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Journal of Speech, Language, and Hearing Research

American Speech Language Hearing Association

Preprints posted in the last 90 days, ranked by how well they match Journal of Speech, Language, and Hearing Research's content profile, based on 10 papers previously published here. The average preprint has a 0.00% match score for this journal, so anything above that is already an above-average fit.

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Phonemic awareness deficits in an alphasyllabary language: Effects of task type and linguistic complexity in children with Specific Learning Disorder-Reading

Soman, A.; Dev, S. S.; Ravindren, R.

2026-04-07 psychiatry and clinical psychology 10.64898/2026.04.02.26349894 medRxiv
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Background Phonemic awareness deficits are a core feature of Specific Learning Disorder-Reading (SLD-R). How task- and language-specific factors influence these deficits in alphasyllabary languages may help clarify the cognitive mechanisms underlying reading impairment in SLD-R. Methods Thirty children with a DSM-5 diagnosis of SLD-R (mean age 11.4 years) and 29 age-matched typically developing children were given phoneme blending (words and pseudowords) and segmentation tasks in Malayalam. The effects of age and consonant clusters on task performance were evaluated. Results Children with SLD-R performed significantly worse than controls across most phonemic awareness tasks, with the largest deficits observed in pseudoword blending and word blending, and smaller deficits in segmentation. No significant difference was observed for initial phoneme deletion. In typically developing children, age showed strong positive correlations with phonemic performance across most tasks, whereas the SLD-R group showed weak or absent correlations, except in word blending and initial phoneme deletion. Consonant clusters significantly affected performance in both groups, with SLD-R showing more severe deficits. Conclusions Phonemic awareness deficits observed in SLD-R in alphasyllabary languages like Malayalam are more prominent in tasks where lexical support is absent, like pseudoword blending. These deficits vary across task types and linguistic complexity. Phonemic awareness improves with age in typically developing children, while improvement is uneven in children with SLD-R. The findings suggest that phonemic awareness deficits are a core feature of SLD-R across languages, but their manifestation is shaped by orthographic and linguistic characteristics of the writing system.

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Iconic Sound-Shape Correspondences in Aphasia

Dorsi, J.; Sandberg, C.; Lacey, S.; Nygaard, L.; Sathian, K.

2026-05-19 neuroscience 10.64898/2026.05.18.725976 medRxiv
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PurposeTo examine speech iconicity for shape in aphasia, we compared iconicity ratings from people with aphasia to those from neurologically intact individuals and evaluated how iconicity relates to phonological and semantic processing profiles in aphasia. MethodEleven people with aphasia and 11 age- and gender-matched neurologically intact participants rated how rounded or pointed 50 auditory pseudowords sounded using a 5-point scale. Ratings from participants with aphasia were compared to predicted iconicity ratings derived from reference ratings from prior work and to ratings from neurologically intact participants. For each participant with aphasia, correlations between individual ratings and predicted ratings were related to measures of phonological and semantic processing. ResultsRatings from people with aphasia were significantly correlated with both the predicted ratings and the ratings from neurologically intact participants. The strength of the correlation between individual ratings and predicted ratings did not differ significantly between groups, although there was a trend toward weaker correlations in the aphasia group. There were indications that greater language impairment was associated with greater disruption of iconicity ratings; in particular, deficits in phonological segmentation and semantic processing were associated with reduced sensitivity to shape iconicity. ConclusionThese findings suggest that sensitivity to shape iconicity is preserved in individuals with aphasia to varying degrees. The specific nature of language impairment appears to play an important role in determining iconicity processing in aphasia.

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Speech-Based Markers in Paediatric ADHD: A Longitudinal Case-Control Study of Voice Features and Medication Effects

Bamberger, R.; Kuhles, G.; Lotter, L. D.; Dukart, J.; Konrad, K.; Guenther, T.; Siniatchkin, M.; Fuchs, M.; von Polier, G.

2026-03-31 psychiatry and clinical psychology 10.64898/2026.03.25.26348708 medRxiv
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Background Diagnosis and treatment monitoring of attention-deficit/hyperactivity disorder (ADHD) largely rely on subjective assessments, highlighting the need for objective markers. Voice features and speech embeddings represent promising candidates for such markers, as they may capture alterations in speech production relevant to ADHD. However, it remains unclear which speech features are most informative for distinguishing ADHD and monitoring treatment effects, and which speech tasks most reliably elicit such differences. Methods Twenty-seven children with ADHD and 27 age-matched neurotypical controls completed six speech tasks across two study visits. Children with ADHD were unmedicated at baseline (first visit) and were assessed under prescribed methylphenidate treatment at follow-up, whereas controls underwent repeated assessment without intervention. Established acoustic voice features (eGeMAPS) and high-dimensional speech embeddings (WavLm, Whisper) were extracted and analysed using linear mixed models to examine baseline group differences and group-by-time interaction effects reflecting medication-associated change patterns. Results At baseline, children with ADHD differed significantly from controls in frequency, spectral, and temporal voice features, characterized by lower and more variable pitch, altered spectral properties, and reduced rhythmic stability. Group-by-time interaction effects indicated medication-associated modulation in the ADHD group, including reduced loudness variability and increased precision of vowel articulation at follow-up, changes not observed in controls. Speech embeddings revealed additional baseline and interaction effects beyond established acoustic features. Free speech tasks, particularly picture description, yielded the most robust and consistent effects. Conclusion Children with ADHD differed from neurotypical controls in vocal features at baseline and showed distinct longitudinal change patterns consistent with medication-related change. These findings support further investigation of speech-based measures as candidate digital phenotypes and potential digital biomarkers in ADHD, with picture description emerging as a particularly promising task for future clinical assessment protocols.

