Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 14 appraisals
Neuropsychologia
Reading between the lines: Combining pause dynamics and semantic coherence for automated assessment of thought disorder.
Formal thought disorder (FTD), a hallmark of schizophrenia spectrum disorders, manifests as incoherent speech and poses challenges for clinical assessment. Traditional clinical rating scales, though validated, are resource-intensive and lack scalability. Automated speech recognition (ASR) allows for objective quantification of linguistic and temporal features of speech, offering scalable alternatives. Furthermore, ASR-derived utterance timestamps provide access to pause dynamics, which are thought to reflect the cognitive processes underlying speech production. Yet, their added value beyond semantic measures remains insufficiently explored. In this study, we evaluated a scalable multimodal framework that integrates pause features with semantic coherence metrics across three datasets: naturalistic self-recorded diaries (AVH, n = 140 participants), structured picture descriptions (TOPSY, n = 72 participants), and dream narratives (PsyCL, n = 43 participants). Pause-related features were evaluated alongside established coherence measures using support vector regression (SVR) to predict clinical FTD scores. Models using pause features alone robustly predict manually rated FTD severity consistently across datasets. Integrating pause features with semantic coherence metrics enhanced predictive performance compared to coherence-only models, with late fusion yielding the most robust and consistent gains in all three datasets. On average across datasets, Spearman correlation increased from ρ = 0.413 for semantic-only models to ρ = 0.455 with late fusion. The performance gains from semantic and pause features integration held consistently across all contexts, though the nature of the most informative pause patterns was dataset-dependent. These findings suggest that both pause dynamics and semantic coherence reflect complementary aspects of thought disorganization. Our integration framework provides a scalable approach for refining the assessment of disorganized speech to advance automated speech analysis in psychosis.
29 July 2026
Read appraisal →Science advances
Curiosity-driven development of action and language in robots through self-exploration
Infants acquire language with generalization from minimal experience, whereas large language models require billions of training tokens. What underlies efficient development in humans? We investigated this problem through experiments wherein robotic agents learn to perform actions associated with imperative sentences (e.g., push red cube) via curiosity-driven self-exploration. Our approach amortizes active inference using Q-learning, enabling intrinsically motivated developmental learning. The simulations reveal key findings corresponding to observations in developmental psychology. (i) Generalization improves markedly as the scale of compositional elements increases. (ii) Curiosity-driven exploration enables faster learning. (iii) Rote pairing of sentences and actions precedes compositional generalization. (iv) Exception handling induces U-shaped developmental performance, a pattern like representational redescription in child language learning. These results suggest that curiosity-driven active inference accounts for how intrinsically motivated sensorimotor-linguistic learning supports scalable compositional generalization and exception handling in humans and artificial agents.
25 July 2026
Read appraisal →Behavior research methods
The English spaced compound word database
Compound words combine existing words to form a new concept. Spaced compound words represent one form of compound words in which the orthographic space is preserved between the two constituent words (e.g., coffee table). While recent research has mostly focused on unspaced compound words, spaced compound words offer important insight into the cognitive processes that support lexical retrieval and comprehension. Critically, whether readers process spaced compound words as single lexical units has important implications for how these items are stored and accessed in memory. To support future research, we developed the English Spaced Compound Word Database, wherein we collected familiarity, age-of-acquisition (AoA), and semantic transparency (ST) ratings for 1,162 spaced compound words. We conducted correlational analyses to compare these ratings across words, as well as across previously collected data on compound words' constituents. These analyses revealed a strong association overall between familiarity ratings and AoA, as well as familiarity and ST. When examining the relationship between ratings and the characteristics of a compound word's constituents, we found a strong relationship between frequency, AoA, and structural simplicity (i.e., number of characters, syllables, morphemes, and lexical similarity) within all three rating tasks. These findings provide a basis for testing future theoretical models of lexical processing and reading.
12 July 2026
Read appraisal →Journal of speech, language, and hearing research : JSLHR
Language-Common and Language-Specific Error Patterns in Children With Speech Sound Disorders: A Systematic Review
OBJECTIVES: This systematic review synthesized cross-linguistic evidence on speech error patterns in children with speech sound disorders (SSDs), focusing on percent consonants correct (PCC), SODA (substitution, omission, distortion, and addition) error profiles, and phonological processes, as well as factors contributing to variations in error patterns. METHOD: Comprehensive searches were conducted in PubMed, CINAHL Ultimate, Scopus, Web of Science, and Linguistics and Language Behavior Abstracts in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies included empirical research on children with phonological, articulation, or functional SSDs that reported quantitative error analyses. Twenty-eight studies met the inclusion criteria. Methodological quality, evaluated using a 16-item framework, ranged from 50.0% to 100.0% (M = 82.7%). RESULTS: The 28 studies spanned nine languages (English, German, Spanish, Portuguese, Italian, French, Turkish, Korean, and Chinese), including three dialects each of Spanish and Chinese and two dialects of Portuguese. Reported PCC values (typically 65.0%-85.0%) indicated predominantly mild-moderate to moderate impairment. Substitution errors were the most prevalent across languages, followed by omissions and distortions. Both language-common and language-specific phonological processes were documented. DISCUSSION: The findings indicate that PCC is generally comparable across languages, whereas SODA error profiles and phonological processes reflect both cross-linguistic similarities and language-specific characteristics. Phonological processes, in particular, exhibit greater cross-linguistic variation. Collectively, these results emphasize the need for culturally responsive diagnostic practices and highlight the importance of developing cross-linguistic frameworks to guide the assessment of SSDs. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.32649549.
10 July 2026
Read appraisal →Language, speech, and hearing services in schools
Enhancing Clinical Practice Through Research: Tools for School-Based Speech-Language Pathologists
PURPOSE: Speech-language pathologists (SLPs) in the school setting need to efficiently locate, evaluate, and utilize research evidence in their clinical practice. This tutorial provides resources focused on the foundational aspects of evidence-based practice (EBP) and its application for SLPs to implement research into clinical practice. METHOD: This tutorial (a) reviews study design and discusses clinical questions best suited to each; (b) provides key tips for extracting information from main sections of research articles; (c) discusses the use of generative artificial intelligence (AI) as a clinical and research tool, including actionable steps and examples for using AI in EBP; and (d) provides detailed strategies to increase interaction with research beyond reading articles. RESULTS: School-based SLPs can utilize the information and strategies provided to increase their confidence in evaluating research literature, applying information, and incorporating resources from research articles into their clinical practice. CONCLUSIONS: This tutorial equips school-based SLPs with actionable steps and concrete tools to increase ease and efficiency of applying research evidence into clinical practice. It provides guidance on different study designs, practical strategies to review research articles, and a case study demonstrating these strategies as well as discusses the potential use of AI to support clinicians in generating clinical questions and the steps of the EBP process. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.31652170.
4 July 2026
Read appraisal →The Behavioral and brain sciences
Large language models have learned to use language.
Acknowledging that large language models have learned to use language can open doors to breakthrough language science. Achieving these breakthroughs may require abandoning some long-held ideas about how language knowledge is evaluated and reckoning with the difficult fact that we have entered a post-Turing test era.
2 July 2026
Read appraisal →Phonetica
Gradient boundaries through confidence intervals for forced alignment estimates using model ensembles
Forced alignment is a common tool to align audio with orthographic and phonetic transcriptions. Most forced alignment tools provide only point-estimates of boundaries. The present project introduces a method of producing gradient boundaries by deriving confidence intervals using neural network ensembles. Ten different segment classifier neural networks were previously trained, and the alignment process is repeated with each classifier. The ensemble is then used to place the point-estimate of a boundary at the median of the boundaries in the ensemble, and the gradient range is placed using a 97.85 % confidence interval around the median constructed using order statistics. Gradient boundaries are taken here as a more realistic representation of how segments transition into each other. Moreover, the range indicates the model uncertainty in the boundary placement, facilitating tasks like finding boundaries that should be reviewed. As a bonus, on the Buckeye and TIMIT corpora, the ensemble boundaries show a slight overall improvement over using just a single model. The gradient boundaries can be emitted during alignment as JSON files and a main table for programmatic and statistical analysis. For familiarity, they are also output as Praat TextGrids using a point tier to represent the edges of the boundary regions.
27 June 2026
Read appraisal →Progress in neuro-psychopharmacology & biological psychiatry
Neural correlates of late talking: A systematic review of electrophysiological and neuroimaging studies.
BACKGROUND: Late talking (LT), a delay in expressive vocabulary in early childhood, affects a significant minority of toddlers and can be a precursor to persistent language and literacy impairments. While behavioral profiles are well-documented, a systematic synthesis of its underlying neurobiology is lacking. This systematic review aimed to identify, evaluate, and synthesize evidence from electrophysiological (EEG) and neuroimaging (MRI) studies on the neural correlates of late talking in children. METHODS: We conducted a systematic search of Scopus, Web of Science, and PubMed from inception to September 2025, following PRISMA guidelines. Studies investigating children formally identified as late talkers without comorbid neurological or global developmental conditions, using EEG/ERP or MRI modalities, were included. Risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool. RESULTS: Sixteen studies (8 EEG, 8 neuroimaging) comprising 231 LT children in EEG studies and 315 in neuroimaging studies were included. EEG studies revealed a neurodevelopmental cascade, beginning with atypical oscillatory activity (increased frontal gamma power) and deficits in auditory discrimination (reduced Mismatch Negativity), progressing to higher-order impairments in phonological (absent PMN) and lexical-semantic (altered N400) processing. Neuroimaging studies consistently identified structural and functional anomalies within a distributed perisylvian network, including reduced gray matter in left temporal regions, atypical right-hemispheric lateralization, reduced activation in cortical-subcortical circuits, and altered white matter connectivity. These neural markers demonstrated significant predictive value for later language outcomes. CONCLUSION: Late talking is a clear neurodevelopmental disorder with a cascading pattern of neural dysfunction. The identified neural signatures are not just findings but have strong clinical potential as biomarkers for early identification and prognosis. This evidence advocates for a shift to a precision medicine approach, opening the door to novel, neurobiologically-informed interventions like neuromodulation that target the underlying brain circuits.
20 June 2026
Read appraisal →Behavior research methods
Lexique 4: A major upgrade of the Lexique French lexical database
Lexique 4, an updated French lexical database, expands upon its predecessor, Lexique 3, by incorporating several significant improvements to enhance its utility in psycholinguistics, computational linguistics, and education. The new version is based on a larger corpus of 316 million words derived from 65,317 documents, including movie, TV show, and documentary subtitles, which offers more accurate frequency estimates and includes contemporary neologisms. Lexique 4 introduces new variables, such as orthographic surface frequency, contextual diversity (CD), and detailed morphological structure, which provide a more comprehensive view of lexical properties. We find that contextual diversity is a slightly better predictor than word frequency, in line with previous work. Moreover, the integration of lexical decision times from the French Lexicon Project into Lexique 4 facilitates more in-depth linguistic research. Enhancements to the user interface, including a redesigned web platform, enable dynamic searches and sorting capabilities, increasing accessibility and usability for researchers. Statistical analyses indicate that the updated frequency measures in Lexique 4 are better predictors of lexical decision times compared to Lexique 3, supporting the value of these enhancements. Overall, Lexique 4 represents a comprehensive and flexible tool for analyzing French lexical properties, making it an essential asset for a broad range of users.
27 Apr 2026
Read appraisal →Psychonomic bulletin & review
Speaker effects in language comprehension: An integrative model of language and speaker processing
The identity of a speaker influences language comprehension through modulating perception and expectation. This review explores speaker effects and proposes an integrative model of language and speaker processing that integrates distinct mechanistic perspectives. We argue that speaker effects arise from the interplay between bottom-up perception-based processes, driven by acoustic-episodic memory, and top-down expectation-based processes, driven by a speaker model. We show that language and speaker processing are functionally integrated through multi-level probabilistic processing: prior beliefs about a speaker modulate language processing at the phonetic, lexical, and semantic levels, while the unfolding speech and message continuously update the speaker model, refining broad demographic priors into precise individualized representations. Within this framework, we distinguish between speaker-idiosyncrasy effects arising from familiarity with an individual and speaker-demographics effects arising from social group expectations. We discuss how speaker effects serve as indices for assessing language development and social cognition, and we encourage future research to extend these findings to the emerging domain of artificial intelligence (AI) speakers, as AI agents represent a new class of social interlocutors that are transforming the way we engage in communication.
17 Apr 2026
Read appraisal →Journal of speech, language, and hearing research : JSLHR
A Speech-Segregation Algorithm for Spatial Hearing Aids to Operate With Multiple Sound Sources
PURPOSE: Hearing-aid users often face challenges in noisy environments due to time, level, and spectral cues being compromised by current generation hearing aids. This study explored a physiologically based speech-segregation algorithm that selectively removes or attenuates unwanted sound sources. METHOD: In our previously developed localization algorithm, the time-frequency responses after a unique normalization approach always reside inside the unit circle of the model space. Given the "sparseness" property of daily sound, the model forms distinct clusters that correspond to the source locations. In the present study, the localization model was adapted to segregate speech by using a binary mask to remove the cluster of unwanted sound. The speech target was one of 200 intelligible sentences. The interfering sound was time-reversed sentences in a random sequence spoken by the same speaker. Automatic speech recognition transcribed the sound mixture before and after the segregation algorithm. RESULTS: When both target and noise were located at the front, applying a hard mask (i.e., 1 or 0) almost perfectly removed the energy of noise. When the sound sources moved to the side or back with smaller angular separations, clusters were less distinguishable, leading to worse intelligibility performance. Applying a soft mask (i.e., 1 or 0.2) instead showed slightly lower performance for the front but improved performance for the back and side. CONCLUSION: Our algorithm performs localization and segregation in a combined and straightforward manner, potentially for spatial hearing aids to function better in challenging listening environments.
12 Apr 2026
Read appraisal →Journal of speech, language, and hearing research : JSLHR
Auditory-Somatosensory Interactions in Speech Perception in Individuals With Hearing Impairment: An Exploratory Case Study
OBJECTIVES: Individuals with hearing impairment can perceive speech sounds with the help of cochlear implants or hearing aids. Recent studies have shown that orofacial somatosensory inputs may modify speech perception. This study explored the potential role of such somatosensory inputs in speech perception in individuals with hearing impairment. DESIGN: Twenty-one native French-speaking participants with various profiles of bilateral hearing impairment and wearing hearing aids and/or cochlear implants were tested to explore the extent to which an orofacial somatosensory stimulation, consisting in facial skin stretch provided by a robotic device, would affect their speech perception performance in a vowel identification task, in comparison with 25 participants with normal hearing. This potential somatosensory effect was evaluated in relation to their hearing ability assessed by both their hearing threshold of digits in acoustic noise and their audiological profile, and with their production ability assessed by variability in a vowel production task. RESULTS: The somatosensory effects varied depending on participants' hearing ability, with three different profiles. A first group of eight participants, who were able to identify the vowels auditorily though with thresholds in noise higher than for individuals with normal hearing, did not show any somatosensory effect, with identical vowel identification scores without and with facial deformation. The other 13 participants were unable to auditorily identify the vowels and had high thresholds in noise. Among them, eight participants who had used a hearing device for a long duration (≥ 18 years) showed a strong somatosensory bias modifying vowel identification when facial deformation was present. These participants also showed greater variability in vowel production. The last five participants in this second group showed no somatosensory effect at all. CONCLUSION: These three profiles were related to the role of auditory experience and hearing ability in the development of auditory-somatosensory integration.
12 Apr 2026
Read appraisal →Journal of speech, language, and hearing research : JSLHR
Rhotic Generalization Is More Rapid in Biofeedback Than Motor-Based Treatment for Residual Speech Sound Disorder: Secondary Outcomes of a Randomized Controlled Trial
PURPOSE: This study examined the effects of visual biofeedback approaches and nonbiofeedback motor-based treatment on generalization outcomes following speech therapy for children with residual speech sound disorders (RSSDs). METHOD: A total of 108 children aged 9-15 years with RSSD affecting American English /ɹ/ were randomly assigned to receive 19 motor-based speech treatment sessions, with or without visual biofeedback (divided into ultrasound or visual-acoustic biofeedback). The treatment included practice designed to implement several motor learning principles, with task difficulty systematically adjusted based on the child's performance. Children's /ɹ/ accuracy on untreated words before and after treatment was rated as correct or incorrect by lay listeners who were blinded to participant characteristics, treatment conditions, and time points. RESULTS: The mixed-effects regression model revealed a statistically significant interaction between treatment type and time point. Specifically, both the biofeedback and nonbiofeedback motor-based treatment groups made progress over time, but the amount of generalization to untreated words was significantly greater in the biofeedback condition than in the motor-based treatment. In a subanalysis comparing biofeedback types, greater generalization was observed following ultrasound biofeedback than visual-acoustic biofeedback, although this effect was strongest at one treatment site. DISCUSSION: This randomized controlled trial found that adding biofeedback to motor-based treatment can increase the rate of accurate production of the American English /ɹ/ in untreated words.
12 Apr 2026
Read appraisal →Language, speech, and hearing services in schools
Intervention Efficacy for Children With Mild Bilateral Sensorineural Hearing Loss
PURPOSE: This study aimed to compare the efficacy of hearing aid (HA) and frequency modulation (FM) systems in improving language, articulation, and speech perception outcomes among children with mild bilateral sensorineural hearing loss (MBHL) over a 12-month intervention period. METHOD: A prospective repeated-measures design was employed, enrolling 43 Cantonese-speaking children aged 6-7 years, with a pure-tone average of 26-40 dB HL. Participants were randomly assigned to either the HA group (n = 16) or the FM group (n = 16). A nontreatment control group (n = 11) was formed from children who declined the intervention. The outcome measures included the Hong Kong Cantonese Articulation Test, the Hong Kong Cantonese Oral Language Assessment Scale, and the Cantonese Hearing-in-Noise Test. Assessments were conducted at baseline and 12 months post-intervention. RESULTS: The FM group demonstrated significant improvements in language abilities (p < .01, Cohen's d = 0.53), particularly in word definition, expressive vocabulary, and Cantonese grammar, outperforming both the HA and control groups (p < .05). Articulation improvements were greater in the FM group, with significant gains in consonant production (p < .01). No significant improvements were observed in speech perception across the groups. CONCLUSIONS: FM systems are more effective than HAs in enhancing language and articulation outcomes in children with MBHL, particularly in noisy classroom environments. These findings highlight the importance of individualized intervention strategies and the potential of FM systems to support auditory access and language development. Future research should explore long-term outcomes and the role of contextual factors in intervention efficacy.
5 Apr 2026
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