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from Advances in Speech-Language Pathology
"This study used electropalatography (EPG) to investigate articulatory characteristics of /ts/ and /t/ occlusion in order to provide normative data to be used for the diagnosis and treatment of individuals with speech disorders. EPG data from the EUR-ACCOR database were analysed for nonsense VCV sequences containing /ts/ and /t/ in nine vowel contexts for seven English speaking adults. The main results of this study are that all speakers had a significantly more posterior placement for /ts/ compared to /t/ and that placement was stable during the occlusion phase of both /ts/ and /t/. For most speakers, the occlusion phase was longer for /ts/ compared to /t/, the occlusion phase generally involved more EPG contact and was slightly more variable in /ts/ compared to /t/, but these differences were not statistically significant for all speakers. The implications of the results for diagnosing and treating speech disorders are discussed."
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from International Journal of Audiology
"Previously, unilateral hearing impairment (UHI) has been considered of little consequence. However, a recent meta-analysis of children with UHI displayed educational and behavioural problems and possible delays of speech and language development. Further, patients with UHI consequently report hearing difficulties. Our study investigated hearing function, possible inner ear protection, and self-assessed hearing problems in 57 subjects aged between 3-80 years with single-sided congenital ear malformations and conductive UHI. Pure-tone thresholds and speech recognition (quiet, noise) were measured, and all patients completed a self-assessment questionnaire. Pure-tone thresholds corresponding to sensorineural function did not significantly differ between the normal (air conduction) and affected ear (bone conduction). However, speech recognition in both quiet and in noise was normal on the non-affected side but significantly worse on the malformed side. A moderate to high degree of self-assessed hearing problems were reported. In conclusion, hearing function in the affected ear was found to be subnormal in terms of supra threshold signal processing. Furthermore, a high degree of hearing difficulty was reported. Therefore, active treatment, surgery, or hearing amplification, might be considered."
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from International Journal of Audiology
"Severe hearing loss among children has often been found to be associated with educational disadvantage and lower-than-average performance on cognitive tests, but less is known about the much more widespread milder levels of hearing loss. In a cohort of 22 162 young Danish men appearing before the draft board, about 75% had normal hearing at 20 dB, and about 20% had mild hearing loss not worse than 25 dB in both ears for all tones less than 3000 Hz, and not worse than an average of 45 dB in both ears for all tones above 2000 Hz. The remaining 5% had more severe hearing loss. The proportions who had continued school education after age 16 years among the three groups were 51%, 42% and 34% respectively and their mean IQs were 101, 98 and 94. The evidence suggests that even mild hearing loss is associated with distinct educational and cognitive disadvantage which itself may result from difficulties in following classroom teaching."
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from International Journal of Audiology
"The paper describes the outcomes of an ongoing universal hearing screening program in Tirana, Albania. The main objectives of the project were the evaluation of the feasibility of a neonatal hearing screening program in Albania, and an evaluation of the prevalence of risk factors in the NICU environment. One thousand five hundred and sixty-one (1561) infants from both the WB and NICU were screened with transient evoked otoacoustic emissions (TEOAE). A detailed history of risk factors was collected in each case, thus it was possible to evaluate the main factors influencing the output of the screening program. It was concluded that the program had the capacity to identify infants with congenital hearing loss provided that an informative component is well-structured and delivered. Also, although the prevalence of risk factors appeared high, the reduction of 'case leakage' would allow the precise estimation of the incidence of hearing loss in the Albanian population."
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from International Journal of Audiology
"The purpose of this paper is to determine if a relationship exists between APOE alleles and nonsyndromic, sensorineural hearing loss (SNHL) in adults. APOE genotype was determined on DNA obtained from a sample of 89 subjects with nonsyndromic, adult onset SNHL. Median age was 64 years old, and 51 (57%) were males. Allele frequencies in the study population were compared to those in the general population. Subjects were divided into two groups, one by severity of hearing loss and another by severity of impairment of word recognition. Each group was stratified by severity, and allele frequencies were compared to the general population. The study found that the APOE allele 4 was less prevalent in the study population with SNHL than in the general population. No relationship was found between the 4 allele and severity of hearing loss or severity of impairment of word recognition. The study revealed that the APOE 4 allele was under-represented in the study sample as compared to the general population. Future studies associating the 4 allele with SNHL need to be population-based, longitudinal, or done in younger subjects."
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from International Journal of Audiology
"The amplitude of the 2f1-f2 distortion product otoacoustic emission (DPOAE) can be suppressed by presenting contralateral acoustic stimulation. To test the hypothesis that DPOAE contralateral suppression is influenced by the primary frequency in DPgrams, DPgrams were recorded at resolutions of 1, 8, and 17 pts/octave, in the absence and presence of contralateral broadband noise (BBN). Participants were 20 normal-hearing human adults. In DPgrams with higher frequency resolutions, DPOAE suppression at amplitude peaks in DPgrams (8 pts/octave: Mean = - 0.92 dB, SD = 0.71 for BBN at 60 dB SPL; 17 pts/octave: Mean = - 0.25 to -1.44 dB, SD = 0.51 to 0.86 for BBN at 40 to 70 dB SPL, respectively) was larger than the suppression at the dips in DPgrams (8 pts/octave: Mean = - 0.13 dB, SD = 1.00; 17 pts/octave: Mean = - 0.03 to -0.73 dB, SD = 0.55 to 0.91). A larger intersubject variability in DPOAE contralateral suppression was observed at the dips. The results suggest that measuring DPOAE contralateral suppression at the primary frequencies corresponding to the peaks in DPgrams with higher frequency resolutions may improve the assessment of the efferent system function."
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from International Journal of Audiology
"PAX6 encodes a transcriptional regulator that is essential for brain morphogenesis. Heterozygous PAX6 mutation is associated with aniridia and abnormalities of the interhemispheric pathway in humans. We present the case of a 12 year old boy with a known mutation of the PAX6 gene. There were parental concerns regarding his hearing, but repeated pure-tone audiograms were normal. He had a battery of standard central auditory tests, which gave abnormal results in tests which required auditory interhemispheric transfer (dichotic digits and pattern tests). A speech and language assessment, which yielded age-appropriate scores for speech, receptive and expressive language, revealed impaired verbal working memory. These test results were interpreted as indicating impaired auditory sensory and higher order interhemispheric transfer, consistent with reported findings in adults with mutations in PAX6, and correlated with his parent-reported hearing difficulties. This is the first report of central auditory and verbal working memory deficits in a child with a PAX6 mutation. Further research is needed to assess how these deficits impact on academic performance particularly in childhood."
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from the current issue of the International Journal of Language and Communication Disorders
"Background: People who stutter produce speech that is characterized by intermittent, involuntary part-word repetitions and prolongations. In addition to these signature acoustic manifestations, those who stutter often display repetitive and fixated behaviours outside the speech producing mechanism (e.g. in the head, arm, fingers, nares, etc.). Previous research has examined the attitudes and perceptions of those who stutter and people who frequently interact with them (e.g. relatives, parents, employers). Results have shown an unequivocal, powerful and robust negative stereotype despite a lack of defined differences in personality structure between people who stutter and normally fluent individuals. However, physiological investigations of listener responses during moments of stuttering are limited. There is a need for data that simultaneously examine physiological responses (e.g. heart rate and galvanic skin conductance) and subjective behavioural responses to stuttering. The pairing of these objective and subjective data may provide information that casts light on the genesis of negative stereotypes associated with stuttering, the development of compensatory mechanisms in those who stutter, and the true impact of stuttering on senders and receivers alike.