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Consistency of Linguistic and Cognitive Processing Measures to Discriminate Children with and without Developmental Language Disorder (DLD): Comparing Likelihood Ratios (LHs) and Elastic Net Regression Computational Models.

Sharma, S.; Golden, R. M.; Montgomery, J. W.; Gillam, R. B.; Evans, J.

2026-03-09 psychiatry and clinical psychology 10.64898/2026.03.09.26347082 medRxiv
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Because both monothetic and polythetic diagnostic classification approaches focus on the presence of individual symptom(s) to identify individuals in a clinical population, they may be diagnostically sensitive clinical markers of multidimensional disorders such as developmental language disorder (DLD). DLD researchers have also used likelihood ratios (LHs) to identify possible diagnostic clinical markers of DLD, however the diagnostic sensitivity of LHs varies markedly across studies. A recent multidimensional computational elastic-net regression examined a total of 71 measures of spoken language and cognitive processing from a cohort of 223 children ages 7;0 to 11;0 with and without DLD (DLD = 110; typically developing (TD) controls = 113). All 200 iterations of the model had high discriminative power (87% - 88%) in positively identifying and distinguishing the DLD participants across all thresholds. Notably, the models identified a sparse DLD-specific deficit profile which only included nine of the 71 measures. In this study, we ask if the individual LHs for each of these nine measures are equally sensitive in identifying and discriminating the children with DLD from TD controls or if diagnostic markers of multidimensional disorders such as DLD can only be identified based on computational modeling approaches. The LHs for each of the nine measures were in the moderately high ranged (3.25 - 10). However, at the the highest LH cut points for each measure, there was little to no overlap in the children each measure identified as having DLD. Follow up analysis revealed that the elastic net model-derived predictive scores for each participant were significantly correlated with the participants language ability. The model also identified a subgroup of TD participants as having the same DLD-deficit profile as the DLD participants. This subgroup were younger, predominantly male participants whose standardized language assessment scores were lower as compared to the larger TD cohort. Taken together, the results from this study show that, because multidimensional modeling approaches such as elastic net regression leverage the variability in the deficit profiles across individual members of a diagnostic group and the unique contributions of each of the behavioral features of the phenotype, they may be an effective tool in deriving diagnostically specific deficit profiles for phenotypically complex, multicausal, multidimensional, neurodevelopmental disorders such as DLD. The results also demonstrate the robustness of the derived DLD-specific deficit profile in identifying individuals with "mild" or subclinical DLD, demonstrating the potential utility of this approach in both clinical and research arenas. What this paper adds.O_ST_ABSWhat is already known on this subject.C_ST_ABSThe identification of diagnostic markers for DLD has been a challenge for both clinicians and researchers across multiple decades. Monothetic classification markers such as non-word repetition, optional infinitive, or syntax dependencies have been explored, as well as polythetic classification approaches where a list of diagnostic symptoms is used together. However, each assumes different criteria and symptoms that should be included as diagnostic markers of DLD. What this study adds.Our study assessed the feasibility and effectiveness of monothetic vs. polythetic classification approaches for identifying DLD. Since our prior work, which used elastic net logistic regression computational modeling with strong discriminatory power, consistently selected nine key features as the DLD-deficit profile, in this effort, we calculated each of the nine features likelihood ratios to examine each measures ability to identify children with DLD. The monothetic approach failed to identify a consistent set of children with DLD, and the polythetic classification approach also did not identify participants who were shown to have mild DLD by the elastic net modeling approach. Instead, our analysis showed that a computational modeling approach, such as elastic net regression, that included small but important input from multiple cognitive and linguistic aspects of children, could better capture multifaceted information about the disorder, better account for individual variability, and consistently identify most participants with DLD. Clinical implications of this study.Elastic net logistic regression identifies a small subset of important features for distinguishing DLD and can assign a probability of DLD presence for each participant. Instead of the polythetic and monothetic approaches commonly used in the field, our study shows that integrating advanced computational modeling, such as elastic net regression, with clinician judgment can better refine assessment processes and address prior and ongoing inconsistencies in the DLD literature and diagnostic practices.

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Automated Macrolinguistic Discourse Analysis for Transdiagnostic Detection of Language Impairments

Lee, S. H.; Wang, S.; Varkanitsa, M.; Kiran, S.

