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  • 1.
    Andersson, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Hörselscreening av en population med utvecklingsstörning: Utvärdering av psykoakustisk testmetod och av OAE-registrering som komplementär metod2013Licentiate thesis, comprehensive summary (Other academic)
    Abstract [sv]

    Populationer med utvecklingsstörning behöver kontinuerlig hörseltestning, men konsensus om lämplig testmetod saknas.

    Syfte: Syftet med Studie I var att utvärdera psykoakustisk testmetod och med Studie II att utvärdera OAE-registrering som komplementär metod.

    Studie I. 1478 barn och vuxna med lätt till djup utvecklingsstörning, i åldrarna 7-91 år deltog i studien. De testades med tonaudiometri på sex frekvenser på screeningnivån 20 dB HL med lätt modifierad testutrustning. Kriterierna för remittering var tröskelnivåer på ≥ 25 dB HL på två frekvenser eller flera på ett öra eller båda. 1470 (99,5%) barn och vuxna medverkade i screeningen och 1325 (90%) testades på båda öronen på samtliga sex frekvenser. En majoritet, 987 (67,1%), medverkade i vanlig tonaudiometri, 234 (15,9%) i lekaudiometri, och 249 (16,9%) testades med observationsaudiometri. 669 (45%) visade normala värden medan 809 (55%) visade onormala värden relaterat till screeningkriterierna. Av de 809 accepterade 441 (54,5%) remittering för hörselutredning.

    Studie II. 38 vuxna med måttlig till djup utvecklingsstörning, i åldrarna 31-73 år deltog i studien, alla med ofullständiga testresultat vid tonaudiometri. Portabel utrustning, ILO 288 Echoport och dator Compaq LTE 5100 med mjukvara ILO 88 V 4.2, användes. Otoskopi och tympanometri kompletterade registreringen. Kriterierna för emissioner var S/N 3 dB eller mer och reproducerbarhet på 60% eller mer på åtminstone tre frekvensband. Kriterierna för partiella emissioner var desamma men för en eller två frekvenser. Två personer behövdes för att genomföra testningen: en för att hålla testpersonen lugn och tyst och den andra för att sköta testapparaturen. Reproducerbara TEOAE-svar registrerades från 11 öron (7 personer), partiella svar från 6 öron (4 personer), inga emissioner kunde registreras från 15 öron (10 personer) och 4 öron (4 personer) med otit eller vaxpropp testades inte. Registreringen från 24 öron (13 personer) kunde inte värderas p g a alltför mycket yttre och inre störningar. 8 personer vägrade delta i testningen. Endast 4 personer visade emissioner på båda öronen. Resultatet av undersökningen blev att 34 personer (89.5%) behövde testas om eller bli remitterade för ytterligare utredning, 21 av dem (55%) beroende på störningar vid registreringen eller p g a vägran att medverka.

    Konklusion: Tonaudiometri med lätt modifiering kan användas för screening av en population med lätt till djup utvecklingsstörning. TEOAE-registrering, som den genomfördes, kan inte uppfylla kraven på en fungerande testmetod för en population med måttlig till djup utvecklingsstörning. I det enskilda fallet kan TEOAE-registrering vara ett komplement till andra hörseltest. Det mest utmanande och tidskrävande är att introducera testprocedurerna på ett sätt som begränsar oro och skapar tillit. Oberoende av testmetod är en audionom med tålamod och vana att samarbeta med personer med utvecklingsstörning en viktig förutsättning för framgångsrik och säker testning.

    List of papers
    1. Audiometric screening of a population with intellectual disability
    Open this publication in new window or tab >>Audiometric screening of a population with intellectual disability
    2013 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 52, no 1, p. 50-56Article in journal (Refereed) Published
    Abstract [en]

    Objective: Evaluation of pure-tone audiometry (PTA) in hearing screening of a population with mild to profound intellectual disability (ID).

    Design: PTA was performed at six frequencies at the screening level 20 dB HL. Referral criteria were threshold levels ≥ 25 dB HL at two or more frequencies for one ear or both.

    Study sample: 1478 participants aged 7–91 years were included.

    Results: 1470 (99.5%) people cooperated in screening of which 1325 (90%) could be tested on both ears at all six frequencies. A majority, 987 (66.8%), performed ordinary PTA, 234 (15.8%) conditioned play audiometry, and 249 (16.9%) behavioural observation audiometry. Six hundred and sixty-nine (45%) passed and 809 (55%) failed according to referral criteria. Of those failing, 441 (54.5%) accepted referral to clinical evaluation.

    Conclusions: PTA with slight modifications is applicable for screening of a population with mild to profound intellectual disability. The most challenging and time-consuming activity is to introduce the test procedure in a way that reduces anxiety and establishes trust.

    Place, publisher, year, edition, pages
    London: Informa Healthcare, 2013
    Keywords
    intellectual disability, screening audiometry, psycho-acoustic method
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-87267 (URN)10.3109/14992027.2012.700773 (DOI)000312223800008 ()
    Available from: 2013-04-09 Created: 2013-01-14 Last updated: 2017-12-06Bibliographically approved
    2. Evaluation of OAE-recording as a complementary test method for adults with moderate to profound mental retardation
    Open this publication in new window or tab >>Evaluation of OAE-recording as a complementary test method for adults with moderate to profound mental retardation
    2000 (English)In: Scandinavian Audiology, ISSN 0105-0397, E-ISSN 1940-2872, Vol. 29, no 2, p. 120-126Article in journal (Refereed) Published
    Abstract [en]

    The recording of otoacoustic emissions (OAE) was evaluated as a complementary test method for adults with moderate to profound mental retardation (MR). A portable apparatus, ILO 288 Echoport linked to a Compaq LTE 5100 notebook with software ILO 88 V 4.2, was used. Otoscopy and tympanometry were also performed. Criteria for emissions were S/N 3 dB or more and reproducibility 60% or more for at least three frequency-bands. The criteria for partial emissions were the same, but for only one or two frequencies. Two examiners were needed: one to keep the tested person calm and quiet and the other to handle the keyboard. Thirty-eight people with different degrees of MR in connection with other disabilities were included. They had all exhibited incomplete results in a previous hearing screening of more than 1000 adults with MR. Reproducible transiently evoked OAEs (TEOAE) were recorded from II ears (7 people), partial TEOAEs from 6 ears (4 people) and no emissions from 15 ears (10 people). Registration from 24 ears (13 people) could not be evaluated because of too much external and internal noise. Eight people rejected the examination. Only four people showed emissions in both ears. Accordingly, 34 people (89.5%) had to be re-tested or referred for further investigation, 21 of them (55%) because of noisy recordings or no co-operation. It is concluded that the TEOAE-test in its present form cannot fulfil the demands for a functioning test method for this population. In single cases, however, TEOAE-recording can complement other audiological tests.

    Place, publisher, year, edition, pages
    Taylor & Francis, 2000
    Keywords
    Oto-acoustic emission, mental retardation
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27614 (URN)10.1080/010503900424534 (DOI)12345 (Local ID)12345 (Archive number)12345 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
  • 2.
    Andersson, Ulf
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Cognitive deafness: The deterioration of phonological representations in adults with an acquired severe hearing loss and its implications for speech understanding2001Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of the present thesis was to examine possible cognitive consequences of acquired hearing loss and the possible impact of these cognitive consequences on the ability to process spoken language presented through visual speechreading or through a cochlear implant.

    The main findings of the present thesis can be summarised in the following conclusions: (a) The phonological processing capabilities of individuals who have acquired a severe hearing loss or deafness deteriorate progressively as a function of number of years with a complete or partial auditory deprivation. (b) The observed phonological deterioration is restricted to certain aspects of the phonological system. Specifically, the phonological representations of words in the mental lexicon are of less good quality, whereas the phonological system in verbal working memory is preserved. (c) The deterioration of the phonological representations has a negative effect on the individual's ability to process speech, either presented visually (i.e., speechreading) or through a cochlear implant, as it may impair word recognition processes which involve activation of and discrimination between the phonological representations in the lexicon. (d) Thus, the present research describes an acquired cognitive disability not previously documented in the literature, and contributes to the context of other populations with phonological disabilities by showing that a complete or partial deprivation of auditory speech stimulation in adulthood can give rise to a phonological disability. (e) From a clinical point of view, the results from the present thesis suggest that early cochlear implantation after the onset of an acquired severe hearing loss is an important objective in order to reach a high level of speech understanding with the implant.

    List of papers
    1. Phonological Deterioration in Adults with an Acquired Severe Hearing Impairment
    Open this publication in new window or tab >>Phonological Deterioration in Adults with an Acquired Severe Hearing Impairment
    1998 (English)In: Scandinavian Audiology, ISSN 0107-8593, Vol. 27, no 49, p. 93-100Article in journal (Refereed) Published
    Abstract [en]

    The study examined the phonological processing skills in a group of adults who have acquired a severe hearing loss in adult life. These severely hearing-impaired individuals performed at a significantly lower level on the rhyme judgement tasks and the letter span task, but on a par with the control group on other cognitive tests. A correlation analysis showed that duration of hearing loss is negatively related to performance on the rhyme judgement tasks and letter span task. The results indicate that the phonological processing skills in individuals who have acquired a severe hearing loss in adult life deteriorates. The results are discussed with respect to theoretical and clinical implications.

    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-13496 (URN)
    Available from: 2002-10-01 Created: 2002-10-01 Last updated: 2009-08-17
    2. Deterioration of the phonological processing skills in adults with an acquired severe hearing loss
    Open this publication in new window or tab >>Deterioration of the phonological processing skills in adults with an acquired severe hearing loss
    2002 (English)In: European Journal of Cognitive Psychology, ISSN 0954-1446, Vol. 14, no 3, p. 335-352Article in journal (Refereed) Published
    Abstract [en]

    Phonological processing was examined in a group of individuals with an acquired severe hearing loss and compared to a group of matched normal hearing individuals. The hearing-impaired group was significantly slower and less accurate when performing a visual rhyme-judgement task, and produced fewer rhyming word pairs on a rhyme-generation task than the normal hearing group. In contrast, the hearing-impaired group performed on a par with the normal hearing group on verbal working memory tasks. It is concluded that specific aspects of the phonological system deteriorate in this population as a function of auditory deprivation. In particular, the phonological representations are impaired and this impairment also affects the ability to rapidly perform phonological operations (i.e., analyse and compare). In contrast, phonological processing involved in verbal working memory is preserved in this population.