Aims: To compare the emotional and physiological responses of fluent speakers while listening and observing fluent and severe stuttered speech samples.
Methods & Procedures: Twenty adult participants (mean age = 24.15 years, standard deviation = 3.40) observed speech samples of two fluent speakers and two speakers who stutter reading aloud. Participants' skin conductance and heart rate changes were measured as physiological responses to stuttered or fluent speech samples. Participants' subjective responses on arousal (excited-calm) and valence (happy-unhappy) dimensions were assessed via the Self-Assessment Manikin (SAM) rating scale with an additional questionnaire comprised of a set of nine bipolar adjectives.
Outcomes & Results: Results showed significantly increased skin conductance and lower mean heart rate during the presentation of stuttered speech relative to the presentation of fluent speech samples (p<0.05). Listeners also self-rated themselves as being more aroused, unhappy, nervous, uncomfortable, sad, tensed, unpleasant, avoiding, embarrassed, and annoyed while viewing stuttered speech relative to the fluent speech.
Conclusions: These data support the notion that stutter-filled speech can elicit physiological and emotional responses in listeners. Clinicians who treat stuttering should be aware that listeners show involuntary physiological responses to moderate-severe stuttering that probably remain salient over time and contribute to the evolution of negative stereotypes of people who stutter. With this in mind, it is hoped that clinicians can work with people who stutter to develop appropriate coping strategies. The role of amygdala and mirror neural mechanism in physiological and subjective responses to stuttering is discussed."
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from the current issue of the International Journal of Language and Communication Disorders
"Background: Dysarthria is a common post-stroke presentation. Its management falls within the remit of the speech and language therapy profession. Little controlled evaluation of the effects of intervention for dysarthria in stroke has been reported.
Aims: The study aimed to determine the effects of a period of behavioural communication intervention on communication effectiveness and intelligibility, and of the speech disorder's impact on the person with dysarthria.
Methods & Procedures: Eight people with dysarthria following stroke received individually tailored intervention programmes of 16 sessions during an 8-week period. Conversation, and reading aloud of connected speech and of single words were sampled at four points, at intervals of around 2 months: two before intervention and two after intervention. The data were perceptually evaluated by ten listeners, blind to assessment point, for the overall effectiveness of communication (conversation) and for single-word and reading intelligibility. The impact of dysarthria was assessed at the beginning and end of the intervention period.
Outcome & Results: The level of reliability of listener ratings was high. There was no evidence of group change between assessment points for measures of communication effectiveness during conversation, or for reading and word intelligibility. Individual participant analysis indicated that five speakers improved in at least one of these three measures. In all cases this followed either stability or deterioration during the 2-month pre-intervention period. There was very little evidence of deterioration during the 2 months after withdrawal of treatment. For three participants no intervention-related speech benefit was demonstrated. Age, dysarthria severity or lesion information did not appear to differentiate those who improved from those who did not. Improvement occurred in all who began the intervention phase between 5 and 8 months following stroke onset. Group data indicated no change in the Dysarthria Impact Profile in respect of three sections (The effect of dysarthria on me as a person; How I feel others react to my speech; and How dysarthria affects my communication with others). There was a significant difference between the start and end of intervention for Accepting my dysarthria, suggesting a reduction in the negative impact of dysarthria.
Conclusions: The results demonstrate that some individuals with dysarthria have a capacity to respond positively to intervention, some months after stroke, and to maintain this improvement following 2 months of no intervention. Consideration is given to how the results of the present study may inform subsequent phases of dysarthria stroke research."
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from the current issue of the International Journal of Language and Communication Disorders
"Background: The production of causal sentences (e.g. The house went on fire because the girl was playing with matches) is a key component of the ability to produce explanations, which in turn is an important aspect of children's developing discourse skills. While informal observations by professionals suggest that children with language impairments often have difficulties in producing (and comprehending) causal sentences, there is a dearth of systematic research evidence on the scope and characteristics of such difficulties.
Aims: The study reported herein aimed to establish the scope and characteristics of the difficulties that children with language impairments have with causal sentence production. In particular, it investigated whether they have difficulties with (1) producing causal connectives (because and so), (2) producing semantically appropriate causal sentences, and (3) coordinating the production of more than one clause.
Methods & Procedures: The performance of 5-7-year-old children with language impairments (the LI group, n = 30) was compared with that of typically developing chronological age peers (the CA group, n = 30) on four elicited production tasks designed to encourage children to talk about pictures of causally related events. The tasks required the children to answer causal questions, to complete and imitate causal sentences, and to produce full causal sentences.
Outcomes & Results: Although the groups did not differ in the overall frequency with which they used causal connectives, the LI group produced fewer causal connectives than the CA group on tasks involving higher processing demands, as well as producing a lower percentage of semantically appropriate responses on most tasks. The LI group found imitating causal sentences more difficult than answering causal questions and completing causal sentences, whereas the CA group showed a similar level of performance across these three tasks.
Conclusions: Although 5-7-year-old children with language impairments have causal expressions in their repertoire, they have marked and extensive problems in using these expressions appropriately and in producing full causal sentences even when these are modelled for them. Given the educational importance of explanation, there is a clear need for interventions to target both the semantic appropriateness of causal sentence production and the frequency of use of causal connectives, especially in contexts where children have to cope with the additional processing demands associated with producing two-clause sentences and/or with producing causal sentences autonomously."
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from the current issue of the International Journal of Language and Communication Disorders
"Background: Research on language acquisition and disorders highlights the need to evaluate the early phases of language development for the early identification of children with language problems (screening), and to determine the nature and severity of language disorders (diagnosis).
Aims: The paper presents a new Sentence Repetition Task developed for evaluating language abilities in Italian pre-schoolers. Two studies are reported. The first is aimed at evaluating the power of the Sentence Repetition Task in discriminating the developmental changes in children's capacity to repeat sentences of different length and morphosyntactic complexity. Moreover, the test-retest reliability was assessed. The second study explored the relationship between the Sentence Repetition Task, free speech and verbal memory span.
Methods & Procedures: The test included 27 sentences of different length and complexity. Each sentence was accompanied with a picture reproducing its global meaning. In Study 1, the Sentence Repetition Task was administrated to 100 middle- and lower-class children (balanced for gender) between 2 and 4 years with a test-retest design. Test results were submitted to univariate analysis of variance, using five age levels as independent variables. To evaluate the test reliability, test-retest correlational analyses were conducted. In Study 2, 25 middle- and lower-class children between 2 and 4 years of age, balanced for age and gender, participated. The performance of the children on the repetition test was compared with their spontaneous language data. Moreover, the same children received a Verbal Memory Span test, consisting of a list of ten strings of different number of words. Correlational analyses were conducted to evaluate the relationships between the Sentence Repetition Task, free speech and the Verbal Memory Span test.
Outcomes & Results: Study 1 showed that 2-year-old children's repeated sentences were highly telegraphic. Between the age of 2;0 and 2;6 the mean length of utterance in the Sentence Repetition Task grew from approximately two to three words, and the number of omissions of articles, prepositions and modifiers significantly decreased. After 3;0 years old, omissions of free function words practically disappeared. The results of Study 2 showed that mean length of utterance, omission of articles and use of the verbs in the Sentence Repetition Task correlated with the same measures of the free speech. Moreover, positive correlations were found between verbal memory span and performance of both the repetition task and the free speech.
Conclusions: Results demonstrate that the repetition test is reliable, discriminates between the different age groups examined, highlights the relevant developmental stages described in the literature, and provides a reliable measure of the mean length of utterance."
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from the current issue of the International Journal of Language and Communication Disorders
"Background: Surprizingly little is known about the use of modal auxiliaries by children with specific language impairment (SLI). These forms fall within the category of grammatical morphology, an area of morphosyntax that is purportedly very weak in children with SLI.
Aims: Three studies were conducted to examine the use of modal auxiliaries by preschool-aged children with SLI.
Methods & Procedures: In each study, probe tasks were designed to create contexts that encouraged the use of modals to express the modality functions of ability and permission. In Studies 1 and 3, English-speaking children participated. In Study 2, the participants were Cantonese-speaking children. In each study, three groups of children participated: A group exhibiting SLI, a group of younger typically developing children (YTD), and a group of (older) typically developing children (OTD) matched with the SLI group according to age.
Outcome & Results: In Study 1, English-speaking children with SLI were as proficient as YTD children, though less proficient than OTD children in the use of the modal can to express the modality functions of ability and permission. In Study 2, the same modality functions were studied in the speech of SLI, YTD and OTD groups who were speakers of Cantonese. In this language, tense is not employed, and therefore the modality function could be examined independent of formal tense. Results similar to those of Study 1 were obtained. Study 3 again studied SLI, YTD and OTD groups in English to determine whether the children's expression of ability differed across past (could) and non-past (can) contexts. The results for can replicated the findings from Study 1. However, the children with SLI were significantly more limited than both the YTD and OTD groups in their use of could.
Conclusions: The results suggest that most children with SLI have access to modality functions such as ability and permission. However, the findings of Study 3 suggest that they may have a reduced inventory of modal forms or difficulty expressing the same function in both past and non-past contexts. These potential areas of difficulty suggest possible directions for intervention."
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from the current issue of the International Journal of Language and Communication Disorders
"Background: Children with speech impairment are more likely to have difficulty learning to read compared with children with typical speech development. Researchers have hypothesized that a difficulty in accessing good-quality phonological representations of words stored in the memory may constrain these children's performance on phonological awareness tasks and subsequent early reading acquisition.
Aims: The study investigated the following research questions. (1) Do preschool children with moderate or severe speech impairment show persistent difficulty on tasks designed to tap underlying phonological representations? (2) What is the relationship between performance on phonological representation tasks and measures of speech production, phonological awareness and early print decoding?
Methods & Procedures: Utilizing a longitudinal design, the performance of nine children (aged 3;09-5;03 years at initial assessment) with moderate or severe speech impairment and of 17 children of the same age with typical speech development were assessed on three occasions over a 12-month period. Assessments included receptive-based tasks designed to tap underlying phonological representations, speech production and phonological awareness measures.
Outcomes & Results: Children with speech impairment had greater difficulty judging correct and incorrect productions of words, and had difficulty in reflecting on the accuracy of newly learned non-words. Moderate correlations were observed between performance on phonological representation and phonological awareness tasks.
Conclusions: Poorly specified underlying phonological representations will result in difficulties during listening, speaking and phonological awareness tasks, as well as create additional challenges during the decoding of written words for some children."
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from Clinical Linguistics and Phonetics
"This study examined the linguistic characteristics of high functioning individuals with autism and Asperger syndrome. Each group consisted of 10 participants who were matched on sex, chronological age, and intelligence scores. Participants generated a narrative after watching a brief video segment of the Social Attribution Task video. Each participant was then asked 10 questions related to the stimulus video. The narrative samples and responses to the questions were analysed linguistically. Individuals with high functioning autism and Asperger syndrome performed similarly on most measures of language function; however, results suggest there may be pragmatically-based differences between the groups in the use of verb tense markers."
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from Clinical Linguistics and Phonetics
"Prader-Willi syndrome (PWS) is a genetic disorder which has widespread developmental consequences including motor, cognitive and language delay. Previous research on PWS children has focused primarily on phonological development and dysfluency. In the present study, the lexical development of a boy with PWS was investigated in a series of 18 play sessions recorded over a 4 month period from the ages 3;7 to 3;11. In comparison to the language development of children with Down syndrome this child with PWS appears to display a distinct developmental pattern. The possibility of detailing a behavioural phenotype of genetic disorders affecting language development is discussed."
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from Clinical Linguistics and Phonetics
"The present study examined lexical representation in early Spanish-English bilinguals using an unmasked semantic and translation priming paradigm. In Experiment 1, participants were divided into two groups based on performance (more-balanced bilinguals, MB and less-balanced bilinguals, LB) on the experimental task. In Experiment 2, four patients with bilingual aphasia (BA) performed the same experiment. Results from both experiments revealed that all groups were more accurate for English targets (S-E direction) than Spanish targets (S-E direction). In Experiment 1, semantic priming was observed from English to Spanish in both the LB and MB groups although the effect was greater for the LB group. Further, only the LB group showed priming from Spanish to English. For both normal groups, there was no difference between translation and semantic priming effects. In Experiment 2, patients with bilingual aphasia demonstrated different patterns of activation with no clear trends. Two participants demonstrated greater priming from Spanish to English whereas two participants demonstrated the opposite effect."
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from Clinical Linguistics and Phonetics
"Few studies have examined the ability of individuals with learning disabilities, in general, or with Down syndrome, specifically, to discriminate speech. The purpose of this study was compare the speech discrimination abilities of eight children with Down syndrome (aged 5.7 to 12.8 years) to seven nonverbal mental-age matched controls (aged 4.0 to 5.3 years). A computer program presented the speech discrimination task using a two-cued alternative forced choice procedure. On each trial, the participants heard four successive synthesized speech syllables, with the first and last stimuli being the same and serving as the cue. The results indicated children with Down syndrome differed from their nonverbal mental-age matched peers in their ability to discriminate two of the five pairs, but not in the manner predicted. The relationship between speech discrimination, phonological memory, and speech-language development is also discussed."
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from Neuropsychological Rehabilitation
"Nouns and verbs differ in their neural and psycholinguistic attributes. It is not known whether these differences lead to distinct patterns of response to treatment for individuals with word retrieval impairments associated with aphasia. Eight participants with naming disorders induced by left hemisphere strokes were treated with a semantic-phonologic treatment protocol for nouns and verbs using a single participant multiple baseline design. We measured treatment gains in a picture naming measure and other secondary language and communication measures. Treatment led to improved picture naming for trained nouns and verbs in five of eight patients, with no difference evident between nouns and verbs. Improvements for untrained words were minimal. Improvement in verb retrieval was associated with increases on a functional measure of communicative effectiveness. Improvement for nouns and verbs was associated with severity of word retrieval impairment at onset. Although distinct in neural and psycholinguistic attributes, nouns and verbs were affected by treatment in a similar pattern in this group of individuals. Training-specific effects suggest the need for careful selection of training words to have potential for functional benefit in daily communication."
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from Logopedics Phoniatrics Vocology
"The Voice Activity and Participation Profile (VAPP) is a self-assessment questionnaire describing the limitation of activities and participation of individuals with dysphonia. In this study, the validity and reliability of the Finnish translation of the VAPP was evaluated using 43 outpatients with various functional and organic voice disorders. A control group was formed consisting of 43 subjects matched according to age, gender, and profession, with normal voices. The VAPP was sensitive for voice disorders and items in the questionnaire had high internal consistency. The VAPP had a strong correlation with the Voice Handicap Index. The results showed that the questionnaire is a valid and reliable instrument to measure voice-related quality of life. It also showed that limitations in activity and participation levels should be examined separately."
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from Logopedics Phoniatrics Vocology
"The article explores aspects of the role of prosody as a contextualization cue in aphasic conversation through auditory and acoustic analysis of an aphasic speaker's use of pitch variation in responses to closed yes/no-requests. The results reveal two prosodic realizations of 'yes' and 'no' contextualizing different kinds of responses: a flat realization with no prolongation and minimal pauses, signalling decisiveness, and a realization with movement in pitch, prolongation and preceding pauses, signalling indecisiveness. The analysis also shows how the aphasic uses a particular realization manipulatively for interactional purposes. The study illustrates the vital role that seemingly unimportant details play in the co-constructive process of creating meaning in interaction. The results indicate an area of competence that seems undisturbed in this speaker."
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from Logopedics Phoniatrics Vocology
"The mean fundamental frequency (F0) of 10 normal-hearing (NH) and 10 hearing-impaired (HI) Japanese-speaking children were compared to those of 10 NH and 10 HI American English-speaking children. Results indicated no difference in F0 between the NH groups; while the Japanese-speaking HI children exhibited a significantly higher mean F0 than English-speaking HI children. The HI Japanese-speaking children also exhibited significantly higher F0 values than the NH Japanese-speaking children. The influence of a language-specific difference in pitch application was assumed to be a contributing factor to the F0 differences between the HI groups."
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from Logopedics Phoniatrics Vocology
"The aim of the present pilot study was to explore whether pragmatic language impairments are more prevalent among children referred to child psychiatric services (n=21) than among a comparison group of typically developing children (n=29) in the age range 8-10 years. A second and minor aim was also to assess the usability of a Norwegian translation of the Children's Communication Checklist (CCC). Communication disorders defined as a pragmatic score equal to or below 140 on the CCC were identified in a majority (0.57) of the children in the clinical group; the corresponding proportion for the typically developing comparison group was only 0.10. Thus, the Norwegian version of the CCC distinguishes between children with symptoms of pragmatic language impairments and those with no symptoms, as does the English version."
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from Logopedics Phoniatrics Vocology
"With current progress in genetic research, autosomal, dominant, hereditary, neurodegenerative diseases, affecting the cerebellum and cerebellar connections, are increasingly diagnosed as spinocerebellar ataxias (SCA). In the present study speech samples from 21 subjects with spinocerebellar ataxia (SCA), and 21 matched control subjects were analyzed using perceptual and acoustic methodology. Dysarthria assessment showed that subjects had mild or mild-moderate dysarthria. Perceptual analysis indicated that equalized stress, imprecise consonants, vocal instability, monotony and reduced speech rate were the speech parameters that yielded the highest mean perceptual ratings. A factor analysis of perceptual speech parameters revealed two main factors: Factor 1 was associated with articulatory timing and Factor 2 with vocal quality. Acoustic analysis revealed significantly reduced speech rate during text reading, reduced alternating and sequential motion rates (AMR/SMR), significantly longer and more variable syllable and pause durations, and significantly higher vocal instability for subjects with SCA compared to control subjects."
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from Audiological Medicine
"The review will first outline the history, pathology and pathophysiology of noise-induced hearing loss and then focus on biochemical and molecular mechanisms of hair cell damage. Calcium influx into sensory cells and generation of reactive oxygen species are initial events leading to an imbalance in the redox homeostasis of the cell and the activation of cell death pathways. Vasoconstriction as well as excitotoxic reactions at the inner hair cell synapse may contribute to the overall manifestations of noise trauma. Individual steps in this sequence leading to apoptotic or necrotic cell death will be discussed based on molecular evidence and on pharmacological manipulation of noise-induced signaling pathways."
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from Audiological Medicine
"Otoacoustic emissions (OAEs) are sounds generated by a healthy cochlea, as a by-product of the outer hair cell (OHC) activity, and therefore they can provide valuable information on OHC function. Hence, OAE recording techniques can be used for assessment of noise damage, as the most extensive noise-induced changes occur in the cochlea, involving the OHCs, which seem to be particularly vulnerable to noise. OAE recording techniques are simple, non-invasive, and they provide objective information and they are available in routine clinical practice. OAEs are characterized by a high sensitivity in detecting subtle changes of the OHCs and this property makes them very valuable in identifying early noise induced change, even before any notable shift in the audiometric thresholds. Although there is a high inter-individual variability, OAEs display remarkable intra-individual stability and, therefore, they are useful in intra-individual monitoring of subtle changes in cochlear integrity following noise exposure. In addition to the applications for assessment of structural damage, OAEs may also provide an insight into functional aspects of noise damage, which are less described in the literature. This includes the use of OAEs in objective evaluation of noise-induced tinnitus and hyperacusis, which often occur following noise exposure. Although the expectation that OAEs can provide objective evidence for tinnitus and hyperacusis is unrealistic, their recording may be a step towards evidence-based evaluation of tinnitus and hyperacusis, particularly in conjunction with other auditory tests. Additionally, OAEs can be applied in the evaluation of the medial olivocochlear (MOC) system that controls the OHCs through a direct neural input from the medial superior olivary complex. The relevance of the MOC system to noise damage is that the MOC system may be implicated in physiological protection mechanisms against noise and, therefore, the efficacy of the MOC can be considered a potential factor of inter-individual susceptibility to the damaging effect of noise. A dysfunction of the MOC system may also be of relevance in developing tinnitus."
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from Audiological Medicine
"At present, our knowledge of the genetic factors that are responsible for noise induced hearing loss (NIHL) is still limited, especially compared with the relatively well-studied environmental factors. Nevertheless, there is mounting evidence that several genetic mutations could determine an individual and intrinsic predisposition to noise damage. An important contribution to the study of genetic factors in NIHL derives from laboratory research on genetically modified animals. To date, three loci that contribute to NIHL, have been identified in these strains of mice 10 that contribute to age-related hearing loss, and six loci that promote both. Experimental data obtained in mice have been found and confirmed in humans. The cross-talk between studies in humans and those in model organisms is essential in this field. Genetic polymorphism in several candidate genes showed significant differences between vulnerable and resistant subjects selected among populations of workers exposed to occupational noise. In theory, any gene that weakens the ear functionally or structurally would make it more susceptible to noise damage. The identification and isolation of these genetic factors could have important and practical outcomes. For example, workers genetically predisposed should be more strictly protected against noise, compared with what is requested by actual legislation, which is regulated on the basis of normal worker populations."
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from Audiological Medicine
"The ototoxicity of therapeutic drugs has been a concern in the field of audiology for many years. In comparison, only recently has the ototoxicity of chemicals found in the environment from contaminants in air, food or water, and in the workplace become a concern for audiologists and other health professionals. Studies have shown that some toxins can reach the inner ear through the bloodstream. They were found in the inner ear fluids and have caused damage to some of the inner ear structures and functions. The damage, however, is not always restricted to the cochlea. The onset, site, mechanism and extent of ototoxic damage caused by these toxins vary according to risk factors that include type of chemical, interactions, exposure level and duration of exposure as is the case with therapeutic drugs. Noise exposure has been reported to potentiate or interact synergistically with several toxins. Moreover, it makes the detection and diagnosis of the ototoxicity effect more challenging. The new evidence has prompted the proposal of new guidelines and standards on hearing loss prevention. In this paper, the implications of the studies on the effect of environmental and occupational toxins exposure on the auditory system are discussed. Recent guidelines and legislative developments and alternative strategies for preventing auditory effects of exposure to ototoxic chemicals are examined."
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from Audiological Medicine
"The new EU directive (10/2003/EU) sets new limits for allowable noise levels and sets new requirements to accommodate the individual susceptibility factors, but does not define these factors. We aim to evaluate the effects of environmental and biological factors on the damage to hearing by noise. The history of work exposure, use of hearing protective devices (HPD), audiometric data and information on environmental and biological factors were collected from well over 1000 workers. The group consisted of 406 paper mill workers, 400 miners, 250 metal factory workers, 176 shipyard workers and 124 forestry workers. For comparison we evaluated 685 noise-exposed subjects visiting a hearing aid clinic for fitting of a hearing aid. They were exposed in their work to noise levels of 80-115dB(A). The environmental and biological factors encompassed smoking habits, the use of analgesics, serum cholesterol, systolic or diastolic blood pressure as well as noise exposure. There were a number of confounders which were significant factors in the hearing losses found in the noise-exposed workers. Sensitivity to sunburn, the presence of Raynaud's disease, a history of head injury and the use of analgesics correlated significantly with the extent of noise induced hearing loss (NIHL). The role of serum cholesterol levels as a risk factor for NIHL depended on the age of the subject, with the levels of middle-aged subjects having the greatest effect on NIHL. Hypertension or use of anti-hypertensive medication and use of analgesics correlated with hearing loss and their effect was additive. The correlation of tobacco smoking was also confounded by age. In analyses where the subjects were matched in pairs by age, exposure, blood pressure and serum cholesterol level, the elderly subjects were more susceptible to NIHL than younger subjects. In conclusion, among several susceptibility factors smoking and cholesterol are independently but causally related to NIHL and may cause the subject to be more susceptible for noise damage. Ageing further confounds some of these factors. The current ISO noise standard (1999-1990) has methodological deficiencies in not encompassing these susceptibility factors."
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from Audiological Medicine
"The diagnosis of hearing impairment due to noise damage is based on the assessment of the type and level of exposure to noise, the patient's medical history, and a clinical and audiometric evaluation. The risk for developing hearing loss increases substantially when the equivalent sound pressure levels of noise exceed 80dB(A). Very high exposures (above 100dB(A)), usually to impulse noise (e.g. fireworks), can result in acoustic trauma. In this case, sensorineural hearing loss develops immediately after exposure and is frequently accompanied by tinnitus. It can be unilateral or asymmetrical, and temporary (temporary threshold shift - TTS) or permanent (permanent threshold shift - PTS). Noise-induced hearing loss (NIHL) that develops after prolonged occupational exposures to relatively moderate levels of noise (85-100dB(A)) is a bilateral, symmetrical, or almost symmetrical, and permanent sensorineural hearing loss progressing slowly over the years of employment. The most dynamic rise in PTS can be seen during the first years of exposure to noise. Audiometric characteristics of NIHL include: hearing threshold shift at high frequencies, with a typical notch at 4-6 kHz; presence of recruitment; amplitude reduction or loss in otoacoustic emission, mostly at frequencies corresponding to hearing loss; and impairment of speech intelligibility. The tinnitus associated with NIHL may be more variable in both prevalence and severity than that associated with acoustic trauma. Nevertheless, it requires thorough investigation. In differential diagnosis, age-related hearing loss, aminoglycoside ototoxicity as well as retrocochlear pathology should be considered. To date, NIHL is an irreversible disease, thus an effective protection against noise is the only way to preserve hearing."
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from Audiological Medicine
"Sensorineural hearing loss (SNHL) due to the damaging effects of noise is the second leading cause of SNHL, next to presbyacusis, in the industrialized world. It is the leading cause of preventable SNHL despite the implementation of hearing conservation programs after World War II. While engineering solutions and personal hearing protection devices remain important approaches to preventing noise-induced hearing loss, they have inherent limitations. Therefore researchers from a number of laboratories worldwide have devoted much time in the last decade to elucidating the cellular and molecular mechanisms of cochlear injury due to noise. This has led to the documentation of a number of therapeutic compounds that attenuate noise damage to hearing based on known mechanisms of injury. Some of these effects are quite robust. Clinical studies are beginning to emerge."
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from Aphasiology
"Background: The two versions of the connectionist model of Dell and colleagues offer alternative explanations of aphasic naming disorders (Dell, Schwartz, Martin, Saffran, & Gagnon, 1997; Foygel & Dell, 2000). The semantic-phonological (SP) model hypothesises impairments in lexical-semantic or lexical-phonological connections, and the weight-decay (WD) model assumes global impairments in either connection weights or activation decay. In each version, a patient's error pattern in picture naming is simulated to assess the underlying disorder (connectionist "diagnosis"). A systematic comparison of both model versions in model-oriented naming therapy has not yet been performed. Moreover, if the normalisation of the error pattern during recovery is lesion-specific, as suggested in the SP model (Schwartz, Dell, Martin, Gahl, & Sobel, 2006), this should be observable in the patient data.
Aims: Predictions were made and tested regarding the relation between (1) connectionist diagnosis and therapy outcome, and (2) connectionist diagnosis and error pattern development. For example, patients with phonological disorders in the SP model should (1) benefit more from phonological as compared to semantic therapy, and (2) present a decrease of nonwords in their naming responses.
Methods & Procedures: The connectionist diagnosis and a 4-week therapy with cueing hierarchies (Howard, 2000; Wambaugh et al., 2001) were administered to 10 German-speaking aphasic patients with naming disorders. Six patients, who had been diagnosed by the SP model, received semantic and phonological therapy. The other four patients, diagnosed by the WD model, received increasing and vanishing therapy (Abel, Schultz, Radermacher, Willmes, & Huber, 2005).
Outcomes & Results: Cueing therapy was generally effective for 9 of 10 patients. The trend of improvement was always found in the direction predicted by the connectionist diagnosis, except for two patients diagnosed by the SP model who presented a numerical trend in the opposite direction. Nevertheless, the SP model offered a more plausible explanation of lesion-specific therapy outcomes, and it properly predicted the error pattern development. Moreover, the errorless learning procedure applied in vanishing therapy was favourable for patients with phonological (SP model) or weight (WD model) lesions, and this may be attributed to their characteristic error types and an impairment of editorial processes.
Conclusions: Models can be informative about the effectiveness of potential therapies and error pattern developments. Data from therapy studies can test competing models."
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from Aphasiology
"Background: Repetition conduction aphasia is defined as a phonological short-term memory (STM) deficit. The interactive activation model of verbal STM proposed by N. Martin and Saffran (1992) accounts for this deficit by an increased activation decay rate. Recently Majerus and van der Linden (2001) suggested that these short-term memory impairments could be improved by therapy.
Aims: The purpose of our single case study was to investigate whether the temporary storage of verbal information could be improved by therapy in a patient with repetition conduction aphasia.
Methods & Procedures: A patient suffering from a fluent aphasia was trained over 31 therapy sessions. In the therapy task he had to repeat sentences of four to seven words with an increasing delay between stimulus and response. The control task consisted of repeating sentences of four to six words without delay.
Outcomes & Results: The treatment improved sentence repetition significantly. In addition, sentence length in oral production and spans for digits and bisyllabic words, i.e., measures for phonological STM, improved.
Conclusions: Verbal STM performances were improved through therapy. It is argued that in the light of N. Martin and Saffran's theory, these improvements reflect a partially normalised activation decay, although the role of a probably very mild reduction of connection strength remains unclear."
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from Aphasiology
"Background: Increasingly, computerised communication aids are used by people with severe, chronic aphasia. Although the candidacy for these devices is relatively unknown, it has been hypothesised that cognitive deficits have a negative impact on the functional use of Augmentative and Alternative Communication (AAC). Deficits of executive functioning are assumed to be particularly important, but other functions, such as memory and semantic processing, may also be relevant. In a previous study (van de Sandt-Koenderman, Wiegers, Wielaert, Duivenvoorden, & Ribbers, in press) we reported the functional effect of TouchSpeak (TS), a computerised communication aid, in a group of stroke patients with severe aphasia. The successful participants showed different levels of proficiency. Some were able to use the system independently and creatively in many situations, some used it independently for trained situations, and others remained partner dependent in using TS.
Aims: To find factors associated with the functional success of TS in people with severe aphasia, focusing on memory, executive functioning, semantic processing, and communication skills.
Methods & Procedures: The data of 30 patients with severe aphasia were analysed retrospectively. All were trained to use TS in two self-chosen communicative situations. Four outcome levels were differentiated: no use, dependent use, independent use, and extensive use of TS. Pre-training assessment included memory, executive functioning, semantic processing, and communication skills. The four outcome groups were compared regarding age, time post onset, gender, and aphasia type. The role of the cognitive variables was analysed with univariate ANCOVAs with contrast analysis, with correction for age, gender, aphasia type, or time post onset in case of significant differences between the groups on these variables.
Outcomes & Results: Seven participants were classified as extensive users of TS, five were independent TS users, and five were partner dependent. In 13 cases there was no functional use of TS. Extensive users were younger than the other outcome groups. Independent of this age effect, there was an effect of semantic processing; the no-use group scored significantly lower on semantics than all other groups.
Conclusions: Only a minority of patients with severe aphasia may be expected to become independent, flexible users of high-tech AAC. The finding that functional success was related to semantic processing is clinically important. Prospective studies are needed to support the predictive value of semantic processing for high-tech AAC use. The importance of intact executive functioning is not supported in this study. The broad concept of "executive functioning" needs to be studied in more detail in relation to aphasia."
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from Aphasiology
"Background: SentenceShaper ™ (SSR) is a computer program that supports spoken language production in aphasia by recording and storing the fragments that the user speaks into the microphone, making them available for playback and allowing them to be combined and integrated into larger structures (i.e., sentences and narratives). A prior study that measured utterance length and grammatical complexity in story-plot narratives produced with and without the aid of SentenceShaper demonstrated an "aided effect" in some speakers with aphasia, meaning an advantage for the narratives that were produced with the support of this communication aid (Linebarger, Schwartz, Romania, Kohn, & Stephens, 2000). The present study deviated from Linebarger et al.'s methods in key respects and again showed aided effects of SentenceShaper in persons with aphasia.
Aims: Aims were (1) to demonstrate aided effects in "functional narratives" conveying hypothetical real-life situations from a first person perspective; (2) for the first time, to submit aided and spontaneous speech samples to listener judgements of informativeness; and (3) to produce preliminary evidence on topic-specific carryover from SentenceShaper, i.e., carryover from an aided production to a subsequent unaided production on the same topic.
Methods & Procedures: Five individuals with chronic aphasia created narratives on two topics, under three conditions: Unaided (U), Aided (SSR), and Post-SSR Unaided (Post-U). The 30 samples (5 participants, 2 topics, 3 conditions) were randomised and judged for informativeness by graduate students in speech-language pathology. The method for rating was Direct Magnitude Estimation (DME).
Outcomes & Results: Repeated measures ANOVAs were performed on DME ratings for each participant on each topic. A main effect of Condition was present for four of the five participants, on one or both topics. Planned contrasts revealed that the aided effect (SSR > U) was significant in each of these cases. For two participants, there was also topic-specific carryover (Post-U > U).
Conclusions: Listeners judged functional narratives generated on SentenceShaper to be more informative than comparable narratives spoken spontaneously. This extends the evidence for aided effects of SentenceShaper. There was also evidence, albeit weaker, for topic-specific carryover, suggesting that the program might be used effectively to practise for upcoming face-to-face interactions."
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from Aphasiology
"Background: We present an anomia treatment study using a modified contextual priming (CP) technique for two anomic participants. The reason for the modification attempt is that the most recent studies have indicated that the CP procedure is less effective in the case of impairment to lexical-semantic processes than in the case of phonological deficits (see Martin, Fink, & Laine, 2004a; Martin, Fink, Laine, & Ayala, 2004b; Renvall, Laine, & Martin, 2005).
Aims: Our aim is to study the within- and post-treatment effects of a modified CP procedure and especially whether additional semantic tasks can increase benefits from the CP treatment.
Methods & Procedures: The treatment was conducted for two participants with acquired anomia: LV has primarily a semantic component underlying her anomia, while JP suffers primarily from a phoneme-sequencing deficit. The CP procedure encompassed repeated cycles of spontaneous naming attempts and repetition of target names using arrays of multiple pictures where the targets were either semantically related or unrelated. Our modification was to add picture-to-word matching and phonological "rhyming syllable identification" with the targets to the training sequence. The treatment was carried out in a single-subject multiple-baseline design consisting of several baseline measurements, treatment sessions along with within-treatment measurements, and a post-treatment measurement 1.5 months later.
Outcomes & Results: Both participants showed short-term facilitation of naming target items in all treatment conditions. For LV, post-treatment improvement of naming was statistically significant in the semantic condition irrespective of additional task type, even though the improvement was strongest when the semantic condition was coupled with the additional semantic tasks. In the case of JP, post-treatment improvement was observed in the semantic condition coupled with additional semantic tasks, and in the unrelated condition with both semantic and phonological tasks. No strong evidence of generalisation to untreated items was observed for either of the participants.
Conclusions: The modified CP procedure can provide longer-term improvement of naming target items than the CP training without additional tasks in the face of a lexical-semantic deficit. With lexical-semantic disturbance, the semantic context provided the best results. However, the nature of the additional tasks (semantic vs phonological) appeared to be less important for the treatment of target naming."
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from Advances in Speech-Language Pathology
"Electropalatography (EPG) is a highly effective tool for speech research and for the diagnosis and treatment of a range of speech disorders. The technique requires an EPG palate to be custom made for each user. The manufacture of the palate is both costly and time consuming and inhibits wider uptake of the technique. This paper undertakes a thorough re-examination of all aspects of EPG palate design including criteria for selecting the number and location of contacts, materials properties, costs and safety issues. Palate design over the last 30 years is reviewed and a new design (the Articulate palate) is proposed based on the findings, which minimizes cost while maximizing comfort, safety, convenience, reliability and accuracy."
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from Advances in Speech-Language Pathology
"The articulation of individuals with dysarthria has traditionally been described as consistent. However, conflicting findings have resulted from research examining intra-participant variation in the articulation of individuals with Parkinson's disease (PD) and hypokinetic dysarthria. The current study used electropalatography (EPG) to examine the degree of intra-participant variation in both tongue-palate contact patterns and duration of contact in a group of speakers with PD and hypokinetic dysarthria including consonant imprecision (n = 8). The study also aimed to determine if ageing contributed to any articulatory instability observed. Therefore, two control groups were employed consisting of aged adult (n = 7) and young adult (n = 8) speakers respectively. Participants were asked to read aloud the phrase "I saw a CVC today" were C = /t/, /s/, and /l/ and V = /a/. Intra-participant variation in tongue-palate contact was measured using the absolute and relative variability indexes. Coefficients of variation of duration of tongue contact were employed to examine intra-participant variation in consonant duration. In contrast to the study hypotheses, similar levels of intra-participant variation were observed across the three groups. However, a trend towards increased intra-participant variation in consonant duration was noted in the group with PD. The results of the study suggest that, at least spatially, the articulatory errors of individuals with PD are consistent across repetitions. Research including increased participant numbers and individuals exhibiting greater severity of dysarthria is required to provide further understanding of intra-participant variation in consonant duration in PD."
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from Advances in Speech-Language Pathology
"This paper presents an analysis of connected speech data from six older children (9;05 - 16;03 years) with persisting developmental speech impairments. It uses a combination of perceptual, electropalatographic and acoustic analyses to explore the interplay between articulatory accuracy and prosodic fluency in their speech production, and contrasts their connected speech production with their production of single words. Both normal and atypical word boundary behaviours are identified, and each child presents with a different profile of articulatory and prosodic behaviours which are not observable in their production of single words. The clinical implications of the differences between single word production and connected speech behaviour are discussed."
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from Advances in Speech-Language Pathology
"The purpose of this study was to investigate the use of electropalatography (EPG) and ultrasound in the remediation of vowels in adolescents with hearing impairment. Three adolescents with severe hearing impairment participated in a 6-week vowel remediation programme using electropalatography (EPG) and dynamic two-dimensional ultrasound as adjuncts to speech therapy. Pre- and post-therapy speech productions were evaluated in terms of vowel formant values, EPG tongue-palate contact patterns and phonetic transcription. Notable changes were observed for all vowels across speakers, with most changes in the direction of the adult English targets. Transcription, acoustic and EPG tongue-palate contact results did not necessarily converge across vowels or speakers. Visual feedback as provided by EPG and ultrasound can be facilitative in promoting vowel development in adolescents with hearing impairment. Further research is required to evaluate the stability of changes, the relative impact of ultrasound and EPG and the relationship between phonetic transcriptions, tongue-palate contact and acoustic information about vowels."
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from Advances in Speech-Language Pathology
"This single case study explored the use of EPG as a therapeutic tool for treating inaccurate articulation of the voiceless alveolar plosive /t/. The participant (M) is an 18-year-old deaf1 adult who consistently uses hearing aids, and who communicates using a combination of English, Sign Supported English and British Sign Language (BSL). M received traditional phonological therapy targeting his production of /t/ prior to EPG therapy, but without success. He requested further therapy and EPG was offered as an alternative approach. Pre-EPG therapy, M made tongue placement errors for both /t/ and the voiced alveolar plosive /d/. Based on perceptual analysis by M's speech and language therapist, the first author, his productions were inconsistent, though generally perceived as voiceless and voiced velar plosives respectively. The EPG therapy consisted of six bi-weekly therapy sessions, each lasting for 1 hour, targeting M's production of /t/ in familiar words, using the visual feedback from the EPG display. Trained and untrained listeners perceptually analysed audio recordings of words and sentences collected at three assessment points. Improvements, both over the course of the EPG therapy and during the follow-up period, were found to be statistically significant. Significantly, M was able to generalize his production skills to untaught words containing both /t/ and /d/. Equally significant was the lack of change in M's production of a control sound, the voiceless dental fricative //. More globally, an improvement was observed in ratings of M's intelligibility in sentences and in his voice quality (assessed impressionistically)."
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from Advances in Speech-Language Pathology
"Although previous studies have demonstrated the benefits of using electropalatography (EPG) for treating therapy-resistant articulation errors associated with cleft palate, until recently access to this form of treatment has been limited. For the past 10 years, however, the CLEFTNET Scotland project has provided individuals with cleft palate access to EPG therapy. CLEFTNET Scotland represented a novel form of EPG service delivery - it linked the cleft palate centres throughout Scotland to Queen Margaret University College (QMUC) in Edinburgh through an electronic network. EPG data collected in the centres were sent to QMUC, where experts conducted detailed analysis leading to a precise diagnosis of each individual's specific articulation difficulty and suggested therapy guidelines to the specialist speech-language therapists based on their analysis. This form of service delivery has recently extended to include England, Wales and Northern Ireland to form CLEFTNET UK. This paper describes the CLEFTNET projects, discusses orthodontic issues relevant to EPG therapy for individuals with cleft palate, and presents a case study to illustrate how therapy guidelines for speech-language therapists are derived from data analysis."
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from Advances in Speech-Language Pathology
"training unit (PTU) for clients with residual articulation disorders. The participants were five Japanese children with cleft lip and palate ranging in age from 8 to 13 years when they began EPG home training. These children had residual articulation disorders caused by abnormal tongue-palate contact, although four of them had received conventional speech therapy for 3 to 8 years before starting EPG training. The WinEPG system (Articulate Instruments, Edinburgh) was used to make recordings during the initial assessment and the monthly follow-up. The participants received EPG training sessions when they attended for their monthly recordings. A training programme was developed for each participant, and they were instructed to carry out their homework assignments using the PTU. After 7 to 9 months of home training, marked changes in the EPG patterns and "centre of gravity" values were observed in four of the five participants. The remaining one participant, who had not experienced speech therapy before, needed a longer period of EPG training to achieve good results. Our preliminary data suggested that EPG home training was effective in school-aged participants who had residual articulation disorders."
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from Advances in Speech-Language Pathology
"EPG (Electropalatography) is a visual feedback device designed for clinical and research applications centered on articulation in terms of tongue-to-hard palate contact. EPG has been shown to be effective for a range of speech sound disorders. Several EPG systems have been marketed. One factor that has limited access to EPG treatment, especially in a clinical setting, is the cost of manufacturing the pseudopalates. A new EPG system from Logometrix utilizes a glued on strip of electrodes rather than individually placed electrodes, significantly reducing production expense. Clinical use of the new EPG system is reviewed for 13 clients with varying speech sound disorders, for whom EPG was beneficial in phonetic treatment. Two children were unable to tolerate the pseudopalates, suggesting that practice palates without electrodes be utilized."
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from Advances in Speech-Language Pathology
"This study compared tongue palate contact patterns for oral stops (/t/, /d/) with those for the nasal stop /n/ in order to provide normative data for diagnosing and treating individuals with speech disorders. Electropalatographic (EPG) data were recorded from 15 English speaking adults for word initial /t/, /d/ and /n/ in a high and a low vowel context. EPG frames were classified according to three criteria: (1) anterior constriction; (2) bilateral constriction; and (3) zero posterior central contact. Total amount of contact and variability were also measured. The results showed that almost all (99%) stops met Criteria 1 and 3, with fewer articulations (88% of /t/; 83% of /d/ and 55% of /n/) meeting Criterion 2. Although all stops had similar spatial patterns, /t/ and /d/ had more contact and were more likely to have bilateral constriction than /n/. There were no differences in variability between /t/, /d/ and /n/, however. The clinical implications of the results for the management of individuals with speech disorders are discussed."
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from Advances in Speech-Language Pathology
"This study investigates the phonetic realizations of voicing contrast in alveolar and postalveolar fricatives production in different word positions in order to understand the temporal and spatial production strategies used in the control of voicing and frication, and to provide a frame of reference for speech therapy despite the inter-speaker variation. Seven native speakers of German, originally coming from various regions, participated in the experiment. Acoustic signals were recorded onto DAT, and tongue palate contact patterns were recorded by means of electropalatography (EPG). The temporal parameters were measured using the acoustic signals and the spatial parameters were measured based on the EPG data. The corpus included real words with // occurring at word initial, medial and final positions. Temporal results showed that differences in the overall frication duration for voicing contrast occur at almost all positions (with longer duration for voiceless phonemes). However, voicing during the frication interval was a less reliable discriminator, particularly for Southern German speakers and at word final position. We found a positive correlation between the relative voicing duration and the amount of tongue palate contact for subjects who produced voicing. Especially for the postalveolars, voicing also coincides with more front articulation. Results are discussed with respect to laryngeal-oral co-ordination and aerodynamics."
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from Advances in Speech-Language Pathology
"The present study is concerned with an electropalatographic (EPG) and acoustic analysis of coarticulatory influences in fricative consonant clusters that span a word boundary. We aimed to test whether, as has been found for other languages and consonant-classes, final consonants are more prone to coarticulatory influences than initial ones, and also whether there is any evidence for a relationship between a consonant's susceptibility to coarticulation and the extent to which it exerts a coarticulatory influence on flanking consonants. We developed an algorithm, the similarity index (SI), which quantifies coarticulation in EPG data by measuring the extent of deviation of consonants in heterorganic clusters from their homorganic counterparts. This algorithm was applied to EPG data recorded from three native speakers of Polish producing word-pairs in a carrier sentence such that word-final and word-initial fricatives occurred across a word-boundary for all 16 possible combinations of the four fricatives []. The same data were analysed acoustically using Bark-scaled cepstral coefficients. The results showed that word-final consonants were more susceptible to coarticulatory influences than were initial ones; and there was some evidence that the alveolopalatal fricative [] was most resistant to coarticulation, and exerted the greatest coarticulatory influences."
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from Advances in Speech-Language Pathology
"A number of relatively non-invasive recording and transduction techniques for the analysis and description of continuous speech are now available to the speech scientist and speech pathologist. Two of these techniques are electropalatograpy (EPG) and electromagnetic articulography (EMA). The use of EPG allows us to record and display details of the patterns of tongue contact with the roof of the mouth during continuous speech. The use of EMA provides a two-dimensional midsagittal display of the articulatory movements of the tongue. The combined and coordinated use of these two techniques gives us a clearer and more complete picture of what goes on inside the mouth during continuous speech than the use of either technique alone. This is exemplified by reference to a study of the Norwegian coronal stops /t, d/ and // which shows that the combined use of EMA and EPG brings out articulatory differences between the two sets of plosives that are not apparent when using EPG or EMA alone."
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from the current issue of Journal of Intellectual Disability Research
"Background This study aimed to test the hypothesis that adding symbols to written text can improve its comprehensibility for adults with learning disabilities.
Methods Nineteen adults with mild or borderline learning disabilities attempted to read four short passages of text, two of which had Widgit Rebus symbols added to them. Following each passage, they were asked questions to test their comprehension. A counterbalanced design was employed.
Results Participants’ comprehension scores were significantly higher for the symbolized passages than the non-symbolized ones.
Conclusions Adding symbols to written text can make comprehension easier for some adults with mild and borderline learning disabilities. Future research, exploring how to do this most effectively, would be worthwhile."
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from the Proceedings of the National Academy of Sciences of the United States of America
"The cochlear implant (CI) is a neuroprosthesis that allows profoundly deaf patients to recover speech intelligibility. This recovery goes through long-term adaptative processes to build coherent percepts from the coarse information delivered by the implant. Here we analyzed the longitudinal postimplantation evolution of word recognition in a large sample of CI users in unisensory (visual or auditory) and bisensory (visuoauditory) conditions. We found that, despite considerable recovery of auditory performance during the first year postimplantation, CI patients maintain a much higher level of word recognition in speechreading conditions compared with normally hearing subjects, even several years after implantation. Consequently, we show that CI users present higher visuoauditory performance when compared with normally hearing subjects with similar auditory stimuli. This better performance is not only due to greater speechreading performance, but, most importantly, also due to a greater capacity to integrate visual input with the distorted speech signal. Our results suggest that these behavioral changes in CI users might be mediated by a reorganization of the cortical network involved in speech recognition that favors a more specific involvement of visual areas. Furthermore, they provide crucial indications to guide the rehabilitation of CI patients by using visually oriented therapeutic strategies."