2026-05-21 neurology 10.64898/2026.05.19.26353614 medRxiv
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Macrolinguistic discourse analysis offers valuable insight into how patients with neurogenic communication disorders organize and produce informative speech, yet it remains a largely manual and labor-intensive process. We report an automated pipeline for macrolinguistic discourse analysis for individuals with aphasia and dementia that integrates automatic speech recognition (ASR), utterance segmentation, sentence-level embeddings, centroid-based main-concept matching, and rule-based coherence error classification. These algorithms were applied to Cinderella story retellings from 309 participants (113 controls, 102 post-stroke aphasia (PWA), and 94 dementia). The algorithm reliably identified main concepts (83% accuracy against human labels) and derived interpretable features such as semantic distance to a main concept centroid, main concept coverage, and coherence error rates. Crucially, diagnostic classification results showed that logistic-regression classifiers trained on 10 macrolinguistic features distinguished aphasia from controls with high accuracy (AUC {approx} 0.94) but showed weaker separation for dementia (controls vs dementia AUC {approx} 0.66; aphasia vs dementia AUC {approx} 0.58). Semantic distance to the centroid emerged as a robust, informative predictor for diagnostic classification, demonstrating that the ability to produce narrative-aligned speech is clinically important. The automated pipeline enables scalable macrolinguistic discourse analysis that could support screening and longitudinal monitoring of discourse impairments across neurogenic populations.

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Training-Free Cross-Lingual Dysarthria Severity Assessment via Phonological Subspace Analysis in Self-Supervised Speech Representations

Muller, B.; Ortiz Barranon, A. A.; Roberts, L.

2026-04-17 neurology 10.64898/2026.04.12.26350731 medRxiv
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Dysarthric speech severity assessment typically requires either trained clinicians or supervised machine learning models built from labelled pathological speech data, limiting scalability across languages and clinical settings. We present a training-free method (no supervised severity model is trained; feature directions are estimated from healthy control speech using a pretrained forced aligner) that quantifies dysarthria severity by measuring the degradation of phonological feature subspaces within frozen HuBERT representations. For each speaker, we extract phone-level embeddings via Montreal Forced Aligner, compute d scores along phonological contrast directions (nasality, voicing, stridency, sonorance, manner, and four vowel features) derived exclusively from healthy control speech, and construct a 12-dimensional phonological profile. Evaluating 890 speakers across10corpora, 5 languages for the full MFA pipeline (English, Spanish, Dutch, Mandarin, French) and 3 primary aetiologies (Parkinsons disease, cerebral palsy, amyotrophic lateral sclerosis), we find that all five consonant d features correlate significantly with clinical severity (random-effects meta-analysis rho = -0.50 to -0.56, p < 2 x 10^-4; pooled Spearman rho = -0.47 to -0.55 with bootstrap 95% CIs not crossing zero), with the effect replicating within individual corpora, surviving FDR correction, and remaining robust to leave-one-corpus-out removal and alignment quality controls. Nasality d decreases monotonically from control to severe in 6 of 7 severity-graded corpora. Mann-Whitney U tests confirm that all 12 features distinguish controls from severely dysarthric speakers (p < 0.001).The method requires no dysarthric training data and applies to any language with an existing MFA acoustic model (currently 29 languages) or a model trained from healthy speech alone. It produces clinically interpretable per-feature profiles. We release the full pipeline and phone feature configurations for six languages to support replication and clinical adoption. Author SummaryOne of the authors has lived with ALS for sixteen years. Bernard Muller, who built this entire analytical pipeline using only eye-tracking technology, has experienced the progression of the disease firsthand, including the dysarthric speech that comes with advancing ALS and the tracheostomy that followed. The problem this paper addresses is not abstract to him, and that shapes how the method was designed. We developed a method to measure how well a person with dysarthria can produce distinct speech sounds, without needing any recordings of disordered speech for training. Our approach works by analysing how a widely available AI speech model organises different sound categories -- such as nasal versus oral consonants, or voiced versus voiceless sounds -- and measuring whether those categories become harder to tell apart. We tested this on 890 speakers across 10 datasets in five languages, covering Parkinsons disease, cerebral palsy, and ALS. Because the method only needs healthy speech recordings to set up, it applies to any language with an existing acoustic model, currently covering 29 languages. The resulting profiles show clinicians which specific aspects of speech production are degrading, rather than providing a single opaque severity score. This could support remote monitoring of speech decline in neurodegenerative disease and enable screening in languages and settings where specialist assessment is unavailable.

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Transformer Language Models Reveal Distinct Patterns in Aphasia Subtypes and Recovery Trajectories

Ahamdi, S. S.; Fridriksson, J.; Den Ouden, D.