    Keywords
    Hearing loss, phonological processing, working memory, lexicon, phonological representation
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-13497 (URN)10.1080/09541440143000096 (DOI)
    Available from: 2002-10-01 Created: 2002-10-01 Last updated: 2009-04-24
    3. Phonological representation and speech understanding with cochlear implants in deafened adults
    Open this publication in new window or tab >>Phonological representation and speech understanding with cochlear implants in deafened adults
    Show others...
    1998 (English)In: Scandinavian Journal of Psychology, ISSN 0036-5564, Vol. 39, no 3, p. 175-179Article in journal (Refereed) Published
    Abstract [en]

    In the present study cognitive performance in 15 deafened adult cochlear implant candidates was examined and related to level of speech understanding after 12 months of experience with the implant. The implant group performed on par with normal hearing controls in all cognitive tasks used in the study with one exception: Performance was significantly lower in cognitive tasks where use of a phonological representation of sound is a key task-demand. Observations of the implanted individuals' level of speech understanding indicate that only those individuals who, pre-operatively, were in possession of phonological representations comparable to that of normal hearing could follow and understand a speaker that was out of sight. The results are discussed with respect to (a) deterioration in the phonological representation of sounds as a function of absence of external auditory stimulation, and (b) the role of cognitive factors in predicting success in speech understanding with the implant.

    Keywords
    Cochlear implants, phonological representation, cognition
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-13498 (URN)10.1111/1467-9450.393075 (DOI)
    Available from: 2002-10-01 Created: 2002-10-01 Last updated: 2009-08-19
    4. Cognitive correlates of visual speech understanding in hearing impaired individuals
    Open this publication in new window or tab >>Cognitive correlates of visual speech understanding in hearing impaired individuals
    2001 (English)In: Journal of Deaf Studies and Deaf Education, ISSN 1081-4159, Vol. 6, no 2, p. 103-116Article in journal (Refereed) Published
    Abstract [en]

    This study examined the extent to which different measures ofspeechreading performance correlated with particular cognitiveabilities in a population of hearing-impaired people. Althoughthe three speechreading tasks (isolated word identification,sentence comprehension, and text tracking) were highly intercorrelated,they tapped different cognitive skills. In this population,younger participants were better speechreaders, and, when agewas taken into account, speech tracking correlated primarilywith (written) lexical decision speed. In contrast, speechreadingfor sentence comprehension correlated most strongly with performanceon a phonological processing task (written pseudohomophone detection)but also on a span measure that may have utilized visual, nonverbalmemory for letters. We discuss the implications of this pattern.

    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-13499 (URN)10.1093/deafed/6.2.103 (DOI)
    Available from: 2002-10-01 Created: 2002-10-01 Last updated: 2016-03-14
  • 3.
    Andin, Josefine
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Dealing with Digits: Arithmetic, Memory and Phonology in Deaf Signers2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Deafness has been associated with poor abilities to deal with digits in the context of arithmetic and memory, and language modality-specific differences in the phonological similarity of digits have been shown to influence short-term memory (STM). Therefore, the overall aim of the present thesis was to find out whether language modality-specific differences in phonological processing between sign and speech can explain why deaf signers perform at lower levels than hearing peers when dealing with digits. To explore this aim, the role of phonological processing in digit-based arithmetic and memory tasks was investigated, using both behavioural and neuroimaging methods, in adult deaf signers and hearing non-signers, carefully matched on age, sex, education and non-verbal intelligence. To make task demands as equal as possible for both groups, and to control for material effects, arithmetic, phonological processing, STM and working memory (WM) were all assessed using the same presentation and response mode for both groups. The results suggested that in digit-based STM, phonological similarity of manual numerals causes deaf signers to perform more poorly than hearing non-signers. However, for  digit-based WM there was no difference between the groups, possibly due to differences in allocation of resources during WM. This indicates that similar WM for the two groups can be generalized from lexical items to digits. Further, we found that in the present work deaf signers performed better than expected and on a par with hearing peers on all arithmetic tasks, except for multiplication, possibly because the groups studied here were very carefully matched. However, the neural networks recruited for arithmetic and phonology differed between groups. During multiplication tasks, deaf signers showed an increased  reliance on cortex of the right parietal lobe complemented by the left inferior frontal gyrus. In contrast, hearing non-signers relied on cortex of the left frontal and parietal lobes during multiplication. This suggests that while hearing non-signers recruit phonology-dependent arithmetic fact retrieval processes for multiplication, deaf signers recruit non-verbal magnitude manipulation processes. For phonology, the hearing non-signers engaged left lateralized frontal and parietal areas within the classical perisylvian language network. In deaf signers, however, phonological processing was limited to cortex of the left occipital lobe, suggesting that sign-based phonological processing does not necessarily activate the classical language network. In conclusion, the findings of the present thesis suggest that language modality-specific differences between sign and speech in different ways can explain why deaf signers perform at lower levels than hearing non-signers on tasks that include dealing with digits.

    List of papers
    1. Similar digit-based working memory in deaf signers and hearing non-signers despite digit span differences
    Open this publication in new window or tab >>Similar digit-based working memory in deaf signers and hearing non-signers despite digit span differences
    Show others...
    2013 (English)In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 4, no 942Article in journal (Refereed) Published
    Abstract [en]

    Similar working memory (WM) for lexical items has been demonstrated for signers and non-signers while short-term memory (STM) is regularly poorer in deaf than hearing individuals. In the present study, we investigated digit-based WM and STM in Swedish and British deaf signers and hearing non-signers. To maintain good experimental control we used printed stimuli throughout and held response mode constant across groups. We showed that deaf signers have similar digit-based WM performance, despite shorter digit spans, compared to well-matched hearing non-signers. We found no difference between signers and non-signers on STM span for letters chosen to minimize phonological similarity or in the effects of recall direction. This set of findings indicates that similar WM for signers and non-signers can be generalized from lexical items to digits and suggests that poorer STM in deaf signers compared to hearing non-signers may be due to differences in phonological similarity across the language modalities of sign and speech.

    Keywords
    deaf signers, working memory, short term memory, phonological similarity, Cross-cultural
    National Category
    Psychology (excluding Applied Psychology)
    Identifiers
    urn:nbn:se:liu:diva-102262 (URN)10.3389/fpsyg.2013.00942 (DOI)000331572800002 ()
    Funder
    Swedish Research Council, 20051353Forte, Swedish Research Council for Health, Working Life and Welfare, 2008-0846Riksbankens Jubileumsfond, P2008-0481:1-E
    Available from: 2013-12-04 Created: 2013-12-04 Last updated: 2017-12-06Bibliographically approved
    2. Deaf signers use phonology to do arithmetic
    Open this publication in new window or tab >>Deaf signers use phonology to do arithmetic
    2014 (English)In: Learning and individual differences, ISSN 1041-6080, E-ISSN 1873-3425, Vol. 32, p. 246-253Article in journal (Refereed) Published
    Abstract [en]

    Deaf students generally lag several years behind hearing peers in arithmetic, but little is known about the mechanisms behind this. In the present study we investigated how phonological skills interact with arithmetic. Eighteen deaf signers and eighteen hearing non-signers took part in an experiment that manipulated arithmetic and phonological knowledge in the language modalities of sign and speech. Independent tests of alphabetical and native language phonological skills were also administered. There was no difference in performance between groups on subtraction, but hearing non-signers performed better than deaf signers on multiplication. For the deaf signers but not the hearing non-signers, multiplicative reasoning was associated with both alphabetical and phonological skills. This indicates that deaf signing adults rely on language processes to solve multiplication tasks, possibly because automatization of multiplication is less well established in deaf adults.

    Place, publisher, year, edition, pages
    Elsevier, 2014
    Keywords
    Deaf signers; Arithmetic; Phonology
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-108812 (URN)10.1016/j.lindif.2014.03.015 (DOI)000336820400028 ()
    Available from: 2014-07-07 Created: 2014-07-06 Last updated: 2017-12-05
    3. Phonology and arithmetic in the language-calculation network
    Open this publication in new window or tab >>Phonology and arithmetic in the language-calculation network
    2015 (English)In: Brain and Language, ISSN 0093-934X, E-ISSN 1090-2155, Vol. 143, p. 97-105Article in journal (Refereed) Published
    Abstract [en]

    Arithmetic and language processing involve similar neural networks, but the relative engagement remains unclear. In the present study we used fMRI to compare activation for phonological, multiplication and subtraction tasks, keeping the stimulus material constant, within a predefined language-calculation network including left inferior frontal gyrus and angular gyrus (AG) as well as superior parietal lobule and the intraparietal sulcus bilaterally. Results revealed a generally left lateralized activation pattern within the language-calculation network for phonology and a bilateral activation pattern for arithmetic, and suggested regional differences between tasks. In particular, we found a more prominent role for phonology than arithmetic in pars opercularis of the left inferior frontal gyrus but domain generality in pars triangularis. Parietal activation patterns demonstrated greater engagement of the visual and quantity systems for calculation than language. This set of findings supports the notion of a common, but regionally differentiated, language-calculation network. (C) 2015 The Authors. Published by Elsevier Inc.

    Place, publisher, year, edition, pages
    Elsevier, 2015
    Keywords
    Phonology; Arithmetic; Brain imaging; Perisylvian language network
    National Category
    Basic Medicine
    Identifiers
    urn:nbn:se:liu:diva-117794 (URN)10.1016/j.bandl.2015.02.004 (DOI)000352659600010 ()25797099 (PubMedID)
    Note

    Funding Agencies|Swedish Research Council [2005-1353].

    The previous status of this article was Manuscript and the working title was Phonological but not arithmetic processing engages left posterior inferior frontal gyrus.

    Available from: 2015-05-11 Created: 2015-05-08 Last updated: 2018-01-11Bibliographically approved
    4. Deaf signers use magnitude manipulatioin strategies for mulitplication: fMRI evidence
    Open this publication in new window or tab >>Deaf signers use magnitude manipulatioin strategies for mulitplication: fMRI evidence
    Show others...
    2014 (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Evidence suggests that the lag reported in mathematics for deaf signers derives from difficulties related to the verbal system of number processing as described in the triple code model. For hearing individuals the verbal system has been shown to be recruited for both arithmetic and language tasks. In the present study we investigate for the first time neuronal representations of arithmetic in deaf signers. We examine if the neural network supporting arithmetic and language, including the horizontal portion of the intraparietal sulcus (HIPS), the superior parietal lobule (SPL) bilaterally, the left angular gyrus (AG), pars opercularis (POPE) and pars triangularis (PTRI) of the left inferior frontal gyrus (IFG), is differently recruited for deaf and hearing individuals. Imaging data were collected from 16 deaf signers and 16 well-matched hearing nonsigners, using the same stimulus material for all tasks, but with different cues. During multiplication, deaf signers recruited rHIPS more than hearing non-signers, suggesting greater involvement of magnitude manipulation processes related to the quantity system, whereas there was no evidence that the verbal system was recruited. Further, there was no support for the notion of a common representation of phonology for sign and speech as previously suggested.

