 5dB and 0 dB SNR. We simulated two well-known techniques, namely CIS and SPEAK processors. Ten normal-hearing paid subjects were participated to evaluate the performance in clean, reverberant with no masker and reverberant with masker. The results showed that performance degraded significantly as the reverberation duration increased. Furthermore, the presence of a masker to a target speech in a reverberant room worsened all the evaluated performances compared to the reverberant alone. The results suggested that further investigation is required to reduce the masker effect to improve CI intelligibility.

Cochlear Implantation in Elderly Patients with Residual Hearing.

This retrospective study aimed to investigate the range of hearing levels in a cochlear implant (CI) elderly population receiving electric-acoustic-stimulation (EAS) or electric-stimulation (ES) alone. The investigation evaluates the degree of hearing preservation (HP) and the speech comprehension resulting from EAS or ES-only to identify audiometric factors that predict adequate EAS and ES use. We analyzed the pure tone audiometry and speech perception in quiet and noise preoperatively and 12-months after activation of 89 elderly adults (age of 65 years old or older), yielding in total 97 CIs. Thirty-two (33.1%) patients were potential EAS candidates preoperatively, of which 18 patients used EAS at the time of first fitting and the other 14 patients continued to use their residual hearing for EAS at 12-months. Post-treatment, patients with EAS system and ES-only users’ with longer electrodes showed better results in monosyllable word scores in quiet than ES-only users with shorter electrodes. A similar trend was revealed for the speech recognition in noise. Patients with an EAS system benefit from maintaining their natural residual hearing. Nevertheless, strict preoperative patient selection is warranted particularly in elderly patients, in whom the hearing thresholds for EAS indication differ slightly from that in younger adults.

Characteristics of Japanese Electrolaryngeal Speech Produced by Untrained Speakers: An Observational Study Involving Healthy Volunteers.

Purpose The aim of this study was to investigate the characteristics of electrolaryngeal (EL) speech among untrained speakers to aid in its effective introduction and to identify syllables and words that are easy or difficult to pronounce. Method A total of 21 healthy individuals who had never used an EL were included. The participants were briefed, and tests comprising 100 Japanese syllables and 50 single words were conducted to evaluate EL speech intelligibility. A trained speaker was defined as a certified speech-language pathologist who underwent EL training for 3 months. A 5-point electrolarynx effectivity score (EES) was used for the subjective assessment of EL. Results The median (interquartile range) intelligibility scores of the untrained and trained groups were 24.0% (20.0%-34.0%) and 40.0% (36.0%-45.0%) for syllables and 48.0% (38.0%-60.0%) and 88.0% (82.0%-90.0%) for words, respectively. The intelligibility scores for syllables and words were higher in the trained group than those in the untrained group. Only two syllable subgroups (/m/ and /w/) had > 80% correct answers among untrained speakers. A total of 14 syllable subgroups (/k, kʲ, s, ɕ, t, t͡ɕ, ts, ɲ, h, ç, ɸ, p, pʲ, and a/), a number of which contained voiceless consonants, had < 40% correct answers among both speaker groups. A greater number of morae were associated with higher intelligibility scores. An EES of 4, indicating that the EL was effective, was the most frequent score. Conclusions It was difficult for untrained speakers to produce intelligible speech using an EL. Syllables, including voiceless consonants, were difficult to pronounce using an EL. Longer words with a greater number of morae were more intelligible, even for untrained EL speakers. Supplemental Material https://doi.org/10.23641/asha.16632622.

Cochlear Implantation Outcomes in Observed Vestibular Schwannoma: A Preliminary Report.

Over the last decade there has been a trend toward observation for small nongrowing vestibular schwannoma (VS). Even without tumor growth, patients commonly experience ipsilateral hearing decline, and hearing rehabilitation remains challenging. This study analyzes hearing and speech performance outcomes after cochlear implantation (CI) in observed VS. Retrospective review. Tertiary referral center. Chart review was used to include patients with observed VS who had undergone ipsilateral CI, pre- and postimplantation audiometry, and speech performance. Tumor size pre- and postimplantation was measured with volumetric analysis. Seven patients with ipsilateral VS and CI were identified. Preimplantation tumor volume was 0.11 to 1.02 cm3. Five subjects were implanted with a straight electrode and two with a perimodiolar electrode. The average preimplant pure tone average was 91.3 dB (range, 80-117 dB) and 61.2 dB (range, 12-118 dB) for the implanted and nonimplanted ears, respectively. In all subjects with at least 1 year of listening experience (n = 6), consonant-nucleus-consonant word scores improved at 6 months and 1 year in the CI-alone and bimodal listening conditions. AzBio scores in quiet also improved at 6 months and 1 year. Of subjects with serial pre- and postoperative magnetic resonance imaging, volumetric analysis demonstrated no tumor growth. Our results demonstrate that CI is a successful option for subjects with small nongrowing VS. All subjects had improved performance postimplantation. VS may continue to be observed with serial magnetic resonance imaging given increasing conditionality among CI manufacturers and ability to assess cerebellopontine angle extension despite implant artifact.