2026-03-27 neuroscience 10.64898/2026.03.27.714240 medRxiv
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Language impairments in aphasia are characterized by various representational disruptions that may be reflected in discourse production. This research examines the capacity of transformer-based language models, particularly GPT-2, to serve as a computational framework for analyzing variations in aphasic narrative speech. A longitudinal dataset of narrative speech samples collected at six time points from individuals with aphasia (N = 47) was utilized as part of an intervention study. All transcripts were processed via the GPT-2 language model to obtain activation values from each of the 12 transformer layers. Statistically significant differences in activation magnitude across aphasia subtypes were found at every layer (all p < .001), with the most pronounced effects in the deeper layers. Pairwise Tukey HSD tests revealed consistent distinctions between Brocas aphasia and both Anomic and Wernickes aphasia, suggesting a shared activation profile between the latter two. Longitudinal tests revealed significant changes over time, especially in the final three layers (10-12). These findings suggest that transformer-based activation patterns reflect meaningful variation in aphasic discourse and could complement current diagnostic tools. Overall, GPT-2 provides a scalable tool to model representational dynamics in aphasia and enhance the clinical interpretability of deep language models.

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Neural subtypes in developmental stuttering

Nanda, S.; Gervino, G.; Pang, C. Y.; Garnett, E. O.; Usler, E.; Chugani, D. C.; Chang, S.-E.; Chow, H. M.

2026-03-26 neuroscience 10.64898/2026.03.25.714210 medRxiv
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Developmental stuttering is a complex neurodevelopmental disorder characterized by disfluent speech. At the individual level, the behavioral manifestations of stuttering vary considerably, likely reflecting heterogeneity in underlying neural mechanisms. In this study, we examined individual-specific differences in the brains of children who stutter (CWS), by implementing normative modeling, a framework that quantifies how an individual deviates from an age- and sex-matched reference population. We applied this approach to identify individual-specific structural brain atypicalities using gray and white matter volumes. These volumes were derived from MRI scans from a large mixed-longitudinal dataset of 235 and 240 scans from CWS and fluent controls respectively, aged between 3 and 12 years. Individual deviation maps capturing these atypicalities were then used to cluster CWS into subtypes based on similarities in their neuroanatomical profiles. This analysis identified four neural subtypes with distinct neuroanatomical atypicalities relative to fluent controls. The key findings were a basal ganglia-thalamo-cerebellar subtype associated with higher stuttering severity and lower rates of recovery, and a white matter subtype characterized by mild severity and a higher likelihood of recovery. The remaining two subtypes showed cerebellar differences alongside alterations in brain regions involved in sensorimotor integration. Moreover, cerebellar volume atypicalities were present in all four subtypes, indicating that cerebellar alterations were present across otherwise distinct neural profiles and may represent a shared neuroanatomical feature of stuttering. These findings indicate that examining individual-specific neural differences and subtyping based on patterns of neural atypicalities provides valuable insight into the heterogeneity of developmental stuttering and represents a promising direction for improving our understanding of the disorder.

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Development and clinical application of a consonant confusion task to evaluate hearing aid benefit

Hajicek, J.; Harris, S. E.; Neely, S. T.

2026-04-24 otolaryngology 10.64898/2026.04.23.26351598 medRxiv
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PurposeThis research sought to develop a low-cognitive-load speech-in-noise test based on consonant confusions with the potential for assessing hearing-aid benefit. MethodsVowel-consonant-vowel (VCV) stimuli with added speech-shaped noise were presented as a closed-set consonant identification task. Initially, consonant-confusion matrices were used to select, from a larger set of consonants and vowel contexts, a set of ten consonants and associated signal-to-noise ratios (SNR) that were sensitive to hearing loss. The sensitivity of the qVCV test to hearing loss was validated by comparing predicted pure-tone average (PTA) hearing thresholds with their audiometric PTA. Clinical viability of the qVCV test was assessed by comparisons to the QuickSIN test. Hearing-aid benefit was assessed by comparing test scores in unaided and aided conditions. ResultsThe consonants most sensitive to hearing loss were /b d g t k v z s [esh] n/ in the vowel context /[a]/. A cross-validated prediction of PTA had a mean-absolute error of 5.7 dB. The repeatability of qVCV at 50 trials was equivalent to the QuickSIN average of two lists. Hearing-aid benefit was quantified as a decibel reduction in hearing loss. ConclusionsqVCV and QuickSIN performed similarly when test times are equated. The advantages of qVCV include lower cognitive demand, fewer learning effects, and automated scoring. PTA predicted by qVCV which greatly exceeds audiometric PTA may indicate either cognitive deficits or cochlear neural degeneration. The qVCV quantification of hearing-aid benefit may have clinical value.

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EEG responses to auditory stimuli are less context-dependent in preschoolers with autism spectrum disorder compared to typical development

Shao, M.; McNair, K. A.; Parra, G.; Tam, C.; Sullivan, N.; Senturk, D.; Gavornik, J. P.; Levin, A. R.