    Keywords
    Arithmetic; phonology; fMRI; deaf; sign language; magnitude manipulation
    National Category
    Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-111560 (URN)
    Available from: 2014-10-24 Created: 2014-10-24 Last updated: 2018-04-07Bibliographically approved
  • 4.
    Bengtsson, Staffan
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Educational Sciences.
    Varför får jag icke följa med dit fram?: Medborgarskapet och den offentliga debatten om dövstumma och blinda 1860–19142005Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Different kinds of cultural studies can be used in order to learn more about disability, social policies, attitudes and citizenship. The purpose of this study is to outline some aspects of disability and Swedish society during the 19th century. The ambition is to analyse the issue of the integration of the deaf-mutes and the blind. How did politicians and educators motivate the establishment of compulsory schooling? How was the issue of correction of the body treated? How did they deal with the situation on the labour market? What kind of compensation was contemporary society willing to support? Social policies in the past are likely to be described in terms of control, repression and barriers. This study looks at disability from a more anthropological view which implies the use of hermeneutics, seeking to identify the agent’s own understanding of a problem in order to learn more about how social categorisation and citizenship are integrated and how they change. The use of original sources, such as records from the Swedish parliament and conferences held by experts as well as periodicals, makes this kind of approach possible.

    This thesis argues that disability must be understood as something that is constantly in the arena of a more dialectical struggle where a number of visions and interests have melted together. In the course of state interventionism and growing social justice, citizenship and disability to a greater extent became a question of honour. Being granted certain rights meant that the individual had passed the test and was now sanctioned as disabled, one who deserved the right to rights. This transition promoted a growing group consciousness. A more dialectical approach perforates the border between social control and humanity since they were not always mutually exclusive.

  • 5.
    Birberg Thornberg, Ulrika
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Fats in Mind: Effects of Omega-3 Fatty Acids on Cognition and Behaviour in Childhood2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to examine possible effects of omega-3 fatty acids on children’s cognition and behavior. Longitudinal as well as cross-sectional comparisons were made among children with typical development and children with ADHD /at risk developing ADHD.

    The specific purposes were to examine (1) breast-feeding in relation to cognition; (2) relation between long chain poly unsaturated fatty acids (LCPUFAs) in mothers breast-milk and children´s cognition; (3) effects of EPA supplementation on cognition and behavior in children with ADHD; (4) if LCPUFAs have differential effects on working memory, inhibition, problem-solving and theory of mind (ToM).

    The main conclusions were as follows; (1) duration of breast-feeding was positively correlated to children levels of intelligence (IQ); (2) LCPUFAs in breast-milk was related to children’s ToM and IQ, the quotient DHA/AA, together with length of breastfeeding and gestation week explained 76% of the variance of total IQ; (3) subtypes of children with ADHD responded to EPA supplementation with significant reductions in symptoms, but there were no effects in the whole group with ADHD; (4) ToM ability was related to LCPUFAs, but not to any other cognitive measures as working memory, inhibition and problem-solving.

    To conclude, these results indicate that fatty acid status in breast-milk at birth affect general cognitive function in children at 6.5 years of age, including ToM. Short-term intervention with omega-3 fatty acids does not affect cognition in children with ADHD, but improves clinical symptoms as assessed by means of teacher ratings. These results further indicate that hot executive function and social cognition may be an area of interest for future research.

    List of papers
    1. Nutrition and theory of mind: The role of polyunsaturated fatty acids (PUFA) in the development of theory of mind
    Open this publication in new window or tab >>Nutrition and theory of mind: The role of polyunsaturated fatty acids (PUFA) in the development of theory of mind
    2006 (English)In: Prostaglandins, Leukotrienes and Essential Fatty Acids, ISSN 0952-3278, E-ISSN 1532-2823, Vol. 75, no 1, p. 33-41Article in journal (Refereed) Published
    Abstract [en]

    Breast-milk provides nutrients required for the development of the brain. n-6 and n-3 long-chain polyunsaturated fatty acids (LCPUFAs) have been suggested to be particularly involved. In this study levels of fatty acids in breast-milk were examined in relation to theory of mind (ToM) (n=13) and WISC-III (n=22) in six-year-old children. ToM tasks comprised four illustrated stories with questions about emotional (sad) events. Single polyunsaturated fatty acids (PUFA) were estimated as well as ratios between different fatty acids in order to describe putative associations between PUFA and psychological measures. Results show correlations between both ToM and WISC-III with single n-6 PUFA and the ratios DHA/AA and DHA/DPA. The correlations remained when socio-demographic factors were statistically controlled for. The positive findings related to the n-6 and n-3 LCPUFAs corroborate previous findings related to child cognitive development. © 2006 Elsevier Ltd. All rights reserved.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-50186 (URN)10.1016/j.plefa.2006.04.001 (DOI)
    Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12Bibliographically approved
    2. Breastfeeding, very long polyunsaturated fatty acids (PUFA) and IQ at 6 1/2 years of age
    Open this publication in new window or tab >>Breastfeeding, very long polyunsaturated fatty acids (PUFA) and IQ at 6 1/2 years of age
    2004 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 93, no 10, p. 1280-1287Article in journal (Refereed) Published
    Abstract [en]

    Aim: Breastfeeding seems to be favorable for cognitive development. Could levels of polyunsaturated fatty acids (PUFA) explain this? Methods: Pregnant mothers were recruited consecutively at maternity care centres. PUFA were analysed in colostrum and breast milk at 1 and 3 mo. The product-precursor ratios of n-6+n-3 PUFA were examined as measures of activity in respective steps in the fatty acid metabolic chain. Also, the quotient between DHA and AA was analysed. The children were tested with the full WISC-III at 6.5 y. Results: First, the influence of length of breastfeeding was analysed by multiple regression together with relevant cofactors (except for PUFA). In the best models, 46% of the variation in total IQ was explained. Length of breastfeeding contributed significantly to total IQ (beta = 0.228, p = 0.021), verbal IQ (beta = 0.204, p = 0.040) and performance IQ (beta = 0.210, p = 0.056). There were no significant single correlations between PUFA and measures of cognitive development. However, in multiple regression analysis of colostrum, significant beta-coefficients were found for steps 4+5 in the fatty acid metabolic chain (beta = 0.559, p = 0.002). If length of breastfeeding and gestation week were added to steps 4+5, this three-factor model could explain 67% of the variation of total IQ. Introducing length of breastfeeding and gestation week together with the quotient DHA/AA (beta = 0.510, p < 0.001) yielded a three-factor model, which explained 76% of the variation in total IQ. Conclusion: Our findings could be interpreted as supporting the importance of high levels of PUFA for cognitive development. However, the sample is small and the results must be interpreted with caution.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-22154 (URN)10.1080/08035250410033123 (DOI)1264 (Local ID)1264 (Archive number)1264 (OAI)
    Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13Bibliographically approved
    3. EPA supplementation improves teacher-rated behaviour and oppositional symptoms in children with ADHD
    Open this publication in new window or tab >>EPA supplementation improves teacher-rated behaviour and oppositional symptoms in children with ADHD
    Show others...
    2010 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 10, p. 1540-1549Article in journal (Refereed) Published
    Abstract [en]

    Aim: Measure efficacy of eicosapentaenoic acid (EPA) in children with attention deficit hyperactivity disorder (ADHD). Methods: Randomized controlled trial (RCT) of 0.5 g EPA or placebo (15 weeks) in 92 children (7-12 years) with ADHD. Efficacy measure was Conners Parent/Teacher Rating Scales (CPRS/CTRS). Fatty acids were analysed in serum phospholipids and red blood cell membranes (RBC) at baseline and endpoint with gas chromatography. Results: EPA improved CTRS inattention/cognitive subscale (p = 0.04), but not Conners total score. In oppositional children (n = 48), CTRS total score improved andgt;= 25% in 48% of the children receiving EPA vs. 9% for placebo [effect size (ES) 0.63, p = 0.01]. In less hyperactive/impulsive children (n = 44), andgt;= 25% improvement was seen in 36% vs. 18% (ES 0.41, n.s.), and with both these types of symptoms 8/13 with EPA vs. 1/9 for placebo improved andgt;= 25% (p = 0.03). Children responding to treatment had lower EPA concentrations (p = 0.02), higher AA/EPA (p = 0.005) and higher AA/DHA ratios (p = 0.03) in serum at baseline. Similarly, AA/EPA (p = 0.01), AA/DHA (p = 0.038) and total omega-6/omega-3 ratios (p = 0.028) were higher in RBC, probably because of higher AA (p = 0.011). Conclusion: Two ADHD subgroups (oppositional and less hyperactive/impulsive children) improved after 15-week EPA treatment. Increasing EPA and decreasing omega-6 fatty acid concentrations in phospholipids were related to clinical improvement.

    Place, publisher, year, edition, pages
    Blackwell Publishing Ltd, 2010
    Keywords
    ADHD, Arachidonic acid, DHA, EPA, LCPUFA, RBC, serum phospholipids
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-59732 (URN)10.1111/j.1651-2227.2010.01871.x (DOI)000281556700025 ()
    Available from: 2010-09-24 Created: 2010-09-24 Last updated: 2017-12-12Bibliographically approved
    4. A Placebo controlled, randomized study of PUFA (Poly Unsaturated Fatty Acids) as treatment for neurodevelopmental problems in 7-year-old children and cognitive performance in relation to an age-matched control group
    Open this publication in new window or tab >>A Placebo controlled, randomized study of PUFA (Poly Unsaturated Fatty Acids) as treatment for neurodevelopmental problems in 7-year-old children and cognitive performance in relation to an age-matched control group
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    OBJECTIVE: The goal of the present randomized placebo controlled double-blind study was to investigate the potential effect of PUFA supplementation on cognitive and behavioural performance in children with neurodevelopmental problems at 7 years of age (n = 28) and to compare findings with an age matched healthy control group (n = 20).

    METHODS: Children were screened with parent and teacher rating scales (Conner’s and SNAP-IV), and were included if they showed a range of neurodevelopmental problems that reached ADHD criteria. The group with neurodevelopmental difficulties was randomized to treatment with an EPA rich formula (n = 13) or to placebo (n = 15). Cognitive performance was determined at baseline and after 15 weeks of supplementation with a cognitive test battery including executive function and theory of mind tasks.

    RESULTS: Children with neurodevelopmental problems differed from the control group regarding working memory, inhibition and language ability, but not on an advanced theory of mind task. Regarding the treatment with EPA supplement there were no significant advantages in the active treatment group compared to placebo in any of the cognitive measures or in parents or teacher rating scales.

    CONCLUSION: The significant differences in cognitive performance and rating scales between the group with neurodevelopmental problems and the healthy control group at baseline indicate problems at a clinical level and suitability for treatment. However we found no significant effects of PUFA supplementation. The study is small and limited by a number of drop-outs.

