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Hintergrund: Mit der im Jahr 2020 aktualisierten AWMF-Leitlinie zur Versorgung mit einem Cochleaimplantat (CI) wurde erstmals der gesamte Prozess einer CI-Versorgung definiert. In der vorliegenden Studie wurden die Machbarkeit und die Ergebnisse einer sehr frühen Rehabilitationsmaßnahme (Reha) untersucht.
Methodik: Es wurden 54 Patienten in die Interventionsgruppe (IG) eingeschlossen, bei der die Reha innerhalb von 14 (maximal 28) Tagen nach der Implantation eingeleitet wurde. In eine Kontrollgruppe (KG, n = 21) wurden Patienten mit deutlich längerer Wartezeit eingeschlossen. Neben dem Beginn und der Dauer der Reha wurde das mit CI erreichte Sprachverstehen zu verschiedenen Zeitpunkten innerhalb von 12 Monaten erfasst. Zusätzlich wurde mit Fragebögen der Aufwand der Anpassung des CI-Prozessors und die Zufriedenheit der Patienten mit dem Ergebnis sowie dem Zeitpunkt des Beginns der Reha ermittelt.
Ergebnisse: Die Wartezeit zwischen Implantation und Beginn der Reha lag in der IG bei 14 Tagen und in der KG bei 106 Tagen (Mediane). Es konnten 92,6 % der Patienten der IG die Reha innerhalb von 14 Tagen antreten. Der Effekt der Reha lag in der IG bei 35 und in der KG bei 25 Prozentpunkten (Freiburger Einsilbertest). Nach 6 und 12 Monaten (M) CI-Nutzung zeigten beide Gruppen sowohl in der Testbedingung in Ruhe (IG/KG 6M: 70 %/70 %; 12M: 70 %/60 %, Freiburger Einsilbertest) als auch im Störgeräusch (IG/KG 6M: −1,1 dB SNR/–0,85 dB SNR; 12M: −0,65 dB SNR/+0,3 dB SNR, Oldenburger Satztest) vergleichbare Ergebnisse. Die mittels des Fragebogens Speech, Spatial and Qualities of Hearing Scale (SSQ) erfassten Ergebnisse für die Einschätzung der Hörqualität zeigten nach 6 Monaten eine bessere Bewertung in der IG, die sich nach 12 Monaten an die Ergebnisse der KG anglich. Die IG war mit dem Zeitpunkt des Beginns der Reha deutlich zufriedener als die KG. Alle anderen aus Fragebögen ermittelten Daten zeigten keine Unterschiede zwischen den beiden Gruppen.
Schlussfolgerung: Der sehr frühe Beginn einer stationären Reha nach Cochleaimplantation ist erfolgreich umsetzbar. Die Reha konnte innerhalb von 7 Wochen nach der Implantation abgeschlossen werden. Der Vergleich der Ergebnisse der Tests des Sprachverstehens vor und nach der Reha zeigte eine deutliche Steigerung. Somit ist ein deutlicher Reha-Effekt nachweisbar. Die Aufnahme der CI-Rehabilitation in den Katalog der Anschlussheilbehandlungen ist somit wissenschaftlich begründet und damit dringend zu empfehlen.
Background: The Association of the Scientific Medical Societies in Germany (AWMF) clinical practice guideline on cochlear implant (CI) treatment, which was updated in 2020, defined the entire process of CI care for the first time. In the present study, the feasibility and results of very early rehabilitation were examined.
Materials and methods: The intervention group (IG) comprised 54 patients in whom rehabilitation was initiated within 14 (maximally 28) days after implantation. Patients with a significantly longer waiting time were included in the control group (CG, n = 21). In addition to the start and duration of rehabilitation, the speech intelligibility achieved with CI was recorded at different timepoints within a 12-month period. In addition, questionnaires were used to assess the effort of fitting the CI processor and the patients’ satisfaction with the outcome as well as the timing of the start of rehabilitation.
Results: Median waiting time between implantation and start of rehabilitation was 14 days in the IG and 106 days in the CG; 92.6% of IG patients were able to start rehabilitation within 14 days. The effect of rehabilitation in the IG was 35 and in the CG 25 percentage points (Freiburg monosyllabic test). After 6 and 12 months of CI use, both groups showed comparable results in the test condition in quiet (IG/CG 6 months: 70%/70%; 12 months: 70%/60%, Freiburg monosyllabic test) and in noise (IG/CG 6 months: −1.1 dB SNR/–0.85 dB SNR; 12 months: −0.65 dB SNR/+0.3 dB SNR, Oldenburg sentence test). Hearing quality assessment scores collected by SSQ (Speech, Spatial and Qualities of Hearing Scale) questionnaire showed better scores in the IG at 6 months, which converged to CG scores at 12 months. The IG was significantly more satisfied with the timing of the start of rehab than the CG. All other data obtained from questionnaires showed no differences between the two groups.