2026-04-25 neurology 10.64898/2026.04.17.26350631 medRxiv
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Individuals with autism spectrum disorder (ASD) often exhibit atypical auditory processing, yet it remains unclear whether and how the integration of simple acoustic features and contextual information is impacted in ASD. One real-world example of this integration is the auditory looming bias, the prioritized processing and perception of approaching auditory stimuli. We designed a paradigm that presents intensity-rising (looming) and intensity-falling (receding) auditory stimuli to 3-4-year-old children with ASD (n = 21), children with sensory processing concerns who do not have ASD (SPC; n = 16) and children with typical development (TD; n = 30). We recorded neural responses using electroencephalography (EEG) and found evidence of looming bias in the SPC and TD groups, as indexed by greater P1 peak amplitude during the looming than receding stimuli (TD: t(64) = 6.87, p < .001; SPC: t(64) = 4.07, p < .001). But this finding was not present in the ASD group (p = .194). Additionally, the ASD group showed reduced differentiation between looming and receding stimuli, as indicated by significantly lower Rise-Fall Difference Score (RFDS) in comparison to the TD group (Z = -3.00, padj = .008). These findings suggested altered context-dependent modulation of sensory input in ASD. Lay SummaryMany children with autism show differences in how they process sounds. Using sound patterns in which loudness gradually increased and decreased over time, like many real-world sounds, we found that children with autism showed less neural differentiation between increasing and decreasing sounds. This finding suggested that the brain may process changes in sound differently in autism, particularly in how it adjusts to sounds as they change over time, which could contribute to the sensory challenges many children with autism experience in daily life.

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Looking to and Processing of Audiovisual Speech and Associations with Language in Infant Siblings of Autistic and Non-autistic Children

Dunham-Carr, K.; Keceli-Kaysili, B.; Markfeld, J. E.; Pulliam, G.; Clark, S. M.; Feldman, J. I.; Santapuram, P.; McClurkin, K.; Agojci, D.; Schwartz, A.; Lewkowicz, D. J.; Woynaroski, T. G.

2026-03-14 neurology 10.64898/2026.03.10.26347805 medRxiv
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Differences in looking to and processing of audiovisual speech have been theorized to contribute to heterogeneity in language ability in autistic children. Differential audiovisual speech processing has been indexed by event-related potentials (ERPs), specifically via amplitude suppression in response to audiovisual versus auditory-only speech, and linked with vocabulary in school-aged children. This study used an intact-group comparison and concurrent correlational design in infant siblings of autistic children (Sibs-Autism) and non-autistic children (Sibs-NA) to determine whether amplitude suppression is (a) present in infancy, (b) different in Sibs-Autism versus Sibs-NA, and (c) related to looking to audiovisual speech and language abilities. We collected EEG data from 54 infants aged 12-18 months (29 Sibs-Autism; 25 Sibs-NA) while they viewed videos of audiovisual and auditory-only speech, as well as eye tracking and language data. We found significant amplitude differences at the N2 ERP component in response to audiovisual versus auditory-only speech but no significant group differences in ERP amplitudes. Associations between looking to audiovisual speech, amplitude effects, and language were moderated by group, chronological age, and biological sex. Our findings suggest that differential audiovisual speech processing is present in 12-18-month-olds and may explain heterogeneity in looking to audiovisual speech and emerging language ability.

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Naming Performance in Bilinguals with Alzheimer's Disease and Mild Cognitive Impairment

Sainz-Pardo, M.; Hernandez, M.; Suades, A.; Juncadella, M.; Ortiz-Gil, J.; Ugas, L.; Sala, I.; Lleo, A.; Calabria, M.

2026-03-25 neurology 10.64898/2026.03.23.26349075 medRxiv
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Introduction. There is consistent evidence of a disadvantage in bilinguals' speech production compared to monolinguals in healthy individuals, but studies investigating this phenomenon in clinical populations such as Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD) are scarce. Given that both clinical groups are characterized by wordfinding difficulties, understanding how bilingualism influences speech production in these populations is essential. Methods. Early and highly proficient Catalan-Spanish bilinguals (active bilinguals) were compared to Spanish-dominant speakers with low proficiency in Catalan (passive bilinguals) using a picture-naming task. The study included 58 older adults, 66 patients with AD, and 124 individuals with MCI. Reaction times, accuracy, and error types were collected in the naming task in each individual's dominant language. Results. First, active bilinguals demonstrated faster naming latencies than passive bilinguals, particularly for low-frequency words. Second, active bilinguals with MCI exhibited more naming errors than passive bilinguals with MCI, including a higher incidence of crosslanguage intrusions and anomia. Third, passive bilinguals with MCI and AD showed more semantic errors than active bilinguals. Discussion. These findings underscore the impact of second language use on naming performance in MCI and AD. Moreover, they provide insight into the potential mechanisms underlying lexical retrieval differences in bilinguals, including lexico-semantic processing and language control.

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Multivariate Prediction of Conductive Dysfunction in Well and NICU Newborns using Wideband Acoustic Immittance with Acoustic Reflex Tests

Hunter, L. L.; Feeney, M. P.; Fitzpatrick, D.; Keefe, D. H.