    National Category
    Psychology
    Identifiers
    urn:nbn:se:liu:diva-68080 (URN)
    Available from: 2011-05-10 Created: 2011-05-10 Last updated: 2011-05-10Bibliographically approved
  • 6.
    C. Manchaiah, Vinaya K.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Institute of Technology.
    Evaluating the process of change: Studies on patient journey, hearing disability acceptance and stages-of-change2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Person with hearing impairment (PHI) and their Communication partners (CPs) have a range of experiences and milestones before, during and after their audiological assessment and/or rehabilitation sessions. The term ‘patient journey’ refers to understanding the experiences and the processes the patient goes through during the course of the disease and the treatment regime. The aims of the current thesis were: (1) to further develop patient journey models of individuals with gradual-onset hearing impairment and CPs by taking their views into consideration; (2) to develop the patient journey model for PHI of sudden-onset; (3) to develop a self-reported measure of hearing disability acceptance and to study its construct and concurrent validity; (4) to investigate the health behaviour change characteristics of people noticing hearing difficulties using the stages-of-change model. 

    Papers I (n=32) and III (n=9) were aimed at further developing the journey model of PHI and their CPs proposed by the Ida Institute. Both studies employed qualitative methods (i.e., focus groups and interviews for data collection and thematic analysis for data analysis), and defined the models based on the perspectives of PHI and CPs both of which had seven main phases. These data were compared with the professionals’ perspectives of the journey as reported in the Ida Institute model which had six main phases. Our studies highlight new phases (i.e., self-evaluation in PHI journey and adaptation in CP journey) and also various commonalities and differences in the perspectives expressed by professionals and patients.

    Paper II included a pilot study to explore the patient journey of sudden-onset acquired hearing impairment from both professionals (n=16) and patients (n=4) perspectives. Both identified all the six main phases, which include: awareness; movement; diagnostics; rehabilitation; self-evaluation; and resolution. The pre-awareness phase may hinder the realisation of hearing loss in persons with gradual onset hearing loss, whereas it is far more straightforward in persons with sudden-onset due to its nature of onset.

    Papers IV and V employed a cross-sectional design (n=90). Paper IV was aimed at developing a Hearing Disability Acceptance Questionnaire (HDAQ), and to study its construct and concurrent validity. Results suggested that the HDAQ has a two factor structure which explains 75.7% of the variance and had good internal consistency (Cronbach’s alpha of 0.86). Also, the scale had good concurrent validity in relation to self-reported hearing disability, self-reported anxiety and depression and readiness to change measures. Paper V was aimed at understanding the stages-of-change in adults with hearing disability using the University of Rhode Island Change Assessment Scale.  As predicted a high percentage of participants (over 90%) were in the contemplation and preparation stages, supporting the stages-of-change model.

    Overall, the papers presented in this thesis may contribute to a better understanding of process of change through hearing impairment in PHI and their CPs. 

    List of papers
    1. The patient journey of adults with hearing impairment: the patients’ views
    Open this publication in new window or tab >>The patient journey of adults with hearing impairment: the patients’ views
    2011 (English)In: Clinical Otolaryngology, ISSN 1749-4478, E-ISSN 1365-2273, Vol. 36, no 3, p. 227-234Article in journal (Refereed) Published
    Abstract [en]

    Objective:  The term ‘patient journey’ refers to the experiences and processes the patient goes through during the course of a disease and its treatment. The study explores the perspectives of adults with acquired hearing impairment and to further develop the patient journey template based on the Ida model. Design:  Qualitative approach using thematic analysis and process mapping. Setting:  Support groups of people with hearing impairment. Participants:  Thirty-two adults with acquired hearing impairment from two hearing impaired groups in Wales. All were hearing aid users. Main outcome measure:  Participants worked in small groups to describe their experiences through hearing loss. These data were used to develop a template of the patients’ perspective of the journey. This was then compared with the perspective of professionals, and a ‘patient journey template for adults with acquired hearing impairment’ was developed. Results:  This template identifies seven main phases as follows: (i) pre-awareness; (ii) awareness; (iii) movement; (iv) diagnostics; (v) rehabilitation; (vi) self-evaluation; and (vii) resolution. The study identified a number of new components. The self-evaluation component was not defined by professionals and reflects the need for patients to consider the costs, benefits and alternatives to the approach provided by audiologists. It is important for audiologists to be aware of this. Conclusion:  The study highlighted the differences and commonalities in perspectives of professionals and patients. Use of the patient journey can help clinicians to understand the unique experiences their patients go through help them to develop patient-centred treatment.

    National Category
    Otorhinolaryngology
    Identifiers
    urn:nbn:se:liu:diva-87637 (URN)10.1111/j.1749-4486.2011.02320.x (DOI)
    Available from: 2013-01-20 Created: 2013-01-20 Last updated: 2018-04-25
    2. The patient journey of adults with sudden-onset acquired hearing impairment: a pilot study
    Open this publication in new window or tab >>The patient journey of adults with sudden-onset acquired hearing impairment: a pilot study
    2012 (English)In: Journal of Laryngology and Otology, ISSN 0022-2151, E-ISSN 1748-5460, Vol. 126, no 5, p. 475-481Article in journal (Refereed) Published
    Abstract [en]

    Objective: A previous study examined the patient journey of adults with gradual-onset acquired hearing impairment. This study examined the same for adults with sudden-onset acquired hearing impairment, and assessed differences. less thanbrgreater than less thanbrgreater thanStudy design: Data were collected from 16 audiologists, using the Ida Institute template, and from four adults with sudden-onset acquired hearing impairment, through semi-structured interviews. Data were analysed using thematic analysis and presented using a process mapping model. less thanbrgreater than less thanbrgreater thanResults: A patient journey template for sudden-onset acquired hearing impairment was developed based on the professionals and patients perspectives. The main difference between these two groups perspectives was seen in the self-evaluation phase: some stages within this phase were recognised by the patients but not by the professionals. The main difference between the current and the previous study was the absence of a pre-awareness phase in the journey described by patients with sudden-onset acquired hearing impairment, compared with that described by patients with gradual-onset acquired hearing impairment. less thanbrgreater than less thanbrgreater thanConclusion: Patient journey templates could be useful counselling tools for ear and hearing healthcare specialists. However, such templates should be used only as a baseline; it is important to take a detailed case history to understand each patients unique experience, including the psychosocial impact of hearing impairment.

    Place, publisher, year, edition, pages
    Cambridge University Press (CUP), 2012
    Keywords
    Hearing Impairment, Natural History, Prognosis, Rehabilitation, Patient journey, Sudden-onset hearing impairment
    National Category
    Otorhinolaryngology
    Identifiers
    urn:nbn:se:liu:diva-77869 (URN)10.1017/S0022215111003197 (DOI)000303893900008 ()
    Available from: 2012-05-31 Created: 2012-05-31 Last updated: 2018-04-25
    3. Communication partners’ journey through their partner’s hearing impairment
    Open this publication in new window or tab >>Communication partners’ journey through their partner’s hearing impairment
    2013 (English)In: International Journal of Otolaryngology, ISSN 1687-9201, E-ISSN 1687-921X, Vol. 2013, no 707910, p. 1-11Article in journal (Refereed) Published
    Abstract [en]

    The objective of the study was to further the Ida Institute model on communication partner’s (CPs) journey through experiences of person with hearing impairment (PHI), based on the perspectives of CPs. Qualitative approach using thematic analysis and process mapping. Nine CPs of hearing aid users participated in the study, recruited through the Swansea hearing impaired support group. Semi-structured interviews were conducted and the data were used to develop a CP journey template. The Ida Institute model (based on professionals’ perspective) was compared with the new template developed (based on CPs perspectives). Seven main phases were identified which include: (1) contemplation; (2) awareness; (3) persuasion; (4) validation; (5) rehabilitation; (6) adaptation; and (7) resolution. The results suggest some commonalities and differences between the views of professionals and CPs. A new phase ‘adaptation’ was identified from CPs’ reported experiences, which was not identified by professionals in the Ida Institute model. The CP journey model could be a useful tool during audiological enablement/rehabilitation sessions to promote discussion between the PHI and the CP. In addition, it can be used in the training of hearing healthcare professionals.

    Place, publisher, year, edition, pages
    Hindawi Publishing Corporation, 2013
    Keywords
    Patient journey, Communication partners, significant others, hearing impairment, hearing loss
    National Category
    Otorhinolaryngology
    Identifiers
    urn:nbn:se:liu:diva-87633 (URN)10.1155/2013/707910 (DOI)
    Available from: 2013-01-20 Created: 2013-01-20 Last updated: 2018-04-25
    4. The acceptance of hearing disability among adults experiencing hearing difficulties: a cross-sectional study
    Open this publication in new window or tab >>The acceptance of hearing disability among adults experiencing hearing difficulties: a cross-sectional study
    Show others...
    2014 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 4, no e004066Article in journal (Refereed) Published
    Abstract [en]

    Objective This study developed the Hearing Disability Acceptance Questionnaire (HDAQ) and tested its construct and concurrent validities.

    Design Cross-sectional.

    Participants A total of 90 participants who were experiencing hearing difficulties were recruited in the UK.

    Outcome measures The HDAQ was developed based on the Tinnitus Acceptance Questionnaire (TAQ). Participants completed self-report measures regarding hearing disability acceptance, hearing disability, symptoms of anxiety and depression and a measure of stages of change.

    Results The HDAQ has a two-factor structure that explains 75.69% of its variance. The factors identified were activity engagement and avoidance and suppression. The scale showed a sufficient internal consistency (Cronbach's α=0.86). The HDAQ also had acceptable concurrent validity with regard to self-reported hearing disability, self-reported anxiety and depression and readiness to change measures.

    Conclusions Acceptance is likely an important aspect of coping with chronic health conditions. To our knowledge, no previously published and validated scale measures the acceptance of hearing disability; therefore, the HDAQ might be useful in future research. However, the role of acceptance in adjusting to hearing disability must be further investigated

    Place, publisher, year, edition, pages
    BMJ Open, 2014
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-102999 (URN)10.1136/bmjopen-2013-004066 (DOI)000337363700020 ()
    Available from: 2014-01-09 Created: 2014-01-09 Last updated: 2018-04-25
    5. Stages of change in adults noticing hearing difficulties but not using hearing aids
    Open this publication in new window or tab >>Stages of change in adults noticing hearing difficulties but not using hearing aids
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Objective: The aim of the current study was to investigate health behaviour change characteristics based on the transtheoretical stages-of-change model in adults noticing hearing difficulties but not using hearing aids using the University of Rhode Island Change Assessment (URICA) scale.

