Repetition of words and non-words in typically developing children: The role of prosody. AbstractIn this study, segmental and prosodic aspects of word repetition and non-word repetition in typically developing children aged four to six years were investigated. Focus was on developmental differences, and on how tonal word accent and word length affect segment production accuracy. Prosodically controlled words and non-words were repeated by 44Swedish-speaking children. Repetition accuracy for both words and non-words increased with age, and was higher for words than non-words. Further, tonal word accents I and II provided different conditions for segment repetition in favor of accent II during both word repetition and non-word repetition for older children, but only during word repetition for younger children. This suggests age-dependent differences regarding how prosody is stored and integrated with segments. The findings have theoretical significance regarding the role of prosody in the perception, processing and production of phonological information. There are also clinical implications concerning the interpretation of repetition tasks and the potential use of prosody in speech and language intervention.

Purpose: To examine repetition of stress and tonal word accents in real words and non-words in Swedish-speaking children with developmental language disorder (DLD), and to investigate the relation of prosodic repetition to measures of language ability. Method: A cross-sectional study was undertaken with 30 monolingual Swedish-speaking children with DLD, mean age 4;11 (years;months) and 29 age-matched controls, mean age 5;1, who repeated words and non-words with systematically varying prosody. Group differences for the repetition of prosodic features, and correlations between repetition and phonology, grammar, and vocabulary, were explored. Result: Children with DLD performed below controls on repetition of prosodic features of words and non-words. Repetition of stress and tonal word accent was not correlated with phonological production or receptive vocabulary, but a significant correlation was found between stress repetition in words and expressive grammar. Conclusion: Repetition of stress and tonal word accents is challenging for children with DLD acquiring Swedish as their first language, but may not be a good indicator of general language ability. Prosody should be taken into account when interpreting results from clinically used word repetition (WR) and non-word repetition (NWR) tasks.

Children who are deaf or hard of hearing (DHH) are at an increased risk of speech and language deficits. Nonword repetition (NWR) is a potential predictor of problems with phonology, grammar and lexicon in DHH children. The aim of the present study was to examine repetition of prosodic features and segments in nonwords by DHH children compared to children with normal hearing (NH) and to relate NWR performance to measures of language ability and background variables. In this cross-sectional study, 14 Swedish-speaking children with mild-profound sensorineural hearing loss, aged 4-6 years, and 29 age-matched controls with NH and typical language development participated. The DHH children used cochlear implants (CI), hearing aids or a combination of both. The assessment materials included a prosodically controlled NWR task, as well as tests of phonological production, expressive grammar and receptive vocabulary. The DHH children performed below the children with NH on the repetition of tonal word accents, stress patterns, vowels and consonants, with consonants being hardest, and tonal word accents easiest, to repeat. NWR performance was also correlated with language ability, and to hearing level, in the DHH children. Both prosodic and segmental features of nonwords are problematic for Swedish-speaking DHH children compared to children with NH, but performance on tonal word accent repetition is comparably high. NWR may have potential as a clinically useful tool for identification of children who are in need of speech and language intervention.

Children with hearing impairment (HI) are at an increased risk of developing speech and language problems similar to those of children with developmental language disorder (DLD), including difficulties with phonology and grammar. This study investigated similarities and differences in phonological and grammatical production between children with bilateral sensorineural HI (n=14) and children with DLD (n=30) between 4-6 years of age and agematched controls with typical language development and normal hearing (TLD) (n=29), all with Swedish as their first language. Production of consonants, vowels, stress patterns and tonal word accents was assessed in a picture naming task, and in a word and nonword repetition task. Grammatical production was assessed for verb and noun morphology, and syntax. While performance for both children with HI and DLD were generally significantly below that of the controls with TLD, production of accents and syntax emerged as relative strengths. There were few differences between the between the children with HI and DLD, but noun-adjective agreement in predicative was more challenging for the children with HI.The results have implications for language assessment and planning of intervention.

Many children with developmental language disorder (DLD) exhibit difficulties with phonology, i.e. the sounds of language. Children with any degree of hearing impairment (HI) are at an increased risk of problems with spoken language, including phonology. The cause of these difficulties is unknown in children with DLD, and is often assumed to result from reduced hearing acuity in children with HI. Variability in terms of language outcomes is large in both groups, and determining if a child's language ability is within normal limits or not is problematic. A task that has proven useful in differentiating typical from atypical language development is nonword repetition, in which the child listens to a word form without meaning and repeats it back immediately. Performance in nonword repetition tasks is a potential indicator of language ability in both children with DLD and children with HI. However, it has not been established exactly what the task measures. 9 ACKNOWLEDGEMENTS First and foremost, I would like to thank Christina Samuelsson, my main supervisor. Thank you for supporting me and showing unwavering interest in my work throughout this project, and for encouraging me to do research in the first place. Always keeping standards high, you have been generous in sharing your knowledge and creativity, and in helping me correct the mistakes you have given me the freedom to make. Next, I thank my co-supervisor, Björn Lyxell. It has been a true privilege working with you, and my only regret is that I did not bother you with more questions. With calm enthusiasm, you have inspired me to look at the bigger picture, and to never lose touch with the human behind the data. My many thanks to Ulrika Löfkvist. You have been my guide to everyday reality for children with hearing impairment and the speech-language pathologists working with them. Your theoretical and practical resourcefulness has really been invaluable to me, and to this project. My PhD work has been completely reliant on collaboration with hospital clinics and preschools. I would like to thank everyone that have taken their time to help me, with special mention of