The effect of phonological complexity on the order in which words are acquired in early childhood

During the second year of life, children acquire words and expand their receptive and expressive vocabularies at a rapid pace. At this age, toddlers’ phonological abilities are also developing rapidly. The current study investigated the effect of phonological complexity of words on the order in which they are acquired, receptively and expressively. Data were collected from Hebrew-speaking parents of 881 typically developing toddlers: 417 girls and 464 boys, aged 1;0 to 2;0 years old. Parents reported on their child’s receptive and expressive vocabularies by completing a computerized version of the Hebrew adaptation of the MacArthur-Bates Communicative Development Inventories. Phonological complexity scores of the target words were calculated using the Phonological Mean Length of Utterances measure. The proportion of children who were reported to understand and produce each word at each age was calculated. Results showed that phonological complexity affected the acquisition of word comprehension and word production. Words that are less phonologically complex were acquired earlier, representing a process of subconscious selection of words that are easier to produce.

Sex differences in cognitive function of first-diagnosed and drug-naïve patients with bipolar disorder

BackgroundBipolar disorder (BD) is a severe mental illness that affects more than 1% the world's population with high recurrence rates and a series of comorbidities. Cognitive dysfunction is an endophenotype of BD, but sex influences in cognitive impairment remains unclear. MethodWe evaluated the performance of 139 patients with first-diagnosed, drug-naïve BD (44 males and 95 females) and 92 healthy controls (24 males and 68 females) using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) scale and the Stroop color–word test. ResultImmediate memory, visuospatial/constructional ability, language, attention, delayed memory, total RBANS score, and Stroop color–word scores were significantly lower in patients with first-diagnosed, drug-naïve BD than healthy participants. Thus, male patients had worse attention and delayed memory scores compared with female patients with BD. Importantly, a worse performance in visuospatial/constructional ability was negatively associated with the Young Mania Rating Scale score in male patients only. ConclusionMale patients with first-diagnosed, drug-naïve bipolar disorder had worse cognitive dysfunction than female patients in attention and delayed memory. Cognitive deficits were correlated with mania severity only in male patients. These findings reveal the sexual dimorphism in the cognitive deficits of early BD patients with mild and moderated symptoms for further pathophysiological exploration.

Subtotal Petrosectomy with Cochlear Implantation or Osseointegrated Hearing Rehabilitation: A Single Institutional Study.

To examine audiologic outcomes and operative considerations for patients undergoing subtotal petrosectomy (STP) followed by implantable hearing restoration. Retrospective review. Tertiary academic referral hospital. All patients who underwent STP and implantable hearing restoration from 2014 to 2020. Single or staged STP with cochlear implantation (CI) or placement of an osseointegrated hearing implant (OHI). Indications for STP and CI or OHI; postoperative complication and reoperation rates; audiologic outcomes through speech recognition thresholds, AzBio sentence scores, and consonant-nucleus-consonant scores. Twenty-six adults (age 33-85) and six children (age 1-17) underwent 37 STP procedures with 33 CIs and four OHI. Thirty-one cases were planned single-stage, but six (16%) cases required revision surgery postoperatively due to refractory postauricular infection and breakdown of wound closure. Therefore, 25 cases were single procedures and 12 were staged. Indications for staged procedures included extensive cholesteatoma (n = 5, 42%), chronic middle ear inflammation (n = 5, 42%), and osteoradionecrosis (n = 2, 17%). No patients with OHI required revision surgery. For patients undergoing CI, the mean speech recognition thresholds improved from 80 ± 21 dB to 31 ± 9 dB (p < 0.001), mean aided AzBio scores improved from 11% to 43% (p = 0.002) and aided consonant-nucleus-consonant word scores improved from 6% to 47% (p < 0.001) in quiet. Subtotal petrosectomy is effective for creating a safe, dry ear in patients with chronic inflammation or anatomically challenging ears. Rehabilitative hearing options following STP can be achieved safely, restoring hearing to an acceptable level with CI. Careful consideration should be undertaken to approach as a single or staged procedure.

Is Cochlear Implantation Effective for Auditory Rehabilitation Following Vestibular Schwannoma Treatment?

Is Cochlear Implantation Effective for Auditory Rehabilitation Following Vestibular Schwannoma Treatment?

Sleep and Behavior 24 Months After Early Tonsillectomy for Mild OSA: An RCT.

The Preschool Obstructive Sleep Apnea Tonsillectomy and Adenoidectomy study is a prospective randomized controlled study of children aged 3 to 5 years. This follow-up evaluated postoperative outcomes 24 months after randomization. Baseline, 12-month, and 24-month assessments included intellectual ability, polysomnography, audiology, a pediatric sleep questionnaire, the parent rating scale of the Behavior Assessment System for Children, and the Behavior Rating Inventory of Executive Functioning. In total, 117 (55% male) of 190 children, 61.6% of those initially randomly assigned, attended 24-month follow-up; 62 of 99 were assigned T/A within 2 months (eT/A); and 55 of 91 were assigned to T/A after the 12-month follow-up (T/A12). Intellectual ability, our primary outcome, did not differ according to the timing of T/A. Exploratory analyses revealed changes in both groups after T/A, including fewer children having day sleeps (eT/A from baseline 97% to 11%, T/A12 from 36% at 12 months to 9%), improved symptom scores (eT/A 0.62 to 0.25, T/A12 0.61 to 0.26; P < .001), improved behavior T-scores (eT/A 71.0 to 59.9, T/A12 63.6 to 50.5; P < .001), and improved polysomnography (obstructive apnea-hypopnea index eT/A 1.9 to 0.3 per hour, T/A12 1.3 to 0.3; P < .001). The eT/A group revealed temporary postoperative improvement of Woodcock-Johnson III subscales (sound blending and incomplete word scores) and behavioral withdrawal. T/A for mild obstructive sleep apnea led to large improvements in sleep and behavior in preschool-aged children, regardless of the timing of surgery.