    Design: The study employed a cross-sectional design.

    Study Sample: The study was conducted in United Kingdom and 90 pre-clinical participants completed URICA as well as measures of self-reported hearing disability, self-reported anxiety and depression, self-reported hearing disability acceptance and also provided some demographic details online.

    Results: As predicted, the results indicate that a high percentage of participants (over 90%) were in the contemplation and preparation stages. This was in contrast to a previous study, which included participants attending audiology clinic, where most participants (about 80%) were in the action stage (Laplante-Lévesque et al., 2013). In addition, statistically significant differences were observed in terms of readiness to change composite and committed action composite between the study samples in the current and the previous study.

    Conclusions: Study results support the stages-of-change model. In addition, implications of the current study and areas for future research are discussed.

    Keywords
    Hearing disability, hearing loss, stages of change, readiness for change, hearing helpseeking, audiological rehabilitation
    National Category
    Otorhinolaryngology
    Identifiers
    urn:nbn:se:liu:diva-95919 (URN)
    Available from: 2013-08-09 Created: 2013-08-09 Last updated: 2018-04-25Bibliographically approved
  • 7.
    Classon, Elisabet
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Representing sounds and spellings: Phonological decline and compensatory working memory in acquired hearing impairment2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis examined phonological processing in adults with postlingually acquired moderate-to-severe hearing impairment (HI) and whether explicit working memory processing of phonology and individual working memory capacity (WMC) can compensate for degraded phonological representations in this group (papers I-III). A second aim was to provide reference data for a test of WMC, the reading span test, and to examine the relation between reading span test performance and speech recognition in noise in a larger sample of 50-89 year olds with HI (paper IV). Non-auditory tasks of phonological processing, episodic long-term memory and WMC were used in papers I-III, and both behavioral and electrophysiological measures were collected. Results showed that phonological processing was impaired in the group with HI but that WMC and explicit working memory processing of phonology could be employed to compensate for degraded phonological representations. However, this compensation may come at the cost of interfering with episodic memory encoding. An  electrophysiological marker of HI in text-based rhyme judgments was found. Paper IV presented reference data for reading span test performance in two versions of the test in individuals with HI, and results suggesting that WMC may be differentially predictive of speech recognition in noise in different age groups of older adults with HI. The clinical implications of the present results concerns the double disadvantage of individuals with lower WMC and HI. A structured assessment of WMC in rehabilitative settings would help to identify these individuals and tailor treatment to their needs. The reading span test is suggested as a suitable future candidate for clinical WMC assessment.

    List of papers
    1. Early ERP signature of hearing impairment in visual rhyme judgment
    Open this publication in new window or tab >>Early ERP signature of hearing impairment in visual rhyme judgment
    2013 (English)In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 4, no 241Article in journal (Refereed) Published
    Abstract [en]

    Postlingually acquired hearing impairment (HI) is associated with changes in the representation of sound in semantic long-term memory. An indication of this is the lower performance on visual rhyme judgment tasks in conditions where phonological and orthographic cues mismatch, requiring high reliance on phonological representations. In this study, event-related potentials (ERPs) were used for the first time to investigate the neural correlates of phonological processing in visual rhyme judgments in participants with acquired HI and normal hearing (NH). Rhyme task word pairs rhymed or not and had matching or mismatching orthography. In addition, the inter-stimulus interval (ISI) was manipulated to be either long (800 ms) or short (50 ms). Long ISIs allow for engagement of explicit, top-down processes, while short ISIs limit the involvement of such mechanisms. We hypothesized lower behavioral performance and N400 and N2 deviations in HI in the mismatching rhyme judgment conditions, particularly in short ISI. However, the results showed a different pattern. As expected, behavioral performance in the mismatch conditions was lower in HI than in NH in short ISI, but ERPs did not differ across groups. In contrast, HI performed on a par with NH in long ISI. Further, HI, but not NH, showed an amplified N2-like response in the non-rhyming, orthographically mismatching condition in long ISI. This was also the rhyme condition in which participants in both groups benefited the most from the possibility to engage top-down processes afforded with the longer ISI. Taken together, these results indicate an early ERP signature of HI in this challenging phonological task, likely reflecting use of a compensatory strategy. This strategy is suggested to involve increased reliance on explicit mechanisms such as articulatory recoding and grapheme-to-phoneme conversion.

    Place, publisher, year, edition, pages
    Switzerland: Frontiers Research Foundation, 2013
    Keywords
    event-related potentials, hearing impairment, phonology, visual rhyme judgment, inter-stimulus interval, N2, N400, FP
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-92284 (URN)10.3389/fpsyg.2013.00241 (DOI)000330942000001 ()
    Available from: 2013-05-08 Created: 2013-05-08 Last updated: 2017-12-06Bibliographically approved
    2. Working memory capacity compensates for hearing related phonological processing deficit
    Open this publication in new window or tab >>Working memory capacity compensates for hearing related phonological processing deficit
    2013 (English)In: Journal of Communication Disorders, ISSN 0021-9924, E-ISSN 1873-7994, Vol. 46, no 1, p. 17-29Article in journal (Refereed) Published
    Abstract [en]

    Acquired hearing impairment is associated with gradually declining phonological representations. According to the Ease of Language Understanding (ELU) model, poorly defined representations lead to mismatch in phonologically challenging tasks. To resolve the mismatch, reliance on working memory capacity (WMC) increases. This study investigated whether WMC modulated performance in a phonological task in individuals with hearing impairment. A visual rhyme judgment task with congruous or incongruous orthography, followed by an incidental episodic recognition memory task, was used. In participants with hearing impairment, WMC modulated both rhyme judgment performance and recognition memory in the orthographically similar non-rhyming condition; those with high WMC performed exceptionally well in the judgment task, but later recognized few of the words. For participants with hearing impairment and low WMC the pattern was reversed; they performed poorly in the judgment task but later recognized a surprisingly large proportion of the words. Results indicate that good WMC can compensate for the negative impact of auditory deprivation on phonological processing abilities by allowing for efficient use of phonological processing skills. They also suggest that individuals with hearing impairment and low WMC may use a non-phonological approach to written words, which can have the beneficial side effect of improving memory encoding. less thanbrgreater than less thanbrgreater thanLearning outcomes: Readers will be able to: (1) describe cognitive processes involved in rhyme judgment, (2) explain how acquired hearing impairment affects phonological processing and (3) discuss how reading strategies at encoding impact memory performance.

    Place, publisher, year, edition, pages
    ELSEVIER, 2013
    Keywords
    Hearing impairment, Phonology, Working memory capacity, Episodic recognition
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-74276 (URN)10.1016/j.jcomdis.2012.10.001 (DOI)000314140200002 ()
    Available from: 2012-01-23 Created: 2012-01-23 Last updated: 2017-12-08
    3. Verbal fluency in adults with postlingually acquired hearing impairment
    Open this publication in new window or tab >>Verbal fluency in adults with postlingually acquired hearing impairment
    2013 (English)In: Speech, Language and Hearing, ISSN 2050-571X, Vol. 17, no 2, p. 88-100Article in journal (Refereed) Published
    Abstract [en]

    This study examined verbal retrieval in participants with acquired moderate-to-severe sensorineural hearing impairment (M age = 63, M education level = 13 years) compared to participants with normal hearing thresholds (M age = 62, M education level = 14 years) using the letter and category fluency tasks. Analyses of number of words produced, clustering, and switching, were conducted. There was no significant difference between the groups in category fluency performance. In letter fluency, however, the participants with hearing impairment produced significantly fewer words than the normal hearing participants and their production was characterized by fewer switches. Regression analyses were conducted to examine the relationship between demographic, auditory, and cognitive variables and letter fluency performance in the two groups. Phonological skills and auditory acuity predicted letter fluency output only in participants with hearing impairment and a hearing-related link between phonological skills, working memory capacity, and letter fluency switching was found.

    Keywords
    Hearing impairment, Letter fluency, Category fluency, Clustering, Switching, Phonology, Working memory capacity
    National Category
    Other Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-99778 (URN)10.1179/205057113X13781290153457 (DOI)
    Available from: 2013-10-21 Created: 2013-10-21 Last updated: 2017-11-06Bibliographically approved
    4. Reading span performance in 339 Swedish 50-89 year old individuals with hearing impairment: Effects of test version and age, and relation to speech recognition in noise
    Open this publication in new window or tab >>Reading span performance in 339 Swedish 50-89 year old individuals with hearing impairment: Effects of test version and age, and relation to speech recognition in noise
    Show others...
    2013 (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    The Swedish reading span test (Rönnberg, Lyxell, Arlinger, & Kinnefors, 1989) is often used to assess working memory capacity (WMC) in the field of cognitive hearing science. The test has proven useful as a predictor of speech recognition in noise in adverse conditions. It has been used in a wide range of experimental studies and has been translated to several languages. The purpose of this paper was to provide reference data for the Swedish reading span test (Rönnberg et al., 1989) in a large sample of adults with hearing impairment aged 50-89 years that are representative of patients seeking rehabilitation at audiological clinics. Data from finished and ongoing projects were collated and reanalyzed for this purpose. The original full version and a shortened version of the test were compared, in terms of percentage correct. In addition, performance on the full version was compared across two different age-cohorts, 50-69 year olds and 70-89 year olds. Frequency distributions and percentile scores are reported, as well as relations with demographic variables, and speech recognition in noise. Results showed that reading span performance was related to age, but not sex, with lower scores in older participants. Pure tone hearing thresholds accounted for a small but significant amount of the variance such that higher reading span scores were related to better hearing. The frequency distributions of scores did not differ across the two versions of the test, but the long version seemed to be more sensitive to age. Performance in both versions was significantly correlated with speech recognition in noise. Regression analyses however showed that reading span explained additional variance in speech in noise recognition, after the effects of age and pure tone hearing thresholds were accounted for, only in the 50-69 year olds. These findings are discussed in relation to  age-related differences in the ability to recruit cognitive resources in the service of speech communication.

    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-99780 (URN)
    Available from: 2013-10-21 Created: 2013-10-21 Last updated: 2017-11-06Bibliographically approved
  • 8.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Focus on Chronic Disease through Different Lenses of Expertise: Towards Implementation of Patient-Focused Decision Support Preventing Disability: The Example of Early Rheumatoid Arthritis2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disease. Treatment strategies emphasize early multi-professional interventions to reduce disease activity and to prevent disability, but there is a lack of knowledge on how optimal treatment can be provided to each individual patient.

    Aim: To elucidate how clinical manifestations of early RA are associated to disease and disability outcomes, to strive for greater potential to establish prognosis in early RA, and to facilitate implementation of decision support through analyses of the decision-making environment in chronic care.