2026-03-15 otolaryngology 10.64898/2026.03.13.26348314 medRxiv
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ObjectivesThe overall goal of this study was to assess tympanometric and ambient wideband acoustic immittance (WAI) tests and wideband acoustic reflex thresholds (ART) in well-baby and newborn intensive care (NICU) cohorts with three specific objectives: 1) Assess predictive accuracy for WBT and ART for conductive dysfunction in ears referring on the first or second stages of newborn hearing screening; 2) Identify inadequate tests likely due to probe blockages or leaks; and 3) Assess prediction models separately for well-baby and NICU screening outcomes. DesignProspective, observational study of full-term (n=514) and premature newborns (n=239) recruited from well-baby and NICU nursery birth hospital newborn hearing screening program. Wideband tympanometry, ambient absorbance, and acoustic reflexes were tested after Stage 1 transient otoacoustic emissions (TEOAE) screening. The reference standard for Pass or Refer groups was initially defined on the stage 1 TEOAE test result. Pass or Refer groups were then reassigned based on the stage 2 screening ABR for those who referred at Stage 1, and all NICU infants. Multivariate models were developed using reflectance and admittance variables to predict conductive dysfunction relative to the screening reference standard in a randomized sub-group of subjects at Stage 1 and Stage 2 screening. Classification accuracy was evaluated on a second, independent sub-group. Individual tests were classified as having inadequate probe fits if they had excessively low values of sound pressure level or susceptance (leak) or absorbance (blockage). ResultsDifferences in ambient absorbance for Pass v. Refer screening groups revealed the greatest differences and effect sizes occurring in frequency bins between 1.4-2 kHz. Screening failure at both Stage 1 and 2 was most accurately predicted by models using ambient absorbance and power level variables at frequencies between 1-2.8 kHz, including ARTs. Tympanometric admittance variables at the positive-pressure tail for frequencies between 1-2.8 kHz in combination with the ART were more accurate predictors than those at peak pressure or the negative-pressure tail. Multivariate models generalized well to an independent group of infants at both Stage 1 and 2 for both the ambient and tympanometric models. Ambient tests revealed more inadequate tests than tympanometric tests, primarily due to blocked probe tips. Exclusion of ears to detect probe leaks or blockages slightly improved the ambient prediction models, but did not affect tympanometric models. ConclusionWideband acoustic reflex tests improved all models for ambient and tympanometric absorbance. Multivariate prediction models developed for WAI tests were repeatable in an independent group of well and NICU infants, suggesting that the results are generalizable to these populations. Detection of probe blockage or leaks slightly improved prediction for ambient measures. Pressurized tests have the advantage of ensuring probe seals due to the need for a hermetic seal, thus are useful to ensure adequate probe insertion.

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Auditory Working Memory Mediates the Relationship between Musical Sophistication and Speech-in-noise Perception

Colak, H.; Benzaquen, E.; Guo, X.; Lad, M.; Sedley, W.; Griffiths, T. D.

2026-05-13 neuroscience 10.64898/2026.05.13.724783 medRxiv
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Understanding speech in noisy environments (SPIN) is an important everyday ability, and engaging in musical activities has been proposed as a factor that may support this ability. However, the cognitive mechanisms underlying a potential musical advantage in SPIN perception remain unclear. Here we investigated whether musical sophistication is associated with better SPIN perception in a large population-based sample, and whether this relationship is mediated by auditory working memory (AWM), verbal working memory (VWM), or non-verbal intelligence. We recruited 203 participants and measured SPIN perception at both word and sentence levels. Musical sophistication was assessed using the Goldsmiths Musical Sophistication Index (Gold-MSI). AWM was measured using delayed matching of tone frequency or the modulation rate of amplitude modulated white noise, VWM was based on backward digit span task, and non-verbal intelligence used matrix reasoning. Mediation analyses revealed that AWM fully mediated the relationship between musical sophistication and SPIN perception, whereas VWM showed no mediation effect. Non-verbal intelligence showed a partial mediating effect. Additional control analyses using structural equation modelling revealed that the indirect effect through AWM remained significant after accounting for age, hearing thresholds, and non-verbal intelligence. Together, these findings suggest that individuals with greater musical sophistication demonstrate better daily life listening abilities, and that superior auditory working memory may be the key cognitive mechanism underlying this advantage.

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Verb-Specific Linking Properties Modulate the N400 Effect: Evidence from Thematic Reversal Anomalies in Malayalam

Shalu, S.; Muralikrishnan, R.; Schlesewsky, M.; Bornkessel-Schlesewsky, I.; Choudhary, K. K.

2026-05-19 neuroscience 10.64898/2026.05.15.725327 medRxiv
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The present study examined whether thematic reversal anomalies are processed similarly across subject and object experiencer constructions in Malayalam. Event-related brain potentials (ERPs) were recorded as 30 first-language speakers of Malayalam read transitive sentences with the two types of experiencer verbs, in which the thematic role assignment for the preceding arguments was either correct or reverse. The reversal anomaly became apparent only at the position of the experiencer verb. A linear mixed-models analysis confirmed a biphasic N400-P600 effect at the verb for both verb types when the argument roles were reverse. Thus, our results suggest a uniform processing strategy for TRAs irrespective of the type of experiencer verb involved. However, the N400 amplitude was larger for the object experiencer verb compared to subject experiencer verbs. We suggest that the quantitative difference observed for object experiencer verbs is due to the inverse linking of grammatical function and thematic roles associated with these verbs. In other words, verb-specific linking properties modulate the processing of TRAs involving object experiencer verbs. We argue that this modulation occurs because the parser recalibrates cue weighting when the expected form-to-meaning mappings are overridden by the inverse linking properties of object experiencer verbs.