Conclusion: A very early start of inpatient rehabilitation after cochlear implantation was successfully implemented. The rehabilitation was completed within 7 weeks of CI surgery. Comparison of speech recognition test results before and after rehabilitation showed a significant improvement. A clear rehabilitation effect can therefore be demonstrated. Inclusion of CI rehabilitation in the German catalog of follow-up treatments is thus scientifically justified and therefore strongly recommended.
Embedded implicatures and experimental constraints : a reply to Geurts & Pouscoulous and Chemla
(2010)
Experimental evidence on embedded implicatures by Chemla (2009b) and Geurts & Pouscoulous (2009a) has fewer theoretical consequences than assumed: On the one hand, the evidence successfully argues against obligatory local implicature computation, which has however already been discredited. On the other hand, the data are fully consistent with optional local implicature computation.
Ein "einfach" gebautes Gedicht der 1927 geborenen Christa Peikert-Flaspöhler lässt sich "einfach" interpretieren. Es birgt doch Raum für konnotative Zwischentöne des direkt mit "du" angesprochenen Lesers. Er wird aufgerufen nicht nur mit seinen "Füßen" erdverbunden, realistisch zu bleiben, sondern mit seinen "Flügeln" dem "Lichte der Taube", also der Zuversicht zu folgen.
Erdnähe und Himmelsflug bestimmen das Mensch-Sein; auch "im Ödland" keimt die Hoffnung. Der "Riss", der "lähmt", kann und muss überwunden werden. - Es ist ein "gutes" Gedicht mit einer klaren Botschaft. Die ungekünstelte Analyse kann ebenso auf hochgestochene Begrifflichkeit verzichten, und damit eignet sich dieses Gedicht gut zur Einführung in das Verstehen von Lyrik.
Darüber hinaus kann man das Bild "Füße und Flügel" als literarische Metapher für den Zwiespalt verstehen, überhaupt Gedichte zu schreiben. Dafür werden Belege angefügt, nämlich Stellen aus einem Roman von Martin Walser (2012) und ein Gedicht von Rainer Maria Rilke (1898 / 1909). Eine Gegenposition markiert die literarische Romantik mit einem Gedicht von Joseph von Eichendorff. Gegen das Träumen der Romantiker wendet sich schließlich Ingeborg Bachmann, auf deren Gedicht von 1953 hingewiesen wird.
Redensarten sind für die Deutsch als Fremdsprache Studierenden im hohen Grad interpretationsbedürftig. Auch der Muttersprachler braucht für sie häufig eine nähere Erklärung, die im vorliegenden Fall formal (Redensart veraltet und wegen antisemitischer Sicht nicht verwendbar) und inhaltlich (Zusammenhänge, die kaum einer ahnt) sein muss. Redensarten können einen weitreichenden kulturellen Hintergrund haben und sie sind selbst, entsprechend analysiert, Quelle zur Sprach- und Kulturgeschichte. Die Redensart "... wie in der Judenschule" verrät uns zudem überraschenderweise etwas über die Frühform literarischer Entwicklung im Kulturprozess von der Mündlichkeit zur Schriftlichkeit.
It is well known that English children between the age of 4 and 6 display a so-called Delay of Principle B Effect (DPBE) in that they allow pronouns to refer to a local c-commanding antecedent. Their guessing pattern with pronouns contrasts with their adult-like interpretation of reflexives. The DPBE has been explained as resulting from a lack of pragmatic knowledge or insufficient cognitive resources. However, such extra-grammatical accounts cannot explain why the DPBE only shows up in particular languages and in particular syntactic environments. Moreover, such accounts fail to explain why the DPBE only emerges in comprehension and not in production. This paper hypothesizes that the presence or absence of the DPBE can be explained from the properties of the grammar. Fischer's (2004) optimality-theoretic analysis of binding, explaining cross-linguistic variation, and Hendriks and Spenader's (2005/6) optimality-theoretic account of the acquisition of pronouns and reflexives are combined into a single model. This model yields testable predictions with respect to the presence or absence of the DPBE in particular languages, in particular syntactic environments, and in comprehension and/or production.
