Phonemic awareness, defined as "... the ability to notice, think about, and work with the individual sounds in spoken words" (National Institute for Literacy, 2000), is considered a necessary skill for literacy. The financial and quality-of-life costs of these impairments are significant, not only because of the link with reading difficulties and hence with future employability, but also because there may exist further links between reading difficulties and a range of psychiatric disorders (Goldston et al., 2007). This argues for phonemic awareness intervention beyond what can be taught in a regular pre-school or elementary school curriculum. Such intervention is typically provided in the form of 1-1 sessions with a specialized professional (e.g., a Speech Language Pathologist). However, responding to cost concerns and to poor access to these services and also recognizing the importance of frequent intervention sessions, usage of computerized intervention systems is becoming more common. These computerized intervention systems have been steadily improving. However, one significant drawback continues to be their restricted response modalities, typically consisting of the child using a touch screen or a pointing device to select from a set of pictures. By confining the phonemic awareness skills that the system addresses to those that can be tapped into via "picture-point-and-click", these systems have a restricted scope of what they can teach. We propose to address this restriction by taking advantage of "drag- and-drop" and other touch response modalities that current low-cost touch screen computers (e.g., Apple's iPad) are capable of processing and that children are increasingly more familiar with via video games and Internet applications. A second drawback of many current systems is that their user interface (e.g., visual layout, tempo) is typically not tunable to the individual characteristics of the child. Given the prevalence of phonemic awareness issues in a broad range of neurodevelopmental disorders, including Autism Spectrum Disorder and Developmental Language Disorder, individual tuning may be critical to address individual neurocognitive weaknesses, such as problems in memory, attention, visual scanning, perceptual motor coordination, and processing speed. We propose to incorporate multiple dimensions of individual tunability into the system. Our specific aims are to create a new audio-visual response-processing module for sequencing phonemes in words;to incorporate this module in an individually-tunable, adaptive (i.e., difficulty levels are dynamically adjusted as the child progresses) intervention system;and to evaluate this system with as participants 20 well- characterized children with Developmental Language Disorder or with Autism Spectrum Disorder (who, additionally, also meet criteria for a language disorder).
Public Health Relevance: Computerized intervention systems for phonemic awareness training are limited in that they typically use "picture-point-and-click" as response modality, and also are not individually tunable to a child's individual profile of neurocognitive strengths and weaknesses. The project will address these limitations by creating and evaluating a computerized "Phoneme Sequencing Tutor" system that incorporates a new "drag-and-drop" response-processing module and is individually tunable to a child's neurocognitive profile.
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