Research News in Speech,
Language, and Hearing Disorders
For May 2007

May 31, 2007

Today's news items are from: Medical Informatics & the Internet in Medicine, Reuters, Medical News Today, Brain and Language, European Archives of Oto-Rhino-Laryngology, Deafness and Education International, American Journal of Medical Genetics Part A, and Movement Disorders.

• Using Unified Modelling Language (UML) as a process-modelling technique for clinical-research process improvement
  from Medical Informatics & The Internet in Medicine
  "The Primary Care Data Quality programme (PCDQ) is a quality-improvement programme which processes routinely collected general practice computer data. Patient data collected from a wide range of different brands of clinical computer systems are aggregated, processed, and fed back to practices in an educational context to improve the quality of care. Process modelling is a well-established approach used to gain understanding and systematic appraisal, and identify areas of improvement of a business process. Unified modelling language (UML) is a general purpose modelling technique used for this purpose. We used UML to appraise the PCDQ process to see if the efficiency and predictability of the process could be improved. Activity analysis and thinking-aloud sessions were used to collect data to generate UML diagrams. The UML model highlighted the sequential nature of the current process as a barrier for efficiency gains. It also identified the uneven distribution of process controls, lack of symmetric communication channels, critical dependencies among processing stages, and failure to implement all the lessons learned in the piloting phase. It also suggested that improved structured reporting at each stage - especially from the pilot phase, parallel processing of data and correctly positioned process controls - should improve the efficiency and predictability of research projects. Process modelling provided a rational basis for the critical appraisal of a clinical data processing system; its potential maybe underutilized within health care."

• Finger length may foretell academic potential
  from Reuters
  "The length of children's fingers may hint at their natural abilities in math and language, a new study suggests. In a study of 75 children between the ages of 6 and 7 years old, researchers found that finger length correlated with how well the children performed on standardized tests of math and verbal skills. Specifically, boys whose index fingers were short compared with their ring fingers tended to excel at numbers and girls with index and ring fingers of similar length tended to do better on the verbal portion of the test."

• Stuttering And ADHD
  from Medical News Today.com
  "ADHD affects anywhere from 3 to 7% of children in the United States and recent research indicates that as many as 26% of these children also stutter. A new brochure published by the Stuttering Foundation seeks to answer questions and give helpful tips for parents and professionals dealing with the two complex issues. The treatment most often used for ADHD continues to be medication; yet, some recent research indicates that some of these medications may actually aggravate stuttering. Non-stimulant medications such as Strattera may be indicated for ADHD children who also struggle with stuttering."

• Speech-associated gestures, Broca’s area, and the human mirror system
  from Brain and Language
  "Speech-associated gestures are hand and arm movements that not only convey semantic information to listeners but are themselves actions. Broca’s area has been assumed to play an important role both in semantic retrieval or selection (as part of a language comprehension system) and in action recognition (as part of a “mirror” or “observation–execution matching” system). We asked whether the role that Broca’s area plays in processing speech-associated gestures is consistent with the semantic retrieval/selection account (predicting relatively weak interactions between Broca’s area and other cortical areas because the meaningful information that speech-associated gestures convey reduces semantic ambiguity and thus reduces the need for semantic retrieval/selection) or the action recognition account (predicting strong interactions between Broca’s area and other cortical areas because speech-associated gestures are goal-direct actions that are “mirrored”). We compared the functional connectivity of Broca’s area with other cortical areas when participants listened to stories while watching meaningful speech-associated gestures, speech-irrelevant self-grooming hand movements, or no hand movements. A network analysis of neuroimaging data showed that interactions involving Broca’s area and other cortical areas were weakest when spoken language was accompanied by meaningful speech-associated gestures, and strongest when spoken language was accompanied by self-grooming hand movements or by no hand movements at all. Results are discussed with respect to the role that the human mirror system plays in processing speech-associated movements."

• Phonosurgery after endoscopic cordectomies
  from the European Archives of Oto-Rhino-Laryngology
  "Abstract Major glottic incompetence is often encountered after total (Type IV) and extended (Type V) cordectomies and is responsible for poor vocal outcome. Even though the vast majority of patients do not complain of significant limitations in daily life, a selected number of them eventually require some sort of phonosurgical treatment in order to improve voice quality. Different techniques have been described in the literature to ameliorate long-term vocal outcome. The aim of the present report was to retrospectively describe our experience in this challenging clinical scenario. Between April 1999 and March 2005, 24 patients previously treated by Type IV–V endoscopic cordectomies for T1 and T2 glottic cancer presented unsatisfactory vocal outcome in spite of intensive speech therapy and therefore underwent some form of phonosurgical treatment at our Department after at least 12 months without evidence of local-regional recurrence. Patients were treated by medialization thyroplasty with a Montgomery System Implant (two cases), Gore-Tex strips (16 cases), medialization thyroplasty with Gore-Tex associated with anterior commissure laryngoplasty (three cases), and augmentation with Vox Implant injection (three cases). Nineteen patients had comprehensive evaluation by videolaryngoscopic examination and subjective, perceptual, and objective voice analysis both in the pre-phonosurgical treatment period and after at least 12 months. Comparison of pre- and postoperative videolaryngoscopic findings revealed improved glottic closure in 74% of patients. Comparison between the pre- and postoperative subjective, perceptual, and objective voice analysis by the Wilcoxon matched-pair test showed a statistically significant improvement from a Voice Handicap Index mean value of 46 (preoperative) to 21 (postoperative); an improvement for each parameter of the GRBAS scale with statistically significant differences for G, B, A, and S, while R showed only an improving trend; and statistically significant improvement in the mean values of Jitter, Shimmer, Noise to Harmonic Ratio, and Maximum Phonation Time. In conclusion, the different delayed phonosurgical procedures herein used demonstrate the possibility to improve vocal outcomes after total and extended cordectomies in selected and highly motivated patients that have not achieved satisfactory performance after prolonged and intensive speech therapy."

• The influence of an in-service teacher training (INSET) programme on attitudes towards inclusion by regular classroom teachers who teach deaf students in primary schools in Turkey
  from the current issue of Deafness and Education International
  "The aim of the present study is to examine the impact of an INSET programme on regular classroom teachers' attitudes towards deaf students educated in regular primary schools. In this research project, a quantitative research approach is used involving randomised allocation of subjects to groups, and a pre-test - post-test design. The sample for each group consisted of a random allocation of 61 teachers to an experimental group and 61 teachers to a control group. The research instruments were: 1) a programme of INSET courses based on the Deaf Friendly Teaching: Practical Guidance for Teachers Working with Deaf Children (National Deaf Children's Society, 2004), and 2) The Opinions Relative to Mainstreaming survey, which was developed by Antonak and Larrivee (1995), and was translated and adapted by Krcaali-Iftar (1997) in Turkey. The results indicated that the teachers in the experimental group increased their knowledge about deafness and that their attitudes were significantly more positive. In particular, the teachers' attitudes changed in relation to classroom management and knowledge about the education of deaf students in inclusive settings. Copyright © 2007 John Wiley & Sons, Ltd."

• Methylthioadenosine phosphorylase (MTAP) in hearing: Gene disruption by chromosomal rearrangement in a hearing impaired individual and model organism analysis
  from American Journal of Medical Genetics Part A
  "Genes with a role in the auditory system have been mapped by genetic linkage analysis of families with heritable deafness and then cloned through positional candidate gene approaches. Another positional method for gene discovery is to ascertain deaf individuals with balanced chromosomal translocations and identify disrupted or disregulated genes at the site(s) of rearrangement. We report herein the use of fluorescence in situ hybridization (FISH) to map the breakpoint regions on each derivative chromosome of a de novo apparently balanced translocation, t(8;9)(q12.1;p21.3)dn, in a deaf individual. Chromosomal breakpoints were assigned initially by GTG-banding of metaphase chromosomes and then BAC probes chosen to map precisely the breakpoints by FISH experiments. To facilitate cloning of the breakpoint sequences, further refinement of the breakpoints was performed by FISH experiments using PCR products and by Southern blot analysis. The chromosome 9 breakpoint disrupts methylthioadenosine phosphorylase (MTAP); no known or predicted genes are present at the chromosome 8 breakpoint. Disruption of MTAP is hypothesized to lead to deafness due to the role of MTAP in metabolizing an inhibitor of polyamine synthesis. Drosophila deficient for the MTAP ortholog, CG4802, were created and their hearing assessed; no hearing loss phenotype was observed. A knockout mouse model for MTAP deficiency was also created and no significant hearing loss was detected in heterozygotes for Mtap. Homozygous Mtap-deficient mice were embryonic lethal. © 2007 Wiley-Liss, Inc."

• Brief Report Blepharospasm and limb dystonia caused by Mohr-Tranebjaerg syndrome with a novel splice-site mutation in the deafness/dystonia peptide gene
  from Movement Disorders
  "Mohr-Tranebjaerg syndrome (MTS) is an X-linked disorder characterized by childhood-onset progressive deafness, dystonia, spasticity, mental deterioration, and blindness. It is due to mutations in the deafness/dystonia peptide (DDP1) gene. We describe a sporadic 42-year-old man with MTS presenting with postlingual deafness, adult-onset progressive dystonia with marked arm tremor, mild spasticity of the legs, and visual disturbance due to a novel mutation (g to a transition at the invariant gt of the 5 splice donor site of exon 1) in the DDP1 gene. This case, and a review of previously reported cases, highlights a variety of potential diagnostic pitfalls in this condition. © 2007 Movement Disorder Society"

May 30, 2007

Today's stories come from Genetics News, Brain and Development, Medical News Today, EurekAlert, News-Medical.Net, and Otology and Neurotology.

• Genes May Influence Language Learning, Study Suggests
  from Genetics News
  "If you get tongue-tied when trying to learn a new language, your genes may be to blame, a new study suggests. While there is no gene yet found that is responsible for preprogramming a person with a given language, there does appear to be a link between types of two genes and the languages people speak."

• Is Your Tongue in Your Genes?
  from Genetics News
  "There's no gene for speaking Chinese, English, or Swahili. Children grow up chatting like those around them. But a new study suggests that genetic differences may have influenced the type of language a particular culture develops. All languages rely on consonants and vowels to distinguish words. But some languages, such as Chinese, also use changes in pitch for this purpose. These so-called tonal languages are very common in sub-Saharan Africa and Southeast Asia but rare in Europe, Australia, and other parts of Asia. Yet even among these populations, there is variation in ability to perceive tones. In a recent study, neuroscientist Patrick Wong and his colleagues at Northwestern University in Evanston, Illinois, found that adult speakers of English--a nontonal language--were either good or poor at distinguishing tones in an artificial language. Moreover, the brains of the successful subjects had more gray matter in a part of their auditory cortex implicated in pitch perception. Inspired by these findings, language researchers Dan Dediu and Robert Ladd at the University of Edinburgh in the United Kingdom set out to see whether there might be a genetic basis for these differences in tonal aptitude. They hypothesized that the differences might be related to variations in two genes, called ASPM and microcephalin , which are thought to be implicated in brain development. Two variants of these genes, called ASPM-D and microcephalin-D , appear to have arisen fairly recently in human evolution and then spread throughout many parts of the world because they conferred some sort of selective advantage, although this claim is controversial (Science, 22 December 2006, p. 1872)."

• Successful botulinum toxin treatment of dysphagia in a spinal muscular atrophy type 2 patient
  from Brain and Development
  "Prominent dysphagia is seen among patients with spinal muscular atrophy (SMA) type 2, especially at the late stage of their disease progression. Nasogastric tube feeding and gastrostomy are commonly utilized to maintain their nutritional status. However, choosing a treatment strategy to maintain appropriate nutritional status is often complicated by multiple factors, such as physical conditions and social aspects. We report a 21-year-old man with SMA type 2 who has been suffering from severe dysphagia. The findings at video-fluoroscopic swallow study (VSS) were consistent with a diagnosis of cricopharyngeal dysphagia. His dysphagia was successfully treated with percutaneous injection of botulinum toxin A (BTA) into the cricopharyngeal muscle. Our result demonstrates that administration of BTA is one of the effective treatment choices for dysphagia in SMA patients."

• Rapid Test Would Save Babies From Syphilis
  from Medical News Today.com
  "Screening pregnant women with newer, rapid syphilis tests would improve the survival and health of babies, according to research from Haiti. About half of pregnancies in women with untreated syphilis end in death of the baby before or shortly after birth, and surviving infants may suffer lifelong effects such as mental disability, deafness, or blindness. Testing for syphilis infection during pregnancy can prevent these outcomes, but only if the mothers receive prompt treatment. Syphilis tests currently in use require a woman to make a second trip to the clinic to receive her test results. In practice, this means that many mothers in poor countries, especially in rural areas, don't find out they are infected in time to receive treatment to save their babies."

• Watch your language! babies know the difference between French and English
  from News-Medical.net
  "Canadian researchers say that babies as young as 4 months of age know the difference between English and French by looking for visual cues. The researchers at McGill University, British Columbia, say babies are able to differentiate between the English and French language without actually hearing it. The researchers say the study is the first to show that young babies are able to tell languages apart by using only visual information."

• A pioneering system allows autistic children to communicate with their environment
  from EurekAlert.org
  "Communication ability among children who are intellectually disabled or have communication limitations (such as autism, down syndrome, or cerebral palsy) may soon be improved thanks to a research group of the University of Granada (Universidad de Granada [http://www.ugr.es]). SC@UT, which stands for Augmentative and Adaptive Communication System, has been created by the following researchers: 13 lecturers from the UGR Computer Engineering School (ETSI), ASPROGRADES association and a team of psychologists, psycho-pedagogues, and speech therapists. All of them are headed by professor José Juan Cañas Delgado, lecturer of Ergonomics of the department of Experimental Psychology and Behavioural Physiology of the UGR [http://www.ugr.es] and professor María José Rodríguez Fortiz, lecturer at the department of System Informatics. SC@UT, software for augmenting communication by computer devices (PCs, laptops, PDAs, etc.), is designed for children with special communication and educational needs, such as those who suffer from autism."

• Classroom Performance and Language Development of CI Students Placed in Mainstream Elementary School
  from Otology and Neurotology
  "Objective: Investigation of the relation between classroom performance and language development of cochlear implant (CI) students in mainstream education. Structural analyses of assessment of mainstream performance (AMP) and Screening Instrument For Targeting Educational Risk (SIFTER) instruments. Study Design: Cross-sectional instrument and language development analyses. Setting: Tertiary university medical center. Patients: Twenty-six CI children in elementary school with congenital or prelingual deafness were included. At the time of this study, mean period of multichannel CI use was 5.3 years, and children's ages ranged from 6.5 to 12.8 years. Main Outcome Measure: Assessment of mainstream performance and SIFTER instruments measured classroom performance and language development were measured by means of Reynell and Schlichting tests. Results: Assessment of mainstream performance and SIFTER domains showed good reliability (Cronbach [alpha] >0.6), but factor analyses only showed the expected instrument structure in the AMP. In both questionnaires and within all domains, individual variability is detected. Spearman's correlation analyses showed the probable explanation of individual questionnaire variability by language test results (p value mostly <0.01). The AMP and SIFTER instruments showed a predictive capacity for language development, based upon general linear model univariate and linear regression analyses. Conclusion: Individual classroom performance, measured by AMP and SIFTER questionnaires, of CI children in mainstream education varies. Correlation analyses showed strong significant relation between questionnaire results (classroom performance) and both expressive and receptive language test results (Schlichting and Reynell tests). Structural questionnaire analyses of the AMP and SIFTER demonstrated good reliability. The predictive value of the AMP can monitor the actual linguistic functioning of the child."

• Effect of atorvastatin on progression of sensorineural hearing loss and tinnitus in the elderly: results of a prospective, randomized, double-blind clinical trial
  from Otology and Neurotology
  "Objective: To test whether the 3-hydroxy-3-methylglutaryl- coenzyme A reductase inhibitor atorvastatin can slow down the progression of presbycusis. Patients: Fifty patients 60- to 75-years-old with presbycusis and moderately elevated serum cholesterol. Intervention(s): In a double-blind design, patients were randomly assigned to treatment with either atorvastatin (40 mg/d orally) or placebo. Main Outcome Measure(s): Pure-tone audiometry and tinnitus evaluation at enrolment and after 7 and 13 months. Results: Development of hearing thresholds after 7 and 13 months showed no significant differences between the groups. Tinnitus score continuously improved in the atorvastatin group (34.8 at 7 and 27.6 at 13 mo), whereas it slightly deteriorated in the placebo group (24.8 at 7 and 26.8 at 13 mo). The effect on tinnitus was a tendency without statistic significance (p = 0.0833). Conclusion: Atorvastatin had no effect on the development of hearing thresholds, but resulted in a trend toward a relief of tinnitus."

• Hybrid cochlear implantation: clinical results and critical review in 13 cases
  from Otology and Neurotology
  "Objective: To substantiate the benefits of hybrid cochlear implantation (CI) in patients with residual low-frequency hearing. Study Design: Prospective study of patients in a manufacturer-sponsored clinical trial. Setting: Independent referral center for CI. Patients: Thirteen patients who met candidacy criteria for a hybrid CI. The 10 women and 3 men had a mean age of 51 years. Intervention: Preoperative evaluation, CI with a Nucleus Hybrid cochlear implant, subsequent programming, and diagnostic testing. Main Outcome Measures: Benefits of high-frequency electrical stimulation from the hybrid CI as measured by conventional audiometry, consonant-nucleus-consonant monosyllabic word and Bamford-Kowal-Bench sentence in noise testing at quarterly intervals per protocol. Results: Follow-up ranged from 3 to 24 months. All 13 patients had preserved hearing immediately postoperative. However, one lost residual hearing 7 days postoperatively, and 2 patients had delayed hearing losses at 2 and 24 months, the latter apparently due to barotrauma; however, this was not conclusive. Another had a bilateral symmetrically progressive hearing loss. Six patients showed changes in low-frequency hearing less than 10 dB; 2 showed changes in the range 11 to 20 dB; 2, 21 to 30 dB; and 3, more than 50 dB. Eleven of 13 had improved consonant-nucleus-consonant words ranging up to 83% when tested with hearing aid + CI in the operated ear. Four subjects exhibited improvement in Bamford-Kowal-Bench sentence in noise testing, although only one subject showed a significant decline associated with bilateral progression in hearing impairment. Conclusion: Combined electrical and acoustical hearing can result in significant improvement in speech understanding. Only one patient lost residual hearing as a direct result of surgery. Two others had delayed losses. There are no absolute predictive factors as to success with hybrid CI, just as there are none for conventional CI. Similarly, wide variation in results may occur. Further studies may clarify factors involved in such variation."

• Intracranial complications of cochlear implantation
  from Otology and Neurotology
  "Objective: To describe intracranial complications after cochlear implantation in the pediatric and adult populations. Study Design: Retrospective chart review. Setting: Tertiary referral center. Patients: A chart review of the intracranial complications and their management in 345 patients undergoing cochlear implantation was undertaken. Interventions: Variables, including age, sex, implant manufacturer, cause of deafness, intraoperative findings, and postoperative complications, were collected and analyzed. Main Outcome Measure: Presence of intracranial complication of cochlear implantation. Results: There were 134 Nucleus-22 (Cochlear, Englewood, CO) devices, 50 Nucleus-24 devices, 118 Med-El (Durham, NC) devices, and 43 Advanced Bionics Corporation (Sylmar, CA) devices in 151 adults and 194 children. There was a 9.3% overall complication rate, with most (59%) being related to device failure. There were three intracranial complications (<1%), two in elderly individuals and one in a child. Two minor dural defects with cerebrospinal fluid leak at the site of the receiver/stimulator recess in Med-El devices were repaired intraoperatively with temporalis fascia. One elderly patient experienced an acute extensive subdural hematoma after Nucleus-24 implantation, which was treated successfully with immediate evacuation. Conclusion: Intracranial complication rates associated with cochlear implantation are low, although potentially very serious. Surgeons should be aware of intracranial complications, especially in older individuals, and take immediate appropriate action."

• Otosclerosis: selection of ear for cochlear implantation
  from Otology and Neurotology
  "Objectives: 1. To examine whether speech perception after implantation is correlated with the total duration of deafness, the duration of deafness in the implanted ear, or age at implantation. 2. To examine whether the rate of facial nerve stimulation postoperatively is correlated with the type of electrode used. Study design: Retrospective case note review. Setting: Tertiary referral center. Patients: Fifty-nine adults with profound postlingual sensorineural hearing loss due to otosclerosis. Intervention: Cochlear implantation with the Nucleus device using either a straight (n = 35) or Contour (n = 29) electrode array. Main Outcome Measures: Speech perception scores for patients at 3, 6 and 12 months postimplantation were correlated against duration of deafness in the implanted ear, duration of total deafness, and age at implantation. Data on facial nerve stimulation rates postoperatively were collected. Results: Implantation in the shortest deafened ear conferred an initial advantage for speech perception 3 months after surgery; however, this effect was lost by 6 months. There were no significant correlations between the duration of bilateral deafness and hearing outcomes. Age at implantation was negatively correlated with outcome at 3 months, but not at 6 and 12 months. Fourteen of 35 patients with straight electrodes and 0 of 24 patients with Contour electrodes experienced facial nerve stimulation during mapping sessions (p < 0.005, [chi]2). Conclusion: Patients with otosclerosis are not disadvantaged in the long term by implantation in the longest deafened ear. Increasing age at implantation did not predict poorer outcomes. A perimodiolar design of electrode should be used in otosclerotic patients when possible to reduce the risk of facial nerve stimulation."

• Sound Localization Ability of Young Children With Bilateral Cochlear Implants
  from Otology and Neurotology
  "Objective: To evaluate the benefit of bilateral cochlear implantation in young children. Study Design: Clinical trial comparing a group of bilaterally implanted children with a group of unilaterally implanted children. Setting: Tertiary referral center. Patients: Five bilaterally implanted children (mean age at testing, 3 yr 7 mo) were compared with 5 unilaterally implanted children (mean age at testing, 5 yr 3 mo). Meningitis was the cause of deafness in all of the children. Methods: Children were asked to localize a prerecorded melody band limited from 500 to 4,000 Hz presented from loudspeakers placed at either -90 or 90 degrees or -30 or 30 degrees azimuth. Their parents filled in the Speech, Spatial and Qualities of Hearing Scale (SSQ) and PedsQL questionnaires on hearing and health-related quality of life of their children. Results: The bilaterally implanted children had significantly better scores on the localization test than the children with unilateral cochlear implants. The scores of the children with bilateral cochlear implants were also significantly higher on the spatial domain of the SSQ, which concerns localization. No significant differences were found in the speech and quality of hearing domains and the total scores on the SSQ or the PedsQL between the two groups. Conclusion: Children with bilateral cochlear implantation already demonstrate an advantage over unilaterally implanted children at a young age."

May 29, 2007

Today's stories come from Brain and Language, Clinical Neurophysiology, EurekAlert, European Archives of Oto-Rhino-Laryngology, Otology and Neurotology, Audiology and Neuro-Otology, and Topix.net.

• Functional specificity of the visual word form area: General activation for words and symbols but specific network activation for words
  from Brain and Language
  "The functional specificity of the brain region known as the Visual Word Form Area (VWFA) was examined using fMRI. We explored whether this area serves a general role in processing symbolic stimuli, rather than being selective for the processing of words. Brain activity was measured during a visual 1-back task to English words, meaningful symbols (e.g., $, %), digits, words in an unfamiliar language (Hebrew), and geometric control stimuli. Mean activity in the functionally defined VWFA, as well as a pattern of whole-brain activity identified using a multivariate technique, did not differ for words and symbols, but was distinguished from that seen with other stimuli. However, functional connectivity analysis of this region identified a network of regions that was specific to words, including the left hippocampus, left lateral temporal, and left prefrontal cortex. Results support the hypothesis that activity in the VWFA plays a general role in processing abstract stimuli; however, the left VWFA is part of a unique network of brain regions active only during the word condition. These findings suggest that it is the neural “context” of the VWFA, i.e., the broader activity distributed in the brain that is correlated with VWFA, that is specific for visual word representation, not activity in this brain region per se."

• Severity of dysfluency correlates with basal ganglia activity in persistent developmental stuttering
  from Brain and Language
  "Previous studies suggest that anatomical anomalies [Foundas, A. