Canonical syllable reduplication and variegation in infants with sensorineural hearing loss | Revista de Logopedia, Foniatría y Audiología

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D’haeseleer, H. Depypere, S. Claeys, K. van Lierde" "autores" => array:4 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "D’haeseleer" ] 1 => array:2 [ "nombre" => "H." "apellidos" => "Depypere" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "Claeys" ] 3 => array:2 [ "nombre" => "K." 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López-Rubio, E. Mendoza, A. Fernández-Parra" "autores" => array:3 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "López-Rubio" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Mendoza" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Fernández-Parra" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0214460309700312?idApp=UINPBA00004N" "url" => "/02144603/0000002900000004/v1_201305031552/S0214460309700312/v1_201305031552/es/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "titulo" => "Canonical syllable reduplication and variegation in infants with sensorineural hearing loss" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "249" "paginaFinal" => "256" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "D. von Hapsburg, B.L. Davis" "autores" => array:2 [ 0 => array:4 [ "nombre" => "D." "apellidos" => "von Hapsburg" "email" => array:1 [ 0 => "dvh@utk.edu" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "¿" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "B.L." "apellidos" => "Davis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "2" "identificador" => "aff2" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Audiology and Speech Pathology, Universidad de Tennessee, Memphis" "etiqueta" => "1" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Department of Communication, Sciences and Disorders, Universidad de Texas, Austin" "etiqueta" => "2" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondence: University of Tennessee, Department of Audiology and Speech Pathology, 578 South Stadium Hall, Knoxville, TN 37996." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Reduplicación y mezcla de sílabas balbuceadas en niños con hipoacusia" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 598 "Ancho" => 952 "Tamanyo" => 43305 ] ] "descripcion" => array:1 [ "en" => "Percent occurrence of canonical syllable reduplication versus variegation for infants with estimated PTA of 25 dB HL (normal hearing), and infants with better-ear PTA between 37- 65 dB HL (mild-to-moderately-severe hearing loss)." ] ] ] "textoCompleto" => "IntroductionThe entry of infants into the canonical babbling stage of speech production is considered a hallmark milestone in early pre-linguistic development, as rhythmic well-formed syllables emerge during this period. In typically developing infants, canonical babbling emerges between the ages of 6-10 months of age (see <a class="elsevierStyleCrossRef" href="#bib0065">Oller, 2000</a>, for a review) and is characterized by the production of repetitive, well-formed syllable-like output (i.e., [baba] or [daedae]). This period in vocal development is important as the canonical syllables used during the babbling period form the foundation for first word production. Additionally, research suggests that delays in the onset of canonical babbling may be predictive of slow vocabulary development as well as other language delays (Oller, Eilers, Neal and Schwartz, 1999; Stark, Ansel and Bond, 1988; Stoel-Gammon, 1989). Furthermore, it has been shown that canonical babbling is affected by perceptual factors. Thus, severeto-profound hearing loss results in altered patterns of canonical babbling (<a class="elsevierStyleCrossRefs" href="#bib0025">Eilers and Oller, 1994; Koopmans-van Beinum, Clement and van den Dikkenberg-Pot, 2001; Oller and Eilers, 1988; Stoel-Gammon, 1988; Stoel-Gammon and Otomo, 1986; von Hapsburg and Davis, 2006</a>). However, little information exists on the effect of hearing loss on the multisyllabic canonical syllables during the canonical babbling stage. The purpose of this study was to examine the effect of hearing loss on canonical syllable reduplication and variegation patterns.Canonical syllables can be reduplicated (same syllable repeated- [baba]) or variegated (segmental changes occur from one syllable to another within an utterance- [babi]). Both types of syllable sequences are shown to be present in the repertoire of infants from the onset of canonical babbling (<a class="elsevierStyleCrossRefs" href="#bib0045">Mitchell and Kent, 1990; Roug, Landberg and Lundberg, 1989; Smith, Brown-Sweeney and Stoel-Gammon, 1989</a>). Smith et al., studied reduplication and variegation patterns in three groups of infants in the age ranges of 6-9 months, 10-13 months, and 14-17 months. For both age ranges under 13 months, they found that reduplicated babbling accounted for approximately 57% of multisyllabic sequences, whereas variegated babbling accounted for 43% of sequences. However, for the older group of infants, variegated sequences accounted for 66% of the inventory and reduplicated sequences 34%. <a class="elsevierStyleCrossRef" href="#bib0045">Mitchell and Kent (1990)</a> also examined the distribution of reduplicated and variegated syllable sequences in a longitudinal study of one group of infants from 7 to 11 months of age. Similarly, they found that variegation accounted for 52%, 38%, and 43% of the inventory at 7, 9 and 11 months of age.The effect of hearing loss on syllable reduplication and variegation patterns in canonical babbling has not received significant attention. <a class="elsevierStyleCrossRef" href="#bib0040">McCaffrey, Davis, MacNeilage, and von Hapsburg (2000)</a> reported on a case study of the vocal repertoire of a child before and after cochlear implantation occurring at 25 months of age. In the two pre-implant sessions, the majority (80%) of multisyllabic sequences were reduplicated. That is, both consonant and vowel qualities remained the same across syllables. After implantation, the percentage of reduplicated sequences decreased with increased CI experience, such that reduplication accounted for only 20% of the syllable repertoire at 9 months post-implantation. Thus, post-implantation a drastic increase in variegation patterns was observed in this child, with the vowel variegation accounting for the majority of variegation patterns. For this child, when consonant variegation occurred, it tended to conform to the Frames then Content Hypothesis, that is, changes occurred in manner rather than in place of articulation. However, when vowel variegation occurred it did not follow a simple pattern. Most vowel-tovowel changes involved both vowel height and the front-back dimension.<a class="elsevierStyleCrossRef" href="#bib0020">Davis, Morrison, von Hapsburg and Warner Czyz (2005)</a> also examined the reduplication and variegation patterns of 3 infants with varied hearing levels. Two infants with severe-to-profound loss exhibited only reduplicated syllables, whereas, the infant with moderately-severe sensorineural hearing loss showed a predominance of reduplicated syllables, accounting for 78% of the repertoire. When variegation occurred, approximately 80% of variegation was observed in vowel changes across syllables, with the majority tending to be in vowel height. Taken together, these two case studies suggest that in children with hearing impairment, reduplication will exceed variegation and that vowel variegation will be observed instead of consonant variegation. The goal of the present study was to evaluate the role of audition on the distribution of reduplication and variegation of multisyllabic sequences. Multisyllabic sequences of infants with normal hearing were compared to those of infants with mild-to-moderately- severe hearing loss. Based on the previous case studies, it was expected that infants with hearing loss would show a preponderance of reduplicated syllables over variegated syllables.MethodParticipantsTen infants with pure-tone averages ([PTA], the average of hearing thresholds at 500 Hz, 1,000 Hz, and 2,000 Hz) ranging from 25 dB HL to 68 dB HL in the better hearing ear participated. Four infants exhibited hearing sensitivity within normal limits in at least one ear as suggested by soundfield screening at 25 dB HL. Six infants had mild-to-moderately-severe sensorineural hearing loss, bilaterally. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> describes participant demographic characteristics. For purposes of description ease, the infants are grouped according to the PTA in the better hearing ear as follows, normal (PTA = 25 dB HL) and mildto- moderately-severe (PTA = 26-70 dB HL).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Infants with normal hearingData from four (M = 2, F = 2) infants with normal hearing who participated in a larger study of early speech acquisition reported by <a class="elsevierStyleCrossRef" href="#bib0015">Davis and Mac-Neilage (1995a)</a> were used for comparison with the hearing impaired groups (for more details on these infants see <a class="elsevierStyleCrossRef" href="#bib0015">Davis and MacNeilage, 1995a</a>). The average age of the hearing infants was 12.3 months (range = 11-14 months). This age range was chosen to match the average chronological age of the infants with hearing loss. It was also the age at which the hearing infants were still producing a predominance of canonical babbling. Only pre-linguistic vocalizations were analyzed, although two infants (R and N) were entering the first-word stage, based on parent report of spontaneous word use. Tokens believed to be words were not analyzed. All infants in this group passed a sound field hearing screening at 25 dB HL for the frequencies 500-4,000 Hz. Because these infants were screened in the soundfield, it is possible that unilateral losses might have been missed. However, these infants were followed longitudinally over 3 years and developed speech and language normally.Infants with hearing lossData were collected for 6 male infants with bilateral sensorineural hearing loss. <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the PTAs obtained for each ear, for each participant. Because the infants were referred from multiple centers, there were varying amounts of audiological information available in each infant's record. Audiometric threshold information also varied with some having only soundfield information at select frequencies, and others yielding ear-specific data at many of the audiometric frequencies, binaurally. Infant AM had missing information at 2 kHz bilaterally, therefore a two-frequency PTA (500 Hz and 1,000 Hz) was used to calculate his PTA.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>The six infants with bilateral mild-to-moderatelysevere sensorineural hearing loss (mean PTA = 47 dB HL in the better hearing ear) were all male. The average age at which the infants received their first hearing aids was 4.9 months. Average chronological age at the onset of the study was 12 months (range = 7- 15 months). The average amount of experience with hearing aids was 7.1 months (range = 4.5 – 10.8 months). None of the infants demonstrated severe motor or cognitive delays, although some showed mild motor delays based on available testing.All of the infants with hearing loss infants were attending oral/aural habilitation sessions at least once a week. A description of the severity of hearing loss for each infant was obtained from case histories and medical/audiological records provided by parents. Click and tone-burst auditory brainstem response audiometry was used for initial diagnosis and confirmation of hearing loss. All participants had hearing and hearing aid evaluations performed by the audiologist at their local clinic within a month of data collection. Behavioral pure-tone information was obtained either in the sound field or through headphones by the referring clinics. With the exception of one infant, all hearing aids were fit using probe microphone procedures (real-ear-to-coupler difference, RECD) and the Desired Sensation Level (DSL; <a class="elsevierStyleCrossRef" href="#bib0010">Cornelisse, Seewald and Jamieson, 1995</a>) procedure. All participants wore behind-the-ear (BTE) hearing aids binaurally. Parents and the investigator monitored hearing aid function (i.e., made sure the hearing aid batteries were working, listened to the hearing aids, and monitored hearing use) immediately prior to data collection.RecordingAll infants were video and audio recorded with a wireless microphone (Audio Technica ATW-1030 or a Telex ProStar FM remote microphone) clipped to one shoulder of a bib specially made to hold the wireless receiver. All data was recorded on digital audio recorders (Sony TCM-5000 or Tascam DA-P1). Once the microphone and receiver were in place, infants were not typically aware of their presence. The investigator observed the infant and parent interact, mostly in their home, while monitoring the equipment and interacted only as needed for equipment adjustments.The amount of data collected for each infant varied according to parent availability and vocalization volubility. Data were collected at home. Data collection did not exceed a period of one month per child. A total of 360 (Mean = 90) and 869 (Mean = 144) minutes of data were analyzed for infants with normal and mildto-moderately-severe loss, respectively. <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the number of minutes, sequenced canonical syllable pairs, and number of reduplicated and variegated syllables obtained for each infant. All infants were in the canonical babbling stage according to the criterion (CBR > 0.2) described by <a class="elsevierStyleCrossRef" href="#bib0055">Oller and Eilers (1988)</a>.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>TranscriptionData were transcribed using the International Phonetic Alphabet (IPA) system of notation (1996). The primary investigator transcribed data for the infants with hearing loss. Tokens were digitized, and played back through Sony MVR-V500 headphones. Video was used only to corroborate unclear tokens on the audio recordings, or to verify lip rounding when there was uncertainty. Data for typically developing infants were originally transcribed by four transcribers trained in infant-vocalization sampling (<a class="elsevierStyleCrossRef" href="#bib0015">Davis and MacNeilage, 1995ab</a>).Broad transcription of canonical CV syllables was analyzed. Designation of canonical syllable was based on perceptual judgment using <a class="elsevierStyleCrossRef" href="#bib0055">Oller and Eilers (1988)</a> perceptual definition for a canonical syllable. Canonical syllables had 1) at least one fully resonant nucleus (i.e., vowel with an identifiable quality), 2) one non-glottal margin (consonant other than glottal stop or glottal fricative), 3) duration of syllable and formant transitions that fit within the range of mature syllable production (perceptually), and 4) normal phonation and pitch range. <a class="elsevierStyleCrossRef" href="#bib0050">Oller (1986)</a> provides acoustic parameters for each of these aspects of the syllable. However, acoustic analysis was not performed to verify categorization of canonical syllables. Therefore, it is possible that some slow-transition syllables, known as marginal syllables, were included in the analysis. Reliability for canonical versus non canonical syllable judgments was high (overall mean = 91%, range 84%-100% agreement), suggesting that the likelihood of categorizing marginal syllables as canonical syllables may have occurred infrequently.All phones were transcribed regardless of whether they are phonemes in English. For consonants, three places of consonantal articulation were specified: labial (i.e., [p, b, m, w, β]), coronal (i.e., [t, d, n, z, s, з, θ, ð, ¿, t¿, d¿, l, j]), and dorsal (i.e., [k, g, η, x]). Glottal and uvular consonants were excluded from this analysis. Consonants were also classified in terms of the following manner categories, plosive (i.e., [p, b, t, d, k, g]), nasal (i.e., [n, m, η]), fricatives and affricates (i.e., [β, f, v, z, ¿¿, з, θ, ¿, t¿, ¿, h, x]), and approximants (i.e., [l, ä]). For vowels front/back dimensions were specified: (i.e., [ı, e, ¿¿, y, æ), central (i.e., [đ, ∧, a]), or back (i.e., [u, υ, o, ¿, α]). Vocalizations separated by approximately one second were considered to be different utterances. Sound Studio Classic software (<a class="elsevierStyleCrossRef" href="#bib0035">Kwok, 2001</a>) was used to verify utterance boundaries.Data analysisInter-syllabic organizationData were analyzed using the Logical International Phonetics Programs (LIPP, <a class="elsevierStyleCrossRef" href="#bib0060">Oller and Delgado, 1990</a>). Only utterances containing at least two or more sequenced canonical syllables were analyzed for each infant. For example utterances containing at least two sequenced CVs (i.e., CV1 CV2) or more than two sequenced CVs (i.e., CV1 CV2 CV3…CVx) were analyzed. For utterances containing more than two sequenced syllables, the consonant and vowel of the latter syllable was compared to the consonant and vowel qualities of the syllable immediately preceding it. For example, in the example above, the consonant and vowel qualities of CV2 were compared with CV1. And the consonant and vowel qualities of CV3 were compared to those of CV2. For each analysis, the consonant manner and place of two sequential syllables were compared and a determination was made as to whether manner and place where duplicated or variegated across syllables. Similarly for vowels, a determination was made as to whether vowel height or front/back was duplicated or variegated across syllables. Complete duplication across syllables involved reduplication of consonant manner and place as well as reduplication of both vowel height and front/back dimensions, (i.e., [ba ba]) across sequential syllables. Variegated sequences were those in which at least one vowel or consonant changed across sequential syllables.ResultsThe mean number of syllable pairs analyzed for infants with normal hearing and mild-to-moderately-severe loss was 116.5 (range = 90-147) and 116.2 (range =13-330), respectively. The mean percentage of reduplicated syllables and variegated syllables occurring in the corpora for each group was calculated. Infants with normal hearing had approximately equal proportions of reduplicated (mean = 49.6%) and variegated (mean = 50.4%) syllables. However, infants with mild-to-moderately severe hearing loss had on average less reduplicated (mean = 31.2%) syllables than variegated (mean = 68.8%) syllables in their corpora. <a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a> displays the percentage of reduplicated and variegated sequences for the two groups. An analysis of variance showed a marginally significant difference between the means of the two groups (F = 4.5, df = 9, p = 0.06).<elsevierMultimedia ident="fig1"></elsevierMultimedia>An analysis of the multisyllabic sequences involving consonant variegation showed that for both groups of infants, manner variegation (with place duplication) was the most frequently occurring variegation type, accounting for 37% of the inventory for infants with normal hearing and 54% for infants with hearing loss. Place variegation (with manner duplication) accounted for the second most frequently occurring variegation pattern accounting for 30% and 23% of the inventory for infants with normal hearing and hearing impairment, respectively. Sequences for which manner and place were both variegated accounted for approximately 26% and 22% of the inventory for infants with normal and impaired hearing, respectively. No significant group differences emerged for any of these patterns.An analysis of the multisyllabic sequences involving vowel variegation showed similar patterns for both groups. For infants with normal hearing and hearing loss the most frequent vowel variegation pattern involved variegation in height and front/back, accounting for 45% of and 52% of the variegation patterns, respectively. Height variegation accounted for 33% and 30% of the inventory followed by Front/Back variegation in 21% and 17% for infants with normal and impaired hearing, respectively. Analysis of variance showed a statistically significant difference between the two groups for the HVBV pattern only (F=5.59, df=9, p=0.04).DiscussionThe goal of the present study was to determine whether mild-to-moderately-severe sensorineural hearing loss affects the sequential organization of multi-syllabic canonical syllables. To that end, the distribution of reduplicated and variegated syllables in a group of infants with mild-to-moderately-severe sensorineural hearing loss was compared to that observed in a group of typically developing infants. Previous studies of multisyllabic vocalizations have shown that infants with normal hearing, who have entered into the canonical babbling stage typically produce approximately equal proportions of reduplicated and variegated syllables (<a class="elsevierStyleCrossRef" href="#bib0015">Davis and MacNeilage, 1995</a>), with variegation never exceeding 52% in infants up to 13 months of age. The results of the present study are in accord with previous finding for infants with normal hearing but not for infants with hearing impairment. For infants with mild-to-moderately severe hearing loss, variegation accounts for 69% of sequenced syllables.An examination of the individual data for these infants shows that variegation exceeds reduplication for all infants within the hearing loss group, whereas the pattern is true only for two infants with normal hearing. The pattern observed in the infants with hearing loss is more similar to the pattern observed in older infants with normal hearing, in which variegation accounts for 66% of the inventory at an age of 14-17 months (<a class="elsevierStyleCrossRef" href="#bib0075">Smith et al., 1989</a>). Both the oldest (JH) and the youngest (EC) infant with hearing loss in the present study produced the largest proportion of variegated syllables. Infant JH has a chronological age of 15 months, but a hearing age of 8 months. Thus, it is likely that his pattern could be considered ageappropriate if chronological age is taken into account rather than hearing age. However, infant EC is only 8 months of age and had a hearing age of 4 months at the time of this study. Although the average age of the two groups is quite similar (12.3 vs. 12.0), three infants in the group with hearing loss fall in the 13-15 month age range. Thus, it is a possibility that these infants’ data is congruent with their chronological age. Thus, it may suggest that early amplification is having a positive effect on the development of multisyllabic sequencing during the canonical babbling stage. At this point, it is unclear why infants with mildto- moderately severe hearing impairment are showing a different pattern of syllable sequencing than infants with normal hearing. Thus future studies should consider a longitudinal evaluation of syllable reduplication and variegation to determine whether the patterns observed are age related or are rooted in perceptual factors. Additionally, it may be the case that some aspect of habilitation therapy may affect the production of early syllable sequences.The patterns observed in infants with mild-tomoderately severe hearing loss are different from those reported for infants with profound loss in the few case studies available. <a class="elsevierStyleCrossRef" href="#bib0040">McCaffrey, Davis, MacNeilage, and von Hapsburg (2000)</a> reported that prior to implantation 80% of multisyllabic sequences were reduplicated in a 25 month-old infant. However only 9 months post implantation, variegation accounted for 80% of syllable sequences. The data for the infants with milder hearing loss are more consistent with the post-implantation data and suggests that signal audibility may contribute to the emergence of frequent variegated syllables. Additionally, <a class="elsevierStyleCrossRef" href="#bib0020">Davis, Morrison, von Hapsburg and Warner Czyz (2005)</a> also examined the reduplication and variegation patterns of three infants with varied hearing levels. Two infants with severe-to-profound loss exhibited only reduplicated syllables, whereas, the infant with moderately- severe sensorineural hearing loss showed a predominance of reduplicated syllables, accounting for 78% of the repertoire. Clearly the effect of degree of hearing loss on multisyllabic babbling should be examined in a larger group of infants. The present results are also consistent with the few case studies available relative to the types of consonant and vowel variegation patterns observed. For the infants with hearing loss, when consonant variegation occurred, changes occurred in manner rather than in place of articulation. However, when vowel variegation occurred it did not follow a simple pattern. Most vowel-to-vowel changes involved both the vowel height and the front-back dimension. In general the patterns of variegation observed by infants with mild hearing loss seem consistent with those of infants with normal hearing, with the exception of the vowel variegation patterns. This may be indicative of the positive effect early amplification may have on multisyllabic organization of canonical syllables.The results of the present study provide additional evidence that supports the need for further research in the area of vocalization development in infants with hearing impairment. The present results suggest that the sequencing of multisyllabic canonical babbling may be influenced by perceptual factors such as hearing loss. Thus even mild-to-moderately- severe hearing loss may result in a different distribution of multisyllabic sequences in canonical babbling than observed in typically developing infants. Whether this has an effect on subsequent vocabulary development is currently unknown.Early hearing detection and intervention programs (EHDI) have resulted in an increasing number of infants 2 years and under in the caseloads of habilitation therapists and audiologists. However, the theoretical knowledge regarding the effects of hearing aids on the initial stages of speech acquisition is very limited in this young population. Because canonical babbling is one of the first vocal behaviors know to be influenced by perceptual factors, and consequently by amplification devices, it makes sense to continue to examine different aspects of canonical babbling in infants with hearing impairment as these early behaviors may be predictive of vocabulary and later language development.AcknowledgmentsThis research was supported in part by a dissertation grant awarded by the Department of Communication Sciences and Disorders, The University of Texas, Austin.We would like to thank those who volunteered to participate in the study, as well as the centers that participated: Sunshine Cottage, UT Child Hearing Services, and Texas Christian University." "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:2 [ "identificador" => "xres115880" "titulo" => array:5 [ 0 => "Abstract" 1 => "Introduction" 2 => "Method" 3 => "Results" 4 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec103168" "titulo" => "Key words" ] 2 => array:2 [ "identificador" => "xpalclavsec103169" "titulo" => "Palabras clave" ] 3 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 4 => array:3 [ "identificador" => "sec0100" "titulo" => "Method" "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Participants" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Infants with normal hearing" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Infants with hearing loss" ] 3 => array:2 [ "identificador" => "sec0025" "titulo" => "Recording" ] 4 => array:2 [ "identificador" => "sec0030" "titulo" => "Transcription" ] 5 => array:3 [ "identificador" => "sec0035" "titulo" => "Data analysis" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Inter-syllabic organization" ] ] ] ] ] 5 => array:2 [ "identificador" => "sec0045" "titulo" => "Results" ] 6 => array:2 [ "identificador" => "sec0050" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0055" "titulo" => "Acknowledgments" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-04-16" "fechaAceptado" => "2009-09-07" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec103168" "palabras" => array:4 [ 0 => "Amplification" 1 => "canonical babbling" 2 => "early intervention" 3 => "hearing loss" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec103169" "palabras" => array:4 [ 0 => "Amplificación" 1 => "sílabas balbuceadas" 2 => "intervención temprana" 3 => "hipoacusia" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "IntroductionThe purpose of this study was to evaluate the effect of hearing loss on the distribution of reduplicated and variegated syllables in canonical babbling. MethodSpontaneous vocalizations of six earlyidentified infants with mild-to-moderately severe hearing loss, and 4 infants with normal hearing sensitivity were audio-recorded and perceptually transcribed. Utterances containing well-formed multisyllabic canonical syllable sequences were selected for analysis of reduplication and variegation patterns. ResultsInfants with normal hearing showed an equal proportion of reduplicated and variegated syllable sequences. However, for infants with mildto-moderately-severe hearing loss, syllable variegation exceeded reduplication. ConclusionsAuditory sensitivity may contribute significantly to the distribution of reduplicated versus variegated syllable sequences." ] "es" => array:1 [ "resumen" => "IntroducciónEl objetivo de este estudio es evaluar el efecto de la pérdida de audición en la distribución de la reduplicación y mezcla de sílabas balbuceadas. MétodoSe analizaron y registraron las vocalizaciones espontáneas en seis niños con pérdida de oído de leve a moderadamente severa y en cuatro niños con sensibilidad auditiva normal. Las expresiones que contienen secuencias polisilábicas gramaticalmente correctas fueron seleccionadas para el análisis de reduplicación y mezcla de sílabas balbuceadas. ResultadosLos niños con audición normal mostraron una proporción igual de las secuencias de reduplicación y mezcla de la sílaba. Sin embargo, para los niños con pérdida de oído de leve a moderadamente severa, la diversidad de sílaba excedió a la reduplicación. ConclusionesLa sensibilidad auditiva puede contribuir considerablemente a la distribución de la reduplicación de la sílaba frente a la mezcla de secuencias." ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig1" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 598 "Ancho" => 952 "Tamanyo" => 43305 ] ] "descripcion" => array:1 [ "en" => "Percent occurrence of canonical syllable reduplication versus variegation for infants with estimated PTA of 25 dB HL (normal hearing), and infants with better-ear PTA between 37- 65 dB HL (mild-to-moderately-severe hearing loss)." ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Tabla 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Infant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">AA (months) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">CA (months) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">AHAE (months) \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Infants with normal hearing</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">F \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">- \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">- \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NJ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">- \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">F \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">- \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">1.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">1.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Infants with mild-to-moderately-severe hearing loss</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">JH \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AW \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab203614.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Age characteristics of infants: age at time of initial fitting of amplification (AA), chronological age (CA), and amount of hearing aid experience (AHAE) at the time of study" ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Tabla 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="8" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Auditory thresholds in dB HL (re: <a class="elsevierStyleCrossRef" href="#bib0005">ANSI, 2004</a>)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Infant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Ear \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">500 Hz \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">1,000 Hz \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">2,000 Hz \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">4,000 Hz \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">PTA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Best PTA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="8" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Infants with mild-to-moderately severe hearing loss</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">R \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">JH \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">R \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">R \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">DNT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65<a class="elsevierStyleCrossRef" href="#tbl2fn1">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">DNT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68<a class="elsevierStyleCrossRef" href="#tbl2fn1">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">R \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AW \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">R \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Group PTA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab203615.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tbl2fn1" "etiqueta" => "*" "nota" => "PTA estimated from thresholds at 500 and 1,000 Hz." ] ] ] "descripcion" => array:1 [ "en" => "Auditory threshold information for infants with hearing loss. A three-frequency pure-tone average (PTA) was calculated. When no-response was obtained at the limits of the audiometer, a value of 120 dB HL was entered as the threshold for that frequency" ] ] 3 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Tabla 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Infant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"># of minutes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"># of sequenced syllable pairs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"># of syllables reduplicated \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"># of syllables variegated \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Infants with normal hearing</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">147 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">120 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">125 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">120 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">R \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">104 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">116.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">56.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Infants with mild-to-moderately-severe hearing loss</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">152 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">JH \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">330 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">85 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">245 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">119 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">177 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">97 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">EC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">181 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">184 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">140 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AW \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">150 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">144.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">116.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab203616.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Data collected including total number of minutes, sequenced syllables, # syllables reduplicated, number of syllables variegated obtained for each infant" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "ANSI, 2004" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Specifications for audiometers (S3.6-2004)" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "American National Standards Institute" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2004" "editorial" => "ANSI" "editorialLocalizacion" => "New York" ] ] ] ] ] ] 1 => array:3 [ "identificador" => 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Canonical syllable reduplication and variegation in infants with sensorineural hearing loss

Reduplicación y mezcla de sílabas balbuceadas en niños con hipoacusia

D. von Hapsburg1,

Corresponding author

dvh@utk.edu

Correspondence: University of Tennessee, Department of Audiology and Speech Pathology, 578 South Stadium Hall, Knoxville, TN 37996.

, B.L. Davis2

1 Department of Audiology and Speech Pathology, Universidad de Tennessee, Memphis

2 Department of Communication, Sciences and Disorders, Universidad de Texas, Austin

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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Percent occurrence of canonical syllable reduplication versus variegation for infants with estimated PTA of 25 dB HL &#40;normal hearing&#41;&#44; and infants with better-ear PTA between 37- 65 dB HL &#40;mild-to-moderately-severe hearing loss&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The entry of infants into the canonical babbling stage of speech production is considered a hallmark milestone in early pre-linguistic development&#44; as rhythmic well-formed syllables emerge during this period&#46; In typically developing infants&#44; canonical babbling emerges between the ages of 6-10 months of age &#40;see <a class="elsevierStyleCrossRef" href="#bib0065">Oller&#44; 2000</a>&#44; for a review&#41; and is characterized by the production of repetitive&#44; well-formed syllable-like output &#40;i&#46;e&#46;&#44; &#91;baba&#93; or &#91;daedae&#93;&#41;&#46; This period in vocal development is important as the canonical syllables used during the babbling period form the foundation for first word production&#46; Additionally&#44; research suggests that delays in the onset of canonical babbling may be predictive of slow vocabulary development as well as other language delays &#40;Oller&#44; Eilers&#44; Neal and Schwartz&#44; 1999&#59; Stark&#44; Ansel and Bond&#44; 1988&#59; Stoel-Gammon&#44; 1989&#41;&#46; Furthermore&#44; it has been shown that canonical babbling is affected by perceptual factors&#46; Thus&#44; severeto-profound hearing loss results in altered patterns of canonical babbling &#40;<a class="elsevierStyleCrossRefs" href="#bib0025">Eilers and Oller&#44; 1994&#59; Koopmans-van Beinum&#44; Clement and van den Dikkenberg-Pot&#44; 2001&#59; Oller and Eilers&#44; 1988&#59; Stoel-Gammon&#44; 1988&#59; Stoel-Gammon and Otomo&#44; 1986&#59; von Hapsburg and Davis&#44; 2006</a>&#41;&#46; However&#44; little information exists on the effect of hearing loss on the multisyllabic canonical syllables during the canonical babbling stage&#46; The purpose of this study was to examine the effect of hearing loss on canonical syllable reduplication and variegation patterns&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Canonical syllables can be reduplicated &#40;same syllable repeated- &#91;baba&#93;&#41; or variegated &#40;segmental changes occur from one syllable to another within an utterance- &#91;babi&#93;&#41;&#46; Both types of syllable sequences are shown to be present in the repertoire of infants from the onset of canonical babbling &#40;<a class="elsevierStyleCrossRefs" href="#bib0045">Mitchell and Kent&#44; 1990&#59; Roug&#44; Landberg and Lundberg&#44; 1989&#59; Smith&#44; Brown-Sweeney and Stoel-Gammon&#44; 1989</a>&#41;&#46; Smith et al&#46;&#44; studied reduplication and variegation patterns in three groups of infants in the age ranges of 6-9 months&#44; 10-13 months&#44; and 14-17 months&#46; For both age ranges under 13 months&#44; they found that reduplicated babbling accounted for approximately 57&#37; of multisyllabic sequences&#44; whereas variegated babbling accounted for 43&#37; of sequences&#46; However&#44; for the older group of infants&#44; variegated sequences accounted for 66&#37; of the inventory and reduplicated sequences 34&#37;&#46; <a class="elsevierStyleCrossRef" href="#bib0045">Mitchell and Kent &#40;1990&#41;</a> also examined the distribution of reduplicated and variegated syllable sequences in a longitudinal study of one group of infants from 7 to 11 months of age&#46; Similarly&#44; they found that variegation accounted for 52&#37;&#44; 38&#37;&#44; and 43&#37; of the inventory at 7&#44; 9 and 11 months of age&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The effect of hearing loss on syllable reduplication and variegation patterns in canonical babbling has not received significant attention&#46; <a class="elsevierStyleCrossRef" href="#bib0040">McCaffrey&#44; Davis&#44; MacNeilage&#44; and von Hapsburg &#40;2000&#41;</a> reported on a case study of the vocal repertoire of a child before and after cochlear implantation occurring at 25 months of age&#46; In the two pre-implant sessions&#44; the majority &#40;80&#37;&#41; of multisyllabic sequences were reduplicated&#46; That is&#44; both consonant and vowel qualities remained the same across syllables&#46; After implantation&#44; the percentage of reduplicated sequences decreased with increased CI experience&#44; such that reduplication accounted for only 20&#37; of the syllable repertoire at 9 months post-implantation&#46; Thus&#44; post-implantation a drastic increase in variegation patterns was observed in this child&#44; with the vowel variegation accounting for the majority of variegation patterns&#46; For this child&#44; when consonant variegation occurred&#44; it tended to conform to the Frames then Content Hypothesis&#44; that is&#44; changes occurred in manner rather than in place of articulation&#46; However&#44; when vowel variegation occurred it did not follow a simple pattern&#46; Most vowel-tovowel changes involved both vowel height and the front-back dimension&#46;<a class="elsevierStyleCrossRef" href="#bib0020">Davis&#44; Morrison&#44; von Hapsburg and Warner Czyz &#40;2005&#41;</a> also examined the reduplication and variegation patterns of 3 infants with varied hearing levels&#46; Two infants with severe-to-profound loss exhibited only reduplicated syllables&#44; whereas&#44; the infant with moderately-severe sensorineural hearing loss showed a predominance of reduplicated syllables&#44; accounting for 78&#37; of the repertoire&#46; When variegation occurred&#44; approximately 80&#37; of variegation was observed in vowel changes across syllables&#44; with the majority tending to be in vowel height&#46; Taken together&#44; these two case studies suggest that in children with hearing impairment&#44; reduplication will exceed variegation and that vowel variegation will be observed instead of consonant variegation&#46; The goal of the present study was to evaluate the role of audition on the distribution of reduplication and variegation of multisyllabic sequences&#46; Multisyllabic sequences of infants with normal hearing were compared to those of infants with mild-to-moderately- severe hearing loss&#46; Based on the previous case studies&#44; it was expected that infants with hearing loss would show a preponderance of reduplicated syllables over variegated syllables&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Method</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Participants</span><p id="par0020" class="elsevierStylePara elsevierViewall">Ten infants with pure-tone averages &#40;&#91;PTA&#93;&#44; the average of hearing thresholds at 500 Hz&#44; 1&#44;000 Hz&#44; and 2&#44;000 Hz&#41; ranging from 25 dB HL to 68 dB HL in the better hearing ear participated&#46; Four infants exhibited hearing sensitivity within normal limits in at least one ear as suggested by soundfield screening at 25 dB HL&#46; Six infants had mild-to-moderately-severe sensorineural hearing loss&#44; bilaterally&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> describes participant demographic characteristics&#46; For purposes of description ease&#44; the infants are grouped according to the PTA in the better hearing ear as follows&#44; normal &#40;PTA &#61; 25 dB HL&#41; and mildto- moderately-severe &#40;PTA &#61; 26-70 dB HL&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Infants with normal hearing</span><p id="par0025" class="elsevierStylePara elsevierViewall">Data from four &#40;M &#61; 2&#44; F &#61; 2&#41; infants with normal hearing who participated in a larger study of early speech acquisition reported by <a class="elsevierStyleCrossRef" href="#bib0015">Davis and Mac-Neilage &#40;1995a&#41;</a> were used for comparison with the hearing impaired groups &#40;for more details on these infants see <a class="elsevierStyleCrossRef" href="#bib0015">Davis and MacNeilage&#44; 1995a</a>&#41;&#46; The average age of the hearing infants was 12&#46;3 months &#40;range &#61; 11-14 months&#41;&#46; This age range was chosen to match the average chronological age of the infants with hearing loss&#46; It was also the age at which the hearing infants were still producing a predominance of canonical babbling&#46; Only pre-linguistic vocalizations were analyzed&#44; although two infants &#40;R and N&#41; were entering the first-word stage&#44; based on parent report of spontaneous word use&#46; Tokens believed to be words were not analyzed&#46; All infants in this group passed a sound field hearing screening at 25 dB HL for the frequencies 500-4&#44;000 Hz&#46; Because these infants were screened in the soundfield&#44; it is possible that unilateral losses might have been missed&#46; However&#44; these infants were followed longitudinally over 3 years and developed speech and language normally&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Infants with hearing loss</span><p id="par0030" class="elsevierStylePara elsevierViewall">Data were collected for 6 male infants with bilateral sensorineural hearing loss&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the PTAs obtained for each ear&#44; for each participant&#46; Because the infants were referred from multiple centers&#44; there were varying amounts of audiological information available in each infant&#39;s record&#46; Audiometric threshold information also varied with some having only soundfield information at select frequencies&#44; and others yielding ear-specific data at many of the audiometric frequencies&#44; binaurally&#46; Infant AM had missing information at 2 kHz bilaterally&#44; therefore a two-frequency PTA &#40;500 Hz and 1&#44;000 Hz&#41; was used to calculate his PTA&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">The six infants with bilateral mild-to-moderatelysevere sensorineural hearing loss &#40;mean PTA &#61; 47 dB HL in the better hearing ear&#41; were all male&#46; The average age at which the infants received their first hearing aids was 4&#46;9 months&#46; Average chronological age at the onset of the study was 12 months &#40;range &#61; 7- 15 months&#41;&#46; The average amount of experience with hearing aids was 7&#46;1 months &#40;range &#61; 4&#46;5 &#8211; 10&#46;8 months&#41;&#46; None of the infants demonstrated severe motor or cognitive delays&#44; although some showed mild motor delays based on available testing&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">All of the infants with hearing loss infants were attending oral&#47;aural habilitation sessions at least once a week&#46; A description of the severity of hearing loss for each infant was obtained from case histories and medical&#47;audiological records provided by parents&#46; Click and tone-burst auditory brainstem response audiometry was used for initial diagnosis and confirmation of hearing loss&#46; All participants had hearing and hearing aid evaluations performed by the audiologist at their local clinic within a month of data collection&#46; Behavioral pure-tone information was obtained either in the sound field or through headphones by the referring clinics&#46; With the exception of one infant&#44; all hearing aids were fit using probe microphone procedures &#40;real-ear-to-coupler difference&#44; RECD&#41; and the Desired Sensation Level &#40;DSL&#59; <a class="elsevierStyleCrossRef" href="#bib0010">Cornelisse&#44; Seewald and Jamieson&#44; 1995</a>&#41; procedure&#46; All participants wore behind-the-ear &#40;BTE&#41; hearing aids binaurally&#46; Parents and the investigator monitored hearing aid function &#40;i&#46;e&#46;&#44; made sure the hearing aid batteries were working&#44; listened to the hearing aids&#44; and monitored hearing use&#41; immediately prior to data collection&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Recording</span><p id="par0045" class="elsevierStylePara elsevierViewall">All infants were video and audio recorded with a wireless microphone &#40;Audio Technica ATW-1030 or a Telex ProStar FM remote microphone&#41; clipped to one shoulder of a bib specially made to hold the wireless receiver&#46; All data was recorded on digital audio recorders &#40;Sony TCM-5000 or Tascam DA-P1&#41;&#46; Once the microphone and receiver were in place&#44; infants were not typically aware of their presence&#46; The investigator observed the infant and parent interact&#44; mostly in their home&#44; while monitoring the equipment and interacted only as needed for equipment adjustments&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The amount of data collected for each infant varied according to parent availability and vocalization volubility&#46; Data were collected at home&#46; Data collection did not exceed a period of one month per child&#46; A total of 360 &#40;Mean &#61; 90&#41; and 869 &#40;Mean &#61; 144&#41; minutes of data were analyzed for infants with normal and mildto-moderately-severe loss&#44; respectively&#46; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the number of minutes&#44; sequenced canonical syllable pairs&#44; and number of reduplicated and variegated syllables obtained for each infant&#46; All infants were in the canonical babbling stage according to the criterion &#40;CBR &#62; 0&#46;2&#41; described by <a class="elsevierStyleCrossRef" href="#bib0055">Oller and Eilers &#40;1988&#41;</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Transcription</span><p id="par0055" class="elsevierStylePara elsevierViewall">Data were transcribed using the International Phonetic Alphabet &#40;IPA&#41; system of notation &#40;1996&#41;&#46; The primary investigator transcribed data for the infants with hearing loss&#46; Tokens were digitized&#44; and played back through Sony MVR-V500 headphones&#46; Video was used only to corroborate unclear tokens on the audio recordings&#44; or to verify lip rounding when there was uncertainty&#46; Data for typically developing infants were originally transcribed by four transcribers trained in infant-vocalization sampling &#40;<a class="elsevierStyleCrossRef" href="#bib0015">Davis and MacNeilage&#44; 1995ab</a>&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Broad transcription of canonical CV syllables was analyzed&#46; Designation of canonical syllable was based on perceptual judgment using <a class="elsevierStyleCrossRef" href="#bib0055">Oller and Eilers &#40;1988&#41;</a> perceptual definition for a canonical syllable&#46; Canonical syllables had <span class="elsevierStyleItalic">1&#41;</span> at least one fully resonant nucleus &#40;i&#46;e&#46;&#44; vowel with an identifiable quality&#41;&#44; <span class="elsevierStyleItalic">2&#41;</span> one non-glottal margin &#40;consonant other than glottal stop or glottal fricative&#41;&#44; <span class="elsevierStyleItalic">3&#41;</span> duration of syllable and formant transitions that fit within the range of mature syllable production &#40;perceptually&#41;&#44; and <span class="elsevierStyleItalic">4&#41;</span> normal phonation and pitch range&#46; <a class="elsevierStyleCrossRef" href="#bib0050">Oller &#40;1986&#41;</a> provides acoustic parameters for each of these aspects of the syllable&#46; However&#44; acoustic analysis was not performed to verify categorization of canonical syllables&#46; Therefore&#44; it is possible that some slow-transition syllables&#44; known as marginal syllables&#44; were included in the analysis&#46; Reliability for canonical versus non canonical syllable judgments was high &#40;overall mean &#61; 91&#37;&#44; range 84&#37;-100&#37; agreement&#41;&#44; suggesting that the likelihood of categorizing marginal syllables as canonical syllables may have occurred infrequently&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">All phones were transcribed regardless of whether they are phonemes in English&#46; For consonants&#44; three places of consonantal articulation were specified&#58; labial &#40;i&#46;e&#46;&#44; &#91;p&#44; b&#44; m&#44; w&#44; &#946;&#93;&#41;&#44; coronal &#40;i&#46;e&#46;&#44; &#91;t&#44; d&#44; n&#44; z&#44; s&#44; &#1079;&#44; &#952;&#44; &#240;&#44; ¿&#44; t¿&#44; d¿&#44; l&#44; j&#93;&#41;&#44; and dorsal &#40;i&#46;e&#46;&#44; &#91;k&#44; g&#44; &#951;&#44; x&#93;&#41;&#46; Glottal and uvular consonants were excluded from this analysis&#46; Consonants were also classified in terms of the following manner categories&#44; plosive &#40;i&#46;e&#46;&#44; &#91;p&#44; b&#44; t&#44; d&#44; k&#44; g&#93;&#41;&#44; nasal &#40;i&#46;e&#46;&#44; &#91;n&#44; m&#44; &#951;&#93;&#41;&#44; fricatives and affricates &#40;i&#46;e&#46;&#44; &#91;&#946;&#44; f&#44; v&#44; z&#44; ¿¿&#44; &#1079;&#44; &#952;&#44; ¿&#44; t¿&#44; ¿&#44; h&#44; x&#93;&#41;&#44; and approximants &#40;i&#46;e&#46;&#44; &#91;l&#44; &#228;&#93;&#41;&#46; For vowels front&#47;back dimensions were specified&#58; &#40;i&#46;e&#46;&#44; &#91;&#305;&#44; e&#44; ¿¿&#44; y&#44; &#230;&#41;&#44; central &#40;i&#46;e&#46;&#44; &#91;&#273;&#44; &#8743;&#44; a&#93;&#41;&#44; or back &#40;i&#46;e&#46;&#44; &#91;u&#44; &#965;&#44; o&#44; ¿&#44; &#945;&#93;&#41;&#46; Vocalizations separated by approximately one second were considered to be different utterances&#46; Sound Studio Classic software &#40;<a class="elsevierStyleCrossRef" href="#bib0035">Kwok&#44; 2001</a>&#41; was used to verify utterance boundaries&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Data analysis</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Inter-syllabic organization</span><p id="par0070" class="elsevierStylePara elsevierViewall">Data were analyzed using the Logical International Phonetics Programs &#40;LIPP&#44; <a class="elsevierStyleCrossRef" href="#bib0060">Oller and Delgado&#44; 1990</a>&#41;&#46; Only utterances containing at least two or more sequenced canonical syllables were analyzed for each infant&#46; For example utterances containing at least two sequenced CVs &#40;i&#46;e&#46;&#44; CV<span class="elsevierStyleInf">1</span> CV<span class="elsevierStyleInf">2</span>&#41; or more than two sequenced CV<span class="elsevierStyleInf">s</span> &#40;i&#46;e&#46;&#44; CV<span class="elsevierStyleInf">1</span> CV<span class="elsevierStyleInf">2</span> CV<span class="elsevierStyleInf">3</span>&#8230;CV<span class="elsevierStyleInf">x</span>&#41; were analyzed&#46; For utterances containing more than two sequenced syllables&#44; the consonant and vowel of the latter syllable was compared to the consonant and vowel qualities of the syllable immediately preceding it&#46; For example&#44; in the example above&#44; the consonant and vowel qualities of CV<span class="elsevierStyleInf">2</span> were compared with CV<span class="elsevierStyleInf">1</span>&#46; And the consonant and vowel qualities of CV<span class="elsevierStyleInf">3</span> were compared to those of CV<span class="elsevierStyleInf">2</span>&#46; For each analysis&#44; the consonant manner and place of two sequential syllables were compared and a determination was made as to whether manner and place where duplicated or variegated across syllables&#46; Similarly for vowels&#44; a determination was made as to whether vowel height or front&#47;back was duplicated or variegated across syllables&#46; Complete duplication across syllables involved reduplication of consonant manner and place as well as reduplication of both vowel height and front&#47;back dimensions&#44; &#40;i&#46;e&#46;&#44; &#91;ba ba&#93;&#41; across sequential syllables&#46; Variegated sequences were those in which at least one vowel or consonant changed across sequential syllables&#46;</p></span></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0075" class="elsevierStylePara elsevierViewall">The mean number of syllable pairs analyzed for infants with normal hearing and mild-to-moderately-severe loss was 116&#46;5 &#40;range &#61; 90-147&#41; and 116&#46;2 &#40;range &#61;13-330&#41;&#44; respectively&#46; The mean percentage of reduplicated syllables and variegated syllables occurring in the corpora for each group was calculated&#46; Infants with normal hearing had approximately equal proportions of reduplicated &#40;mean &#61; 49&#46;6&#37;&#41; and variegated &#40;mean &#61; 50&#46;4&#37;&#41; syllables&#46; However&#44; infants with mild-to-moderately severe hearing loss had on average less reduplicated &#40;mean &#61; 31&#46;2&#37;&#41; syllables than variegated &#40;mean &#61; 68&#46;8&#37;&#41; syllables in their corpora&#46; <a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a> displays the percentage of reduplicated and variegated sequences for the two groups&#46; An analysis of variance showed a marginally significant difference between the means of the two groups &#40;F &#61; 4&#46;5&#44; df &#61; 9&#44; p &#61; 0&#46;06&#41;&#46;</p><elsevierMultimedia ident="fig1"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">An analysis of the multisyllabic sequences involving consonant variegation showed that for both groups of infants&#44; manner variegation &#40;with place duplication&#41; was the most frequently occurring variegation type&#44; accounting for 37&#37; of the inventory for infants with normal hearing and 54&#37; for infants with hearing loss&#46; Place variegation &#40;with manner duplication&#41; accounted for the second most frequently occurring variegation pattern accounting for 30&#37; and 23&#37; of the inventory for infants with normal hearing and hearing impairment&#44; respectively&#46; Sequences for which manner and place were both variegated accounted for approximately 26&#37; and 22&#37; of the inventory for infants with normal and impaired hearing&#44; respectively&#46; No significant group differences emerged for any of these patterns&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">An analysis of the multisyllabic sequences involving vowel variegation showed similar patterns for both groups&#46; For infants with normal hearing and hearing loss the most frequent vowel variegation pattern involved variegation in height and front&#47;back&#44; accounting for 45&#37; of and 52&#37; of the variegation patterns&#44; respectively&#46; Height variegation accounted for 33&#37; and 30&#37; of the inventory followed by Front&#47;Back variegation in 21&#37; and 17&#37; for infants with normal and impaired hearing&#44; respectively&#46; Analysis of variance showed a statistically significant difference between the two groups for the HVBV pattern only &#40;F<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#46;59&#44; df<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0090" class="elsevierStylePara elsevierViewall">The goal of the present study was to determine whether mild-to-moderately-severe sensorineural hearing loss affects the sequential organization of multi-syllabic canonical syllables&#46; To that end&#44; the distribution of reduplicated and variegated syllables in a group of infants with mild-to-moderately-severe sensorineural hearing loss was compared to that observed in a group of typically developing infants&#46; Previous studies of multisyllabic vocalizations have shown that infants with normal hearing&#44; who have entered into the canonical babbling stage typically produce approximately equal proportions of reduplicated and variegated syllables &#40;<a class="elsevierStyleCrossRef" href="#bib0015">Davis and MacNeilage&#44; 1995</a>&#41;&#44; with variegation never exceeding 52&#37; in infants up to 13 months of age&#46; The results of the present study are in accord with previous finding for infants with normal hearing but not for infants with hearing impairment&#46; For infants with mild-to-moderately severe hearing loss&#44; variegation accounts for 69&#37; of sequenced syllables&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">An examination of the individual data for these infants shows that variegation exceeds reduplication for all infants within the hearing loss group&#44; whereas the pattern is true only for two infants with normal hearing&#46; The pattern observed in the infants with hearing loss is more similar to the pattern observed in older infants with normal hearing&#44; in which variegation accounts for 66&#37; of the inventory at an age of 14-17 months &#40;<a class="elsevierStyleCrossRef" href="#bib0075">Smith et al&#46;&#44; 1989</a>&#41;&#46; Both the oldest &#40;JH&#41; and the youngest &#40;EC&#41; infant with hearing loss in the present study produced the largest proportion of variegated syllables&#46; Infant JH has a chronological age of 15 months&#44; but a hearing age of 8 months&#46; Thus&#44; it is likely that his pattern could be considered ageappropriate if chronological age is taken into account rather than hearing age&#46; However&#44; infant EC is only 8 months of age and had a hearing age of 4 months at the time of this study&#46; Although the average age of the two groups is quite similar &#40;12&#46;3 vs&#46; 12&#46;0&#41;&#44; three infants in the group with hearing loss fall in the 13-15 month age range&#46; Thus&#44; it is a possibility that these infants&#8217; data is congruent with their chronological age&#46; Thus&#44; it may suggest that early amplification is having a positive effect on the development of multisyllabic sequencing during the canonical babbling stage&#46; At this point&#44; it is unclear why infants with mildto- moderately severe hearing impairment are showing a different pattern of syllable sequencing than infants with normal hearing&#46; Thus future studies should consider a longitudinal evaluation of syllable reduplication and variegation to determine whether the patterns observed are age related or are rooted in perceptual factors&#46; Additionally&#44; it may be the case that some aspect of habilitation therapy may affect the production of early syllable sequences&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The patterns observed in infants with mild-tomoderately severe hearing loss are different from those reported for infants with profound loss in the few case studies available&#46; <a class="elsevierStyleCrossRef" href="#bib0040">McCaffrey&#44; Davis&#44; MacNeilage&#44; and von Hapsburg &#40;2000&#41;</a> reported that prior to implantation 80&#37; of multisyllabic sequences were reduplicated in a 25 month-old infant&#46; However only 9 months post implantation&#44; variegation accounted for 80&#37; of syllable sequences&#46; The data for the infants with milder hearing loss are more consistent with the post-implantation data and suggests that signal audibility may contribute to the emergence of frequent variegated syllables&#46; Additionally&#44; <a class="elsevierStyleCrossRef" href="#bib0020">Davis&#44; Morrison&#44; von Hapsburg and Warner Czyz &#40;2005&#41;</a> also examined the reduplication and variegation patterns of three infants with varied hearing levels&#46; Two infants with severe-to-profound loss exhibited only reduplicated syllables&#44; whereas&#44; the infant with moderately- severe sensorineural hearing loss showed a predominance of reduplicated syllables&#44; accounting for 78&#37; of the repertoire&#46; Clearly the effect of degree of hearing loss on multisyllabic babbling should be examined in a larger group of infants&#46; The present results are also consistent with the few case studies available relative to the types of consonant and vowel variegation patterns observed&#46; For the infants with hearing loss&#44; when consonant variegation occurred&#44; changes occurred in manner rather than in place of articulation&#46; However&#44; when vowel variegation occurred it did not follow a simple pattern&#46; Most vowel-to-vowel changes involved both the vowel height and the front-back dimension&#46; In general the patterns of variegation observed by infants with mild hearing loss seem consistent with those of infants with normal hearing&#44; with the exception of the vowel variegation patterns&#46; This may be indicative of the positive effect early amplification may have on multisyllabic organization of canonical syllables&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The results of the present study provide additional evidence that supports the need for further research in the area of vocalization development in infants with hearing impairment&#46; The present results suggest that the sequencing of multisyllabic canonical babbling may be influenced by perceptual factors such as hearing loss&#46; Thus even mild-to-moderately- severe hearing loss may result in a different distribution of multisyllabic sequences in canonical babbling than observed in typically developing infants&#46; Whether this has an effect on subsequent vocabulary development is currently unknown&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Early hearing detection and intervention programs &#40;EHDI&#41; have resulted in an increasing number of infants 2 years and under in the caseloads of habilitation therapists and audiologists&#46; However&#44; the theoretical knowledge regarding the effects of hearing aids on the initial stages of speech acquisition is very limited in this young population&#46; Because canonical babbling is one of the first vocal behaviors know to be influenced by perceptual factors&#44; and consequently by amplification devices&#44; it makes sense to continue to examine different aspects of canonical babbling in infants with hearing impairment as these early behaviors may be predictive of vocabulary and later language development&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Acknowledgments</span><p id="par0115" class="elsevierStylePara elsevierViewall">This research was supported in part by a dissertation grant awarded by the <span class="elsevierStyleGrantSponsor" id="GS1">Department of Communication Sciences and Disorders&#44; The University of Texas</span>&#44; Austin&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">We would like to thank those who volunteered to participate in the study&#44; as well as the centers that participated&#58; Sunshine Cottage&#44; UT Child Hearing Services&#44; and Texas Christian University&#46;</p></span></span>"
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          "titulo" => array:5 [
            0 => "Abstract"
            1 => "Introduction"
            2 => "Method"
            3 => "Results"
            4 => "Conclusions"
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec103168"
          "titulo" => "Key words"
        ]
        2 => array:2 [
          "identificador" => "xpalclavsec103169"
          "titulo" => "Palabras clave"
        ]
        3 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        4 => array:3 [
          "identificador" => "sec0100"
          "titulo" => "Method"
          "secciones" => array:6 [
            0 => array:2 [
              "identificador" => "sec0010"
              "titulo" => "Participants"
            ]
            1 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Infants with normal hearing"
            ]
            2 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Infants with hearing loss"
            ]
            3 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Recording"
            ]
            4 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Transcription"
            ]
            5 => array:3 [
              "identificador" => "sec0035"
              "titulo" => "Data analysis"
              "secciones" => array:1 [
                0 => array:2 [
                  "identificador" => "sec0040"
                  "titulo" => "Inter-syllabic organization"
                ]
              ]
            ]
          ]
        ]
        5 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Results"
        ]
        6 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Discussion"
        ]
        7 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Acknowledgments"
        ]
        8 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2009-04-16"
    "fechaAceptado" => "2009-09-07"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec103168"
          "palabras" => array:4 [
            0 => "Amplification"
            1 => "canonical babbling"
            2 => "early intervention"
            3 => "hearing loss"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec103169"
          "palabras" => array:4 [
            0 => "Amplificaci&#243;n"
            1 => "s&#237;labas balbuceadas"
            2 => "intervenci&#243;n temprana"
            3 => "hipoacusia"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The purpose of this study was to evaluate the effect of hearing loss on the distribution of reduplicated and variegated syllables in canonical babbling&#46;</p> <span class="elsevierStyleSectionTitle">Method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Spontaneous vocalizations of six earlyidentified infants with mild-to-moderately severe hearing loss&#44; and 4 infants with normal hearing sensitivity were audio-recorded and perceptually transcribed&#46; Utterances containing well-formed multisyllabic canonical syllable sequences were selected for analysis of reduplication and variegation patterns&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Infants with normal hearing showed an equal proportion of reduplicated and variegated syllable sequences&#46; However&#44; for infants with mildto-moderately-severe hearing loss&#44; syllable variegation exceeded reduplication&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Auditory sensitivity may contribute significantly to the distribution of reduplicated versus variegated syllable sequences&#46;</p>"
      ]
      "es" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio es evaluar el efecto de la p&#233;rdida de audici&#243;n en la distribuci&#243;n de la reduplicaci&#243;n y mezcla de s&#237;labas balbuceadas&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todo</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Se analizaron y registraron las vocalizaciones espont&#225;neas en seis ni&#241;os con p&#233;rdida de o&#237;do de leve a moderadamente severa y en cuatro ni&#241;os con sensibilidad auditiva normal&#46; Las expresiones que contienen secuencias polisil&#225;bicas gramaticalmente correctas fueron seleccionadas para el an&#225;lisis de reduplicaci&#243;n y mezcla de s&#237;labas balbuceadas&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Los ni&#241;os con audici&#243;n normal mostraron una proporci&#243;n igual de las secuencias de reduplicaci&#243;n y mezcla de la s&#237;laba&#46; Sin embargo&#44; para los ni&#241;os con p&#233;rdida de o&#237;do de leve a moderadamente severa&#44; la diversidad de s&#237;laba excedi&#243; a la reduplicaci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">La sensibilidad auditiva puede contribuir considerablemente a la distribuci&#243;n de la reduplicaci&#243;n de la s&#237;laba frente a la mezcla de secuencias&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig1"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 598
            "Ancho" => 952
            "Tamanyo" => 43305
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Percent occurrence of canonical syllable reduplication versus variegation for infants with estimated PTA of 25 dB HL &#40;normal hearing&#41;&#44; and infants with better-ear PTA between 37- 65 dB HL &#40;mild-to-moderately-severe hearing loss&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Infant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Gender&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">AA &#40;months&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">CA &#40;months&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">AHAE &#40;months&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Infants with normal hearing</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NJ&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Infants with mild-to-moderately-severe hearing loss</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">JH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Mean&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab203614.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Age characteristics of infants&#58; age at time of initial fitting of amplification &#40;AA&#41;&#44; chronological age &#40;CA&#41;&#44; and amount of hearing aid experience &#40;AHAE&#41; at the time of study</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="8" align="center" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Auditory thresholds in dB HL &#40;re&#58; <a class="elsevierStyleCrossRef" href="#bib0005">ANSI&#44; 2004</a>&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Infant&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Ear&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">500 Hz&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">1&#44;000 Hz&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">2&#44;000 Hz&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">4&#44;000 Hz&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">PTA&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Best PTA&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="8" align="center" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Infants with mild-to-moderately severe hearing loss</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">75&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">70&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">68&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">35&nbsp;\t\t\t\t\t\t\n
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                  """
              ]
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Auditory threshold information for infants with hearing loss&#46; A three-frequency pure-tone average &#40;PTA&#41; was calculated&#46; When no-response was obtained at the limits of the audiometer&#44; a value of 120 dB HL was entered as the threshold for that frequency</p>"
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      3 => array:7 [
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                  \t\t\t\t" style="border-bottom: 2px solid black">Infant&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&#35; of minutes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&#35; of sequenced syllable pairs&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&#35; of syllables reduplicated&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&#35; of syllables variegated&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">104&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">116&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">56&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Infants with mild-to-moderately-severe hearing loss</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">152&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">JH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">330&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">245&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">119&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">AM&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">177&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">60&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">181&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">140&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AW&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">144&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">116&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "imagenFichero" => array:1 [
                0 => "xTab203616.png"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Data collected including total number of minutes&#44; sequenced syllables&#44; &#35; syllables reduplicated&#44; number of syllables variegated obtained for each infant</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
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            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "ANSI&#44; 2004"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Specifications for audiometers &#40;S3&#46;6-2004&#41;"
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                          "colaboracion" => "American National Standards Institute"
                          "etal" => false
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            1 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adaptation to language&#58; Evidence from babbling and first words in four languages"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46; Boysson-Bardies"
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                    0 => array:1 [
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                        "tituloSerie" => "Language"
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                        "numero" => "2"
                        "paginaInicial" => "297"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The input&#47;output &#40;i&#47;o&#41; formula&#58; A theoretical approach to the fitting of personal amplification devices"
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                      "Revista" => array:7 [
                        "tituloSerie" => "Journal of the Acoustical Society of America"
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                        "paginaFinal" => "1864"
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The articulatory basis of babbling"
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                  ]
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                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Journal of Speech and Hearing Research"
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                        "paginaFinal" => "1211"
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                          0 => array:2 [
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Article information

ISSN: 02144603
Original language: English

DOI:10.1016/S0214-4603(09)70032-4

The statistics are updated each day

Year/Month	Html	Pdf	Total

2018 July	1	0	1
2018 February	15	5	20
2018 January	1	0	1
2017 December	3	3	6
2017 November	4	3	7
2017 October	8	1	9
2017 September	13	8	21
2017 August	9	0	9
2017 July	11	1	12
2017 June	14	4	18
2017 May	6	2	8
2017 April	8	1	9
2017 March	9	35	44
2017 February	5	0	5
2017 January	3	4	7
2016 December	1	2	3
2016 November	27	4	31
2016 October	25	1	26
2016 September	17	4	21
2016 August	9	4	13
2016 July	10	7	17
2016 June	10	5	15
2016 May	5	13	18
2016 April	5	13	18
2016 March	7	13	20
2016 February	5	13	18
2016 January	4	10	14
2015 December	5	14	19
2015 November	8	11	19
2015 October	11	15	26
2015 September	12	6	18
2015 August	6	9	15
2015 July	5	0	5
2015 June	1	1	2
2015 May	3	2	5
2015 April	5	4	9
2015 March	2	1	3
2015 February	19	0	19
2015 January	5	3	8
2014 December	12	3	15
2014 November	11	3	14
2014 October	15	2	17
2014 September	18	3	21
2014 August	13	1	14
2014 July	31	1	32
2014 June	12	1	13
2014 May	24	1	25
2014 April	12	2	14
2014 March	28	11	39
2014 February	25	14	39
2014 January	27	13	40
2013 December	32	8	40
2013 November	28	10	38
2013 October	31	13	44
2013 September	22	7	29
2013 August	34	16	50
2013 July	27	3	30
2013 June	8	1	9
2013 May	20	7	27
2013 April	12	9	21
2013 March	15	5	20
2013 February	6	3	9
2013 January	7	2	9
2012 December	3	2	5
2012 November	1	3	4
2012 October	1	1	2
2012 September	2	1	3
2009 September	345	0	345

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