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EEG correlates of auditory rise time processing: A systematic review

Manasevich, V.; Kostanian, D.; Rogachev, A.; Sysoeva, O.

2026-03-09 neuroscience 10.64898/2026.03.06.710012 medRxiv
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Rise time (RT) is considered to be one of the most significant acoustical characteristics of auditory speech stimuli. A substantial amount of data has been accumulated on the neurophysiological mechanisms of RT processing under different conditions and in different groups of people, but these data have not been systematised. This review focuses on studies that have investigated electroencephalographic (EEG) markers of RT sensitivity. The present literature search was conducted according to the PRISMA statement in PubMed, Web of Science and APA PsychInfo databases. The resultant review comprised 37 studies that considered diverse aspects of RT processing. The review describes the main stimulation parameters affecting electrophysiological markers of RT processing reflected in different components of event-related potentials, brainstem responses and cortical rhythmic activity. The main finding of this review is that the rise time prolongation leads to a decrease in the amplitude of the main ERP components and an increase in their latencies. However, the sensitivity of the EEG markers varied with the earliest components tracking the subtle difference (few tens of microseconds), while the later components coding the larger one (up to 500 ms). Nevertheless, the observed effects may vary and depend on some aspects of the experimental paradigm, age of participants and speech-related problems. Future research may benefit by addressing understudied clinical groups and ERP components such as P1 and N2, dominated in children.

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Neurophysiological correlates of processing Agreement and Tense in Arabic

Idrissi, A.; Muralikrishnan, R.

2026-04-10 neuroscience 10.64898/2026.04.10.717434 medRxiv
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Most syntactic approaches converge on the fact that Tense and Agreement are two different functional categories, although there is less agreement on their exact representation and relative hierarchical order. Cross-linguistic agrammatic data seems to support the difference between Tense and Agreement, with patterns of dissociation reported from agrammatism between them, in which Tense is generally more impaired than Agreement. To examine whether there is evidence for such a dissociation of tense and agreement processing in neurotypical individuals, the present study employed Event-Related brain Potentials (ERPs) to study the real-time comprehension of Modern Standard Arabic sentences. Critical stimulus sentences were of the form Temporal Adverb-Subject-Verb-PP, in which the intransitive verb was in either the past or future tense, and was preceded by a singular or plural subject and an adverb indicating past or future tense. The subject nouns were all human and either masculine or feminine. The verbs either agreed with the subject noun or presented a person, number or gender agreement violation. They also either agreed or showed a mismatch with the temporal frame of the adverb, the latter being a tense violation. Results at the verb showed that both tense and agreement violations yielded a biphasic N400 - P600 effect. We discuss these results in light of previous ERP findings and conclude that despite the putative configurational differences between Tense and Agreement, the processing of the two categories in Arabic may deploy the same underlying cognitive mechanisms.

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Subtypes of Internalizing and Externalizing Problems in Autistic Preschool Children: Participation in Daily Life and Family Outcomes

Nakamura, T.; Koshio, I.; Nagayama, H.

2026-04-21 psychiatry and clinical psychology 10.64898/2026.04.14.26350723 medRxiv
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AimAutistic children have a high but varied prevalence of internalizing and externalizing problems. This study aimed to identify the subtypes of internalizing and externalizing problems among autistic preschool children in Japan, examine their temporal stability, and investigate differences in participation in daily life and family outcomes across these subtypes. MethodsA prospective cohort study was conducted with 275 caregivers of autistic children aged 51-75 months. Internalizing and externalizing problems were assessed using the Strengths and Difficulties Questionnaire. ResultsLatent transition analysis identified five subtypes: Low-symptom, High-emotional, Externalizing, Comorbid, and Peer-difficulty groups. Membership in the High-emotional and Externalizing groups was relatively stable over time, whereas the Peer-difficulty group showed frequent transitions to subtypes with higher levels of internalizing or externalizing problems. Significant differences in participation in daily life and family outcomes were observed across subtypes, but these patterns were inconsistent with a simple gradient of symptom levels. ConclusionsThe novel findings that the temporal stability of subtype membership varied and that differences in participation in daily life and family outcomes were observed across the subtypes suggest that the heterogeneity of internalizing and externalizing problems may be associated with variations in childrens participation in daily life and family outcomes over time. Plain Language SummaryAutistic preschool children often experience emotional and behavioral difficulties, but the way these difficulties manifest varies widely across individuals. This study aimed to identify the patterns of these difficulties, examine how they change over time, and investigate how participation in daily life and family outcomes differ across autistic preschool children. We conducted a study with 275 caregivers of autistic children aged 4-6 years in Japan. From caregiver reports of childrens emotional and behavioral difficulties, five distinct patterns were identified: a group with mainly emotional difficulties, a group with mainly behavioral difficulties, a group with both types of difficulties, a group with relatively low levels of difficulties, and a group characterized primarily by peer-related difficulties. Our findings suggest that different patterns of emotional and behavioral difficulties are associated with differences in childrens participation in daily life and family outcomes. These differences could not be explained simply by the overall severity of difficulties but rather reflect distinct patterns based on the type of difficulty. The results indicate that autistic children face diverse difficulties that change over time.

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Speech-in-Noise Difficulties in Aminoglycoside Ototoxicity Reflects Combined Afferent and Efferent Dysfunction

Motlagh Zadeh, L.; Izhiman, D.; Blankenship, C. M.; Moore, D. R.; Martin, D. K.; Garinis, A.; Feeney, P.; Hunter, L. R.

2026-03-26 otolaryngology 10.64898/2026.03.23.26348719 medRxiv
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Objectives: Patients with Cystic fibrosis (CF) often receive aminoglycosides (AGs) to manage recurrent pulmonary infections, placing them at risk for ototoxicity. Chronic AG use can lead to complex cochlear damage affecting inner and outer hair cells, the stria vascularis, and spiral ganglion neurons. The greatest damage is typically in the basal cochlear region, which encodes high-frequency hearing, with additional involvement of more apical regions. While extended-high-frequency (EHF) hearing loss (EHFHL; 9-16 kHz) is often the earliest sign of AG ototoxicity, speech in noise (SiN) effects are rarely studied. Our overall hypothesis is that SiN perception difficulties in individuals with CF, treated with AGs, are related to combined cochlear and neural damage, primarily in the EHF range but also in the standard frequency (SF; 0.25-8 kHz) range. Three mechanisms that contribute to SiN perception were evaluated in children and young adults: 1) a primary effect of reduced EHF sensitivity, measured by pure-tone audiometry (PTA) and transient-evoked otoacoustic emissions (TEOAEs); 2) a secondary effect of subclinical damage in the SF range, measured by PTA and TEOAEs; and 3) additional neural effects, measured by middle ear muscle reflex (MEMR) threshold (afferent) and growth functions (efferent).Design:A total of 185 participants were enrolled; 101 individuals with CF treated with intravenous AGs and 84 age and sex-matched Controls without hearing concerns or CF. Assessments included EHF and SF PTA; the Bamford-Kowal-Bench (BKB)-SIN test for SiN perception; double-evoked TEOAEs with chirp stimuli from 0.71 to 14.7 kHz; and ipsilateral and contralateral wideband MEMR thresholds and growth functions using broadband stimuli. Results: Reduced sensitivity at EHFs (PTA, TEOAEs) was not associated with impaired SiN perception in the CF group. SF hearing, regardless of EHF status, was the primary predictor of SiN performance in the CF group. Increased MEMR growth was also significantly associated with poorer SiN in the CF group. Conclusions: In CF, impaired SiN perception was primarily predicted by SF hearing impairment, with additional involvement of the efferent auditory pathway through increased MEMR growth. These results build on prior evidence for efferent neural effects due to ototoxic exposures, supporting both sensory (afferent) and neural (efferent) mechanisms that contribute to listening difficulties in CF. Thus, preventive and intervention strategies should consider these combined mechanisms in people with AG ototoxicity to address their SiN problems.

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Perceived vs. actual navigation ability: Differences between autistic and typically developing children

McKeown, D. J.; Cruzado, O. S.; Colombo, G.; Angus, D. J.; Schinazi, V. R.

2026-04-13 psychiatry and clinical psychology 10.64898/2026.04.09.26350542 medRxiv
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PurposeNavigational ability develops throughout childhood alongside the maturation of brain regions supporting egocentric and allocentric processing. In Autism Spectrum Disorder (ASD), atypical hippocampal development may impact flexible spatial memory; however, findings on navigational ability in autistic children remain inconsistent. This study aimed to compare both objective and perceived navigation ability in children with ASD and typically developing (TD) peers. MethodTwenty-six children with high-functioning ASD and twenty-five age- and gender-matched TD children (M_age = 12.04 years, SD = 1.64) completed a battery of navigational tasks from the Spatial Performance Assessment for Cognitive Evaluation (SPACE), including Path Integration, Egocentric Pointing, Mapping, Associative Memory, and Perspective Taking. Perceived navigation ability was assessed using the Santa Barbara Sense of Direction (SBSOD) scale. ResultsNo significant group differences were observed across any objective navigation tasks. However, children with ASD reported significantly lower perceived navigation ability compared to TD peers. ConclusionThese findings suggest a dissociation between perceived and actual navigational ability in ASD. By early adolescence, objective navigation performance appears intact, potentially reflecting sufficient maturation of underlying neural systems or the presence of compensatory mechanisms. The results underscore the importance of incorporating objective, task-based measures when assessing cognitive abilities in autistic populations.