Background: Children with spina bifida and hydrocephalus (SBH) have malformations of the spinal cord and brain, which can have significant lifelong consequences. Recent studies show that children and young adults with SBH can have “lower than expected” rates of social integration, employment, post-secondary education and independence (Barf et al. 2009; Friedman, Holmbeck, DeLucia, Jandasek & Zebracki, 2009; Holbein et al., 2015). Although speech and language are essential life skills, one important aspect of communication – prosody – has not been investigated systematically in children with SBH. Prosody covers the suprasegmental aspects of speech, centring on how variations in loudness, relative syllable-length and vocal pitch combine to enhance or change the meaning of what is said. Difficulties understanding or using prosody can have a significant negative impact on pragmatic, interactional and general communication skills (Paul, Augustyn, Klin & Volkmar, 2005; Wells & Peppé, 2003), and may possibly underlie some of the lower than expected developmental, educational and social outcomes in children with SBH.
Aims: This research aims to identify the strengths and weaknesses of expressive and receptive prosodic skills in children with SBH, and to compare prosodic ability in this clinical group with age- and language matched typically-developing (TD) peers.
Method: The study included 16 children aged between 7 and 12 years (mean age= 9;05 years) medically identified as having SBH, as well as two control groups of TD children, one matched on chronological age (TDA; mean age= 9;04 years) and one matched on language ability (TDL; mean age= 8;04 years). Each of the three groups contained one bilingual participant; all other participants were monolingual Irish-English speakers. Children’s prosodic ability was measured using the updated 2015 version of PEPS-C (Profiling Elements of Prosody in Speech-Communication) (Peppé & McCann, 2003), which is a computerised prosodic test that examines both expressive and receptive prosody skills in 10 different subtests, such as affect (like vs. dislike), turn-end (question vs. statement), boundary and contrastive/emphatic stress.
Results: Children with SBH as a group scored 75% or above (above chance level) in six out of 10 PEPS-C subtests administered. They performed best with Receptive Affect and worst with Expressive Affect. The SBH group produced scores lower than those of control children in all subtests. The SBH group scored significantly lower than the TDA group on seven subtests, and significantly lower than the TDL group on three subtests. Overall the performance pattern of children with SBH, across the 10 subtests, was similar to that of the control groups, particularly the TDL group, but at a lower level.
Conclusion: The results suggest that children with SBH may have specific difficulties understanding and expressing some aspects of prosody, which would negatively impact on their social communication.