    Methods: Multivariate statistics and mathematical modelling, as well as field observations and focus group interviews.

    Results: Decision support: A prognostic tree that predicted patients with a poor prognosis (moderate or high levels of DAS-28) at one year after diagnosis had a performance of 25% sensitivity, 90% specificity and a positive predictive value of 76%. Implementation of a decision support application at a rheumatology unit should include taking into account incentive structures, workflow and awareness, as well as informal communication structures. Prognosis: A considerable part of the variance in disease activity at one year after diagnosis could be explained by disease progression during the first three months after diagnosis. Using different types of knowledge – different expertise – prior to standardized data mining methods was found to be a promising when mining (clinical) data for new patterns that elicit new knowledge. Disease and disability: Women report more fatigue than men in early RA, although the difference is not consistently significant. Fatigue in early RA is closely and rather consistently related to disease activity, pain and activity limitation, as well as to mental health and sleep disturbance.

    Conclusion: A decision tree was designed to identify patients at risk of poor prognosis at one year after the diagnosis of RA. When constructing prediction rules for good or poor prognosis, including more measures of disease and disability progressions showed promise. Using different types of knowledge – different lenses of expertise – prior to standardized data mining methods was also a promising method when mining (clinical) data for new patterns that elicit new knowledge.

    List of papers
    1. Prognostic components and predictive modelling of prognosis in early RA
    Open this publication in new window or tab >>Prognostic components and predictive modelling of prognosis in early RA
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Introduction: There is a need for tools that are easy to use in clinical practice supporting decision making upon treatment in early rheumatoid arthritis (RA). Aim: The aim was to identify components of prognosticators in early RA and to identify individual patients with a poor prognosis as early as possible.

    Methods: Two cohorts from the Swedish TIRA project including 320+408 patients with recent onset RA were included in the study. Disease activity was measured by C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and the 28-joint count disease activity score (DAS-28), and by the physicians’ global assessment of disease activity (PGA). Disability was assessed as activity limitation by the Swedish version of the Health Assessment Questionnaire (HAQ) and impairment was reported by pain on a visual analogue scale of 0–100 mm. Serological markers were rheumatoid factor (RF) and anti-CCP. RF was measured at the time for diagnosis, and anti-CCP at the time of diagnosis or at one or some of the follow-ups. If at least one anti-CCP test was positive, the patient was judged to be anti-CCP-positive. Assuming different clinical practice in the different cohorts, two different treatment strategies were assumed based on clinical practice in real-world settings. Principal Component Analysis and Multiple Linear Regression Analysis were used to identify prognosticators. Prediction rules were identified by data-driven approach, controlling for different treatment strategies.

    Results: Progression of disease and disability measures and inflammation measures the first three months after inclusion predicted a considerable part of DAS-28 at the 1-year follow-up. Serological markers had a larger explanatory power for men than for women. Anti-CCP was a significant predictor for men, but not for women. Two versions of rules, one for women and one for men, predicting good or poor prognosis at one year after inclusion were produced by using measures of disability (Health Assessment Questionnaire), DAS-28, relative change in DAS-28 during first three months, sex, and test of anti-CCP. The rules demanded high prognostic specificity but the prognostic sensitivity was moderate.

    Conclusion: A considerable part of DAS-28 at one year after inclusion could be explained by the first 3 months’ progression of disease, disability and inflammation. Anti-CCP was predictive for men but not for women, and needs further investigation. A decision tree predicting poor prognosis among individual early RA-patients showed high specificity and moderate sensitivity on a validationcohort. The medical informatics approach used, controlling for different treatment strategies, yields promising results and further studies will control for more specific differences in treatment strategies, e.g. different DMARDs initiated.

    National Category
    Social Work
    Identifiers
    urn:nbn:se:liu:diva-18104 (URN)
    Available from: 2009-05-06 Created: 2009-05-06 Last updated: 2018-04-07Bibliographically approved
    2. A simple method for heuristic modeling of expert knowledge in chronic disease: identification of prognostic subgroups in rheumatology
    Open this publication in new window or tab >>A simple method for heuristic modeling of expert knowledge in chronic disease: identification of prognostic subgroups in rheumatology
    Show others...
    2008 (English)In: eHealth Beyond the Horizon – Get IT There, IOS Press, 2008, Vol. 136, p. 157-162Conference paper, Published paper (Refereed)
    Abstract [en]

    Identification of prognostic subgroups is of key clinical interest at the early stages of chronic disease. The aim of this study is to examine whether representation of physicians' expert knowledge in a simple heuristic model can improve data mining methods in prognostic assessments of patients with rheumatoid arthritis (RA). Five rheumatology consultants' experiences of clinical data patterns among RA patients, as distinguished from healthy reference populations, were formally represented in a simple heuristic model. The model was used in K-mean-clustering to determine prognostic subgroups. Cross-sectional validation using physician's global assessment scores indicated that the simple heuristic model performed better than crude data made in identification of prognostic subgroups of RA patients. A simple heuristic model of experts' knowledge was found useful for semi-automatic data mining in the chronic disease setting. Further studies using categorical baseline data and prospective outcome variables are warranted and will be examined in the Swedish TIRA-program.

    Place, publisher, year, edition, pages
    IOS Press, 2008
    Series
    Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365 ; Vol. 136
    Keywords
    Knowledge engineering, Clinical Decision Support Systems, Semiautomated Data Mining, Rheumatoid Arthritis, Mathematical models in medicine
    National Category
    Social Work
    Identifiers
    urn:nbn:se:liu:diva-18106 (URN)000274308700026 ()18487724 (PubMedID)978-1-58603-864-9 (ISBN)978-1-60750-333-0 (ISBN)
    Conference
    21st International Congress of the European-Federation-for-Medical-Informatic (MIE2008), Gothenburg, Sweden, MAY 25-28, 2008
    Available from: 2009-05-06 Created: 2009-05-06 Last updated: 2018-04-07Bibliographically approved
    3. Factors related to fatigue in women and men with early rheumatoid arthritis: The Swedish TIRA study
    Open this publication in new window or tab >>Factors related to fatigue in women and men with early rheumatoid arthritis: The Swedish TIRA study
    2009 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, no 11, p. 904-912Article in journal (Refereed) Published
    Abstract [en]

    Objective: To study whether there are differences between women and men, with regard to the reported level of fatigue, and to explore the strength of the relations between fatigue and disease activity, pain, sleep disturbance, mental health, and activity limitation in early rheumatoid arthritis, and also to explore the consistency of such findings.

    Design: Analyses and comparisons of cross-sectional data.

    Subjects. 276 patients, 191 women and 85 men, with early rheumatoid arthritis were included.

    Method: Patients were examined with respect to 28-joint count disease activity score, and disability variables reflecting pain, sleep disturbance, fatigue, mental health, and activity limitation, at follow-ups at one, two and three years after diagnosis.

    Results: Women reported somewhat more fatigue than men. Fatigue was closely and rather consistently related to disease activity, pain and activity limitation, and also to mental health and sleep disturbance.

    Conclusion: Although this study does not permit conclusions about causal directions, statistical relationships may be related to clinical conceptions about causation: When disease activity can be significantly reduced by pharmacological treatment, this may have a positive effect on fatigue. Specific treatment with respect to the mentioned disability aspects that are related to fatigue is also a clinically reasonable strategy.

    Place, publisher, year, edition, pages
    Uppsala, Sweden: FOUNDATION REHABILITATION INFORMATION, 2009
    Keywords
    Early rheumatoid arthritis, fatigue, sleep disturbance, sex
    National Category
    Social Work
    Identifiers
    urn:nbn:se:liu:diva-18108 (URN)10.2340/16501977-0444 (DOI)000271102800008 ()19841842 (PubMedID)
    Available from: 2009-05-06 Created: 2009-05-06 Last updated: 2018-04-07Bibliographically approved
    4. Designing a decision support system for existing clinical organizational structures: Considerations from a rheumatology clinic
    Open this publication in new window or tab >>Designing a decision support system for existing clinical organizational structures: Considerations from a rheumatology clinic
    Show others...
    2006 (English)In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 30, no 5, p. 325-331Article in journal (Refereed) Published
    Abstract [en]

    The aim of this study was to identify the social and organizational requirements for a decision support system (DSS) to be implemented in a clinical rheumatology setting, utilizing data-mining techniques. Field observations and focus group interviews were used for data collection. The decision-making was found to be situated, patient-focused, and long-term in nature. At the same time, the main part of peer-to-peer communication was informal. Patient records were involved in almost every decision. The conclusion is that the main challenges, when introducing a DSS at a rheumatology unit, are adapting the system to informal communication structures and integrating it with patient records. Considering incentive structures, understanding workflow and incorporating awareness are relevant issues when addressing these issues in future studies.

    National Category
    Social Work
    Identifiers
    urn:nbn:se:liu:diva-18111 (URN)10.1007/s10916-005-9000-1 (DOI)17068995 (PubMedID)
    Available from: 2009-05-06 Created: 2009-05-06 Last updated: 2018-04-07Bibliographically approved
  • 9.
    Danielsson, Henrik
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Facing the Illusion Piece by Piece: Face Recognition for Persons with Learning Disability2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The general purpose of this thesis was to investigate face recognition for persons with or without learning disability. Three specific research questions were investigated:

    1. How does familiarity of faces interact with familiarity of environments in pictures for persons with learning disability?

    2. Which, if any, of the 2 theoretical approaches to memory conjunction errors, the binding approach and the dual-processing approach, can explain performance for both persons with and without learning disability?

    3. How does working memory relate to performance in memory conjunction error studies?

    The results of the 4 papers included in this thesis provided answers to the questions:

    1. A person by environment interaction was found and was explained by an absent, present or implausible association between the person and the environment in the picture. These semantic relations determined performance and a “lazy” semantic strategy was suggested.

    2. Different group by recognition type interaction patterns, and specifically different amounts of conjunction errors, were found for different degrees of task difficulty. These patterns could neither be explained by the dual processing approach nor the binding approach. Hence, a new frame of interpretation which included working memory was suggested.

    3. High working memory capacity was associated with 2 effects: firstly, recognition of more facial features and, secondly, recognition of more facial configurations. At high working memory demands, participants relied on the first effect to a higher degree, at the expense of the other.

    It was also found that, in a task with low working memory demands, the performance for persons with learning disability was similar to the performance of age-matched controls with higher working memory demands in the task. This indicates that learning disability, at least in this type of recognition task, can be “simulated” by higher working memory demands in a population without learning disability. This finding is discussed in relation to witness psychology and the use of photographs as cognitive assistance.

    List of papers
    1. What am I doing in Timbuktu: Person–environment picture recognition for persons with intellectual disability
    Open this publication in new window or tab >>What am I doing in Timbuktu: Person–environment picture recognition for persons with intellectual disability
    2006 (English)In: Journal of Intellectual Disability Research, ISSN 0964-2633, Vol. 50, no 2, p. 127-138Article in journal (Refereed) Published
    Abstract [en]

    Background The aim of this study was to examine the effects of familiarity of depicted persons and environments in recognition of photographs for pupils with different degrees of intellectual disability (ID).

    Method Forty-five pupils with ID participated.

    Results An interaction effect between the two variables, person and environment, was found in addition to main effects for both the variables. Pictures of the test person himself or herself in familiar environments were easier to recognize than in unfamiliar environments, whereas the opposite was found for pictures of other familiar persons. No interaction effects of degree of ID were found.

    Conclusions The interaction pattern is explained in terms of absent, present or implausible semantic associations between the person and the environmental context. The results are discussed in relation to augmentative and alternative communication with photographs.

    Keywords
    environment recognition, familiarity, intellectual disability, person recognition, picture recognition
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-13745 (URN)10.1111/j.1365-2788.2005.00766.x (DOI)
    Note
    The definitive version is available at www.blackwell-synergy.com: Henrik Danielsson, Jerker Rönnberg and Jan Andersson, What am I doing in Timbuktu: Person–environment picture recognition for persons with intellectual disability, 2006, Journal of Intellectual Disability Research, (50), 2, 127-138. http://dx.doi.org/10.1111/j.1365-2788.2005.00766.x Copyright: Blackwell Publishing Ltd http://www.blackwellpublishing.com/ Available from: 2009-01-13 Created: 2008-12-19 Last updated: 2009-02-17Bibliographically approved
    2. The face you recognize may not be the one you saw: Memory conjunction errors in individuals with or without learning disability
    Open this publication in new window or tab >>The face you recognize may not be the one you saw: Memory conjunction errors in individuals with or without learning disability
    Show others...
    2006 (English)In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 47, no 3, p. 177-186Article in journal (Refereed) Published
    Abstract [en]

    Memory conjunction errors, that is, when a combination of two previously presented stimuli is erroneously recognized as previously having been seen, were investigated in a face recognition task with drawings and photographs in 23 individuals with learning disability, and 18 chronologically age-matched controls without learning disability. Compared to the controls, individuals with learning disability committed significantly more conjunction errors, feature errors (one old and one new component), but had lower correct recognition, when the results were adjusted for different guessing levels. A dual-processing approach gained more support than a binding approach. However, neither of the approaches could explain all of the results. The results of the learning disability group were only partly related to non-verbal intelligence.

    Keywords
    Face recognition, memory conjunction errors, learning disability
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-13746 (URN)10.1111/j.1467-9450.2006.00505.x (DOI)
    Note
    The definitive version is available at www.blackwell-synergy.com: Henrik Danielsson, Jerker Rönnberg, Anna Levén, Jan Andersson, Karin Andersson and Björn Lyxell, The face you recognize may not be the one you saw: Memory conjunction errors in individuals with or without learning disability, 2006, Scandinavian Journal of Psychology, (47), 3, 177-186. http://dx.doi.org/10.1111/j.1467-9450.2006.00505.x Copyright: Blackwell Publishing Ltd http://www.blackwellpublishing.com/ Available from: 2009-01-13 Created: 2008-12-17 Last updated: 2017-12-13Bibliographically approved
    3. Verbal overshadowing and memory conjunction errors in persons with learning disability
    Open this publication in new window or tab >>Verbal overshadowing and memory conjunction errors in persons with learning disability
    2006 (English)Article in journal (Refereed) Submitted
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-13747 (URN)
    Available from: 2006-01-16 Created: 2006-01-16
    4. Memory conjunction errors and working memory capacity in persons with learning disability
    Open this publication in new window or tab >>Memory conjunction errors and working memory capacity in persons with learning disability
    Show others...
    2006 (English)Article in journal (Refereed) Submitted
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-13748 (URN)
    Available from: 2006-01-16 Created: 2006-01-16
  • 10.
    Ferreira, Janna
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Sounds of silence: Phonological awareness and written language in children with and without speech2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The general aim of this thesis was to explore phonological awareness and written language in the presence and absence of speech in children with reading impairments and children with motor speech impairments. The main findings of the present thesis were: (1) For children with reading impairments who are at an early stage of reading development, interventions targeting reading and spelling should focus on their weakness rather than their strength in word decoding. (2) For children with reading impairments, phonological as well as orthographic intervention had effects on reading and spelling. The children with the lowest reading performance also showed effects of phonological intervention. (3) For children with motor speech impairments, significant differences were shown between low level readers and high level readers in the areas of auditory phoneme discrimination skills and general language skills. (4) For children with motor speech impairments, phonological intervention had effect on word spelling skills but not on reading skills. (5) In an analysis of non-word spelling errors of a girl with anarthria, more spelling errors were found on longer words, and a higher proportion of spelling errors were found in medial letter positions, implying deficit in segmentation of spoken words and working memory.

    The findings were discussed in relation to four subfields of phonological processing: phonological representations, phonological production, phonological memory and phonological awareness. The contributions of speech to reading and spelling are complex. Even a severely distorted speech can serve as a phonological feedback and for children with anarthria, the lack of speech does seem to play a role.

    The present thesis has a disability research approach and is a contribution to the overall understanding of phonological awareness and written language. Many of the findings are directly applicable to the clinical context.

    List of papers
    1. Phonological or orthographic training for children with phonological or orthographic decoding deficits
    Open this publication in new window or tab >>Phonological or orthographic training for children with phonological or orthographic decoding deficits
    2007 (English)In: Dyslexia, ISSN 1076-9242, Vol. 13, no 3, p. 211-229Article in journal (Refereed) Published
    Abstract [en]

    In a longitudinal intervention study, Swedish reading disabled children in grades 2-3 received either a phonological (n = 41) or an orthographic (n = 39) training program. Both programs were computerized and interventions took place in ordinary school settings with trained special instruction teachers. Two comparison groups, ordinary special instruction and normal readers, were also included in the study. Results showed strong average training effects on text reading and general word decoding for both phonological and orthographic training, but not significantly higher improvements than for the comparison groups. The main research finding was a double dissociation: children with pronounced phonological problems improved their general word decoding skill more from phonological than from orthographic training, whereas the opposite was observed for children with pronounced orthographic problems. Thus, in this population of children, training should focus on children's relative weakness rather than their relative strength in word decoding.

    Keywords
    intervention, phonological training, orthographic training, reading disability, word decoding
    National Category
    Social Work
    Identifiers
    urn:nbn:se:liu:diva-12731 (URN)10.1002/dys.339 (DOI)
    Available from: 2007-11-08 Created: 2007-11-08 Last updated: 2009-04-28
    2. Reading why not?: Literacy skills in children with motor and speech impairments
    Open this publication in new window or tab >>Reading why not?: Literacy skills in children with motor and speech impairments
    2007 (English)In: Communication Disorders Quarterly, ISSN 1525-7401, E-ISSN 1538-4837, Vol. 28, no 4, p. 236-251Article in journal (Refereed) Published
    Abstract [en]

    In this study, 12 participants with various levels of motor and speech deficits were tested to explore their reading skills in relation to letter knowledge, speech level, auditory discrimination, phonological awareness, language skills, digit span, and nonverbal IQ. Two subgroups, based on a median split of reading performance, are described: the low- and high-level readers, where low-level readers perform significantly lower on reading than the other subgroup. The subgroups had a general tendency to perform low versus high on most variables tested, but not on digit span. The study stresses the importance of auditory discrimination skills and general language skills as a fundamental base for literacy. The study also generates new hypotheses that will need to be investigated further. For example, further intervention studies for phonological awareness are proposed, and a hypothesis about the effect of impaired articulation usage during reading is presented.

    Keywords
    auditory discrimination, literacy, motor disability, phonological awareness, speech impairment
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-12732 (URN)10.1177/1525740107311814 (DOI)
    Available from: 2007-11-08 Created: 2007-11-08 Last updated: 2017-12-14
    3. Phonological awareness training to teach children with impairments in reading or speech
    Open this publication in new window or tab >>Phonological awareness training to teach children with impairments in reading or speech
    2007 (English)Article in journal (Refereed) Submitted
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-12733 (URN)
    Available from: 2007-11-08 Created: 2007-11-08
    4. The spelling of silence: Spelling error analysis of an anarthric Bliss user
    Open this publication in new window or tab >>The spelling of silence: Spelling error analysis of an anarthric Bliss user
    2007 (English)Article in journal (Refereed) Submitted
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-12734 (URN)
    Available from: 2007-11-08 Created: 2007-11-08
  • 11.
    Fredriksson, Carin
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Att lära sig leva med förvärvad hörselnedsättning sett ur par-perspektiv: om anpassningsstrategiers funktionella och sociala innebörder2001Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The aim of the present thesis was to describe the everyday life of couples where one of the spouses has an acquired hearing loss. The main focus was on how they perceived their communicative possibilities in relation to the hearing loss and the role of acceptance in the process of learning to live with acquired hearing loss. The thesis is a longitudinal study based on the perspectives of couples. A combination of data sources was used; interviews, functional auditory assessments, a rating-scale and diary, the main source of information being the interviews.

    The main results of the thesis are; that the adjustment was a mutual process, and couples developed different patterns of responsibility for the adjustment process over time. The adjustment strategies were functional as well as social in their significance. The main strategy was prioritisation. Several situational strategies were also found. They showed a variation in communicative activities and participation. The habits and routines of everyday life played an important role for the manifestation of the disability and at times as a hindrance for acting strategically. The habits and routines call for special treatment for inclusion, special treatment in the sense of accommodating to the needs of the individual. The process of accepting played a mediating role between the individual needs and the needs of social flexibility. Some common features of the consequences of the hearing loss were crystallised despite different ways of examining the phenomenon. Finally implications for rehabilitation based on a couple-perspective were discussed.

  • 12.
    Gustafson, Stefan
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Arts and Sciences.
    Varieties of reading disability: Phonological and orthographic word decoding deficits and implications for interventions2000Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The general aim of this thesis was to examine variations in the word decoding skills of reading disabled children. These variations were related to possible cognitive, developmental, and environmental causes of reading disability. Possible implications for educational interventions were also analysed.

    The thesis critically examines the inclusion of the concept of intelligence in the definition of developmental dyslexia. It is suggested that variations in word decoding skills should offer a more solid basis for a study of varieties of reading disability. The empirical studies showed that a) in young children there was a shift from phonological to orthographic word decoding; b) phonological type children (weak in phonological decoding) were characterised by specific phonological deficits; c) surface type children (weak in orthographic decoding) showed more global cognitive deficits suggesting a general developmental delay; d) surface type children showed impaired visual implicit memory for words, which might be associated with limited print exposure; e) an improvement in phonological awareness only transferred to an improved text reading ability for some reading disabled children; f) children who did not benefit from a phonological intervention seemed to rely on orthographic word decoding in text reading.

    Thus, the thesis suggests that variations in phonological and orthographic word decoding skills offer a useful basis for the study of varieties of reading disability and that educational interventions should pay regard to what the child is already attempting to do when reading.

    List of papers
    1. Intelligence and dyslexia: Implications for diagnosis and intervention
    Open this publication in new window or tab >>Intelligence and dyslexia: Implications for diagnosis and intervention
    1999 (English)In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 40, no 2, p. 127-134Article in journal (Refereed) Published
    Abstract [en]

    In this paper we critically examine theoretical issues and practical consequences of including IQ in the definition of dyslexia. According to the discrepancy criterion individuals are classified as dyslexic if their reading skills are below what would be expected from their IQ scores. However, we argue that intelligence is a fuzzy concept and that there is no clear causal relationship between intelligence level and word decoding skills. Also, high and low IQ poor readers show the same reading performance patterns, indicating that both groups might benefit from the same remedial activities. Evidence for the critical role of phonological skills in dyslexia is presented and a more recent definition of dyslexia is discussed in relation to these findings. Finally, two alternative, more outcome-based classifications of poor readers are suggested and some critical consequences for individual interventions are outlined.

    Place, publisher, year, edition, pages
    Wiley InterScience, 1999
    Keywords
    Intelligence, dyslexia, diagnosis, intervention
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-16552 (URN)10.1111/1467-9450.00109 (DOI)
    Available from: 2009-02-02 Created: 2009-02-02 Last updated: 2017-12-14Bibliographically approved
    2. The Development of Word-decoding Skills in Young Readers
    Open this publication in new window or tab >>The Development of Word-decoding Skills in Young Readers
    1996 (English)In: Scandinavian Journal of Educational Research, ISSN 0031-3831, E-ISSN 1470-1170, Vol. 40, no 4, p. 325-332Article in journal (Refereed) Published
    Abstract [en]

    Most of the research on the acquisition of word-decoding skills has almost exclusively focused on the ability to read words in isolation. The purpose of this article is to extend our knowledge to the independent role of phonological and orthographic word-decoding skills in the reading tasks which children encounter in school. The data were quite consistent with the general core of models suggesting that children first become proficient in phonological decoding then gradually shift towards a more direct orthographic-decoding strategy. As such, these findings have helped to generalize models of the acquisition of word-decoding skills to reading comprehension.

    Place, publisher, year, edition, pages
    Taylor & Francis, 1996
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-16553 (URN)10.1080/0031383960400404 (DOI)
    Available from: 2009-02-02 Created: 2009-02-02 Last updated: 2017-12-14Bibliographically approved
    3. Visual and auditory priming in Swedish poor readers: a double dissociation
    Open this publication in new window or tab >>Visual and auditory priming in Swedish poor readers: a double dissociation
    1998 (English)In: Dyslexia, ISSN 1076-9242, E-ISSN 1099-0909, Vol. 4, no 1, p. 16-29Article in journal (Refereed) Published
    Abstract [en]

    Schacter et al. (1990) found support for a functional dissociation between visual and auditory priming effects in a letter-by-letter reader. Their conclusions were based on the perceptual representation systems framework, suggesting that visual priming is mediated by a visual word form system separate from an auditory word form system responsible for auditory priming. This article focuses on visual and auditory priming effects exhibited by poor readers with phonological or surface subtypes of reading disability. The phonological type of reading disability was defined as an impairment in phonological word decoding, whereas the surface type of reading disability was defined as an impairment in orthographic word decoding. The results demonstrated a double dissociation, such that poor readers with a surface type of reading disability produced more auditory than visual priming, whereas poor readers with a phonological type of reading disability showed more visual than auditory priming. The majority of children with reading disabilities showed weaknesses in both orthographic and phonological word decoding and, importantly, low levels of priming effects for both visually and auditorily presented materials. Finally, age-matched normal readers showed significant priming effects for both visual and auditory presented words. These findings support the assumption that both orthographic and phonological skills can be simultaneously impaired and that a dual-route model for the acquisition of word decoding skills might be the most appropriate framework to describe different subtypes of reading disabilities.

    Place, publisher, year, edition, pages
    Wiley InterScience, 1998
    Keywords
    Poor readers, subtypes of reading disabilities, auditory and visual priming, dissociations
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-16554 (URN)10.1002/(SICI)1099-0909(199803)4:1<16::AID-DYS97>3.0.CO;2-8 (DOI)
    Available from: 2009-02-02 Created: 2009-02-02 Last updated: 2017-12-14Bibliographically approved
    4. Cognitive Abilities and Print Exposure in Surface and Phonological Types of Reading Disability
    Open this publication in new window or tab >>Cognitive Abilities and Print Exposure in Surface and Phonological Types of Reading Disability
    2001 (English)In: Scientific Studies of Reading, ISSN 1088-8438, E-ISSN 1532-799X, Vol. 5, no 4, p. 351-375Article in journal (Refereed) Published
    Abstract [en]

    Subgroups of children with reading disabilities were identified by using the regression method introduced by Castles and Coltheart (1993). Children who were poor in phonological, compared to orthographic, word decoding were identified as phonological-type participants, and children who were poor in orthographic, compared to phonological, decoding were identified as surface-type participants. The results replicated previous findings reported that if categorizations are based on comparisons with younger reading-level-matched controls instead of age-matched controls, the number of surface-type children is significantly reduced. Surface-type children performed below the other groups on most cognitive measures and reported that there were fewer books in their homes, and phonological-type children showed a specific deficit in phonological word decoding. The results provided additional support for the hypothesis that the surface type of reading disability can be characterized as a general developmental delay.

    Place, publisher, year, edition, pages
    Routhledge,Taylor & Francis Group, 2001
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-16556 (URN)10.1207/S1532799XSSR0504_03 (DOI)
    Note
    On the day of the defence date the status of the article was: Manuscript.Available from: 2009-02-02 Created: 2009-02-02 Last updated: 2017-12-14Bibliographically approved
    5. Why Do Some Resist Phonological Intervention?: A Swedish longitudinal study of poor readers in Grade 4
    Open this publication in new window or tab >>Why Do Some Resist Phonological Intervention?: A Swedish longitudinal study of poor readers in Grade 4
    2000 (English)In: Scandinavian Journal of Educational Research, ISSN 0031-3831, E-ISSN 1470-1170, Vol. 44, no 2, p. 145 -162Article in journal (Refereed) Published
    Abstract [en]

    n a longitudinal intervention study, 33 Swedish poor readers in Grade 4 received phonological awareness instruction over 1 year. Three control groups were included in the study: Grade 4 controls, Grade 2 controls (both comparable in reading skill) and normal readers. The results showed that the phonological training group made the most progress in phonological awareness but did not improve their reading skills any more than the controls. However, a re-analysis of the results revealed important individual differences within the phonological training group. Some children improved their reading ability considerably, while others seemed resistant to the intervention. One critical difference between improved and resistant readers was identified. For the improved readers, both orthographic and phonological word decoding predicted text reading performance. For the resistant readers, only orthographic decoding skills predicted text reading before, during and after the intervention, in spite of a steady increase in phonological awareness.

    Place, publisher, year, edition, pages
    Routhledge, Taylor & Francis Group, 2000
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-16557 (URN)10.1080/713696666 (DOI)
    Available from: 2009-02-02 Created: 2009-02-02 Last updated: 2017-12-14Bibliographically approved
  • 13.
    Gustavsson Holmström, Marie
    Linköping University, The Tema Institute. Linköping University, Faculty of Arts and Sciences.
    Föräldrar med funktionshinder: om barn, föräldraskap och familjeliv2002Doctoral thesis, monograph (Other academic)
    Abstract [en]

    An increasing number of people with disabilities are choosing to become parents. However, several official goverment reports and other evidence points to the fact that parents with disabilities sometimes experience negative bias and distrust of their capacities as parents. The aim of this study is to describe and analyse aspects of parenthood in the families including parents with disabilities and/or chronic illness, as well as to illuminate concepts of an thoughts on parenthood and disability in these families. This is a qualitative interview study, complemented with structured diaries and network maps. The impairments or chronic illness of the parents in the eleven families of the study are cerebral palsy, spinal cord injury and multiple sclerosis.

    The different areas of the study are: the parents' reflections on becoming parents, the impact of the surrounding environment on the family, the effects of impairment or chronic illness in the family's everyday life and the parents' reflections on children and parenthood. The parents first and foremost describe their families as like any other families, but at the same time describe the special circumstances they live under. They work to handle the possibilities of negative consequences for the children with different strategies. The parents describe what they regard as the special experiences and knowledge that their children acquire which will benefit them as adults. The study recognises some dichotomous concepts relevant to different areas of family life in families with disabilities. The feeling the parents express of living in a world of double standpoints can be understood as ambivalence or in terms of embrace of paradox.

  • 14.
    Henricson, Cecilia
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Cognitive capacities and composite cognitive skills in individuals with Usher syndrome type 1 and 22015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The present thesis belongs to the research area disability research and deal with specific aspects of cognition in individuals with Usher syndrome type 1 and 2. The subject has been investigated and is discussed within an interdisciplinary framework, though the theories applied and described are derived from the area of cognitive psychology. Usher syndrome is a rare genetic condition causing a combination of visual and hearing impairment: deafblindness. There is a congenital hearing loss that is profound in type 1 and moderate to severe in type 2. During mid-childhood symptoms of visual impairment, e.g. light sensitivity, emerge and a progressive loss of visual field follows as a result of the genetically caused eye disease Retinitis Pigmentosa. The syndrome has previously been well described with respect to the genetical and medical aspects, but there has been very little research with a cognitive perspective on the population. Studies 1 and 2 in the present thesis focused on children with Usher syndrome type 1 with cochlear implants and investigated phonological skills, lexical access, working memory and reading skill in the group. Studies 3 & 4 investigated the same cognitive abilities and theory of mind in adults with Usher syndrome type 2. In study 4 the performance on theory of mind in the adults with Usher syndrome type 2 was also compared to that of another group with genetically caused deafblindness: individuals with Alström syndrome.

    The results were that both the children and adults with Usher syndrome had significantly poorer phonological processing than the control groups with normal hearing. There was a large variation on performance on lexical access, especially in the group of children, however several individuals performed at the same level as the control group. Reading skill was found to be at level with the control groups’. There was also great variation in performance on ToM, however the majority of individuals performed similar to the control group with normal hearing and vision. The present project has resulted in some new knowledge on cognitive performance in  individuals with Usher syndrome type 1 and type 2. Performance in