It has been shown that visual cues play a crucial role in the perception of vowels and consonants. Conflicting consonantal stimuli presented in the visual and auditory modalities can even result in the emergence of a third perceptual unit (McGurk effect). From a developmental point of view, several studies report that newborns can associate the image of a face uttering a given vowel to the auditory signal corresponding to this vowel; visual cues are thus used by the newborns. Despite the large number of studies carried out with adult speakers and newborns, very little work has been conducted with preschool-aged children. This contribution is aimed at describing the use of auditory and visual cues by 4 and 5-year-old French Canadian speakers, compared to adult speakers, in the identification of voiced consonants. Audiovisual recordings of a French Canadian speaker uttering the sequences [aba], [ada], [aga], [ava], [ibi], [idi], [igi], [ivi] have been carried out. The acoustic and visual signals have been extracted and analysed so that conflicting and non-conflicting stimuli, between the two modalities, were obtained. The resulting stimuli were presented as a perceptual test to eight 4 and 5-year-old French Canadian speakers and ten adults in three conditions: visual-only, auditory-only, and audiovisual. Results show that, even though the visual cues have a significant effect on the identification of the stimuli for adults and children, children are less sensitive to visual cues in the audiovisual condition. Such results shed light on the role of multimodal perception in the emergence and the refinement of the phonological system in children.
This paper investigates the production and comprehension of intrasentential anaphoric pronominal reference in Russian. In particular, it examines the elicited imitation and comprehension of three anaphoric pronouns in subject position – personal 3rd singular masculine, demonstrative and zero – in one hundred and eighty monolingual Russian-speaking children and twenty adults. The three types of pronouns were designed to have an antecedent in the preceding sentence containing a verb and two arguments. These antecedents differ in their syntactical role and animacy. The sentence position, agentivity and topicality remained constant. The sentences with (in)animate subjects and objects constituted the following four 'conditions': two sentences with a subject and an object being either animate or inanimate and two sentences with a subject and an object exhibiting a diverse (in)animacy. Regarding the resolution of the anaphoric pronouns the similarity principle (or feature-concord rule) and its possible violations were tested. This principle suggests that an anaphoric pronoun is most likely resolved to the antecedent with a maximum of similar characteristics or features and it primarily governs the assignment of an antecedent to anaphoric pronouns in subject position in the absence of the violating conditions. Results show the influence of this rule on the anaphora resolution process increasing with age, on the one hand, and the development of the impact of animacy, syntactic role and the type of anaphoric pronouns that violate the feature-concord rule, on the other.
The paper presents results from a combined production and comprehension study addressing some of the factors which guide the establishment of intersentential pronominal reference in child and adult Bulgarian. We investigate the time course and different stages in the acquisition of null, personal and demonstrative pro-nouns and their specific anaphoric functions. We target possible age-induced changes in the salience hierarchy of referent features such as animacy and grammatical role. Following the general consent in the field of anaphora research, we assume a division of labour between different pronominal forms with respect to the salience of their referents. Based on the data of Bulgarian preschool children we investigate the validity of this form-function relation, its language-specific shape and its developmentally induced variation. The results reveal an initial prominence of animate referents which later on develops into preference for animate subjects. Although the investigated 3 to 5 year old Bulgarian children do not stick to the adult anaphora resolution strategy, they comply with the principle of the reversed mapping within the range of tested pronouns and react according to their salience criteria which promote animate subjects as the most prominent co-reference candidates.
In anaphora resolution theory, it has been assumed that anaphora resolution is based on a reversed mapping of antecedent salience and anaphora complexity: minimal complex anaphora refer to maximal salient antecedents. In order to ex-amine whether and by which developmental steps German children gain command of this mapping maxim we conducted an experiment on production and comprehension of intersentential pronouns including the three pronoun types zero, personal, and demonstrative pronoun. With respect to antecedent salience, the experiment varied syntactic role (subject/object) and in/animacy. Six age groups of children (age range from 2;0 to 6;0) and an adult control group has been tested. The hypothesis arising from the mapping maxim is that zero pronoun correlates with more salient antecedents than personal and demonstrative pronoun, the latter correlating with the least salient antecedents. The results are: In production, children first establish the opposition of zero pronoun with animate antecedents vs. demonstrative pronoun with inanimate antecedents. In a next step, syntactic role comes into play and a more complex system opposing the three presented pronoun types is established. In comprehension, however, the effect of pronoun type re-mains weak and antecedent features remain a strong factor in reference choice. However, also adults employ pronoun type and antecedent features. The oldest children and the adults show variation in personal pronoun resolution according to the animacy pattern of the potential antecedents. In case of identical animacy features, the subject is the preferred candidate; in case of distinct animacy features, there is a tendency to choose the object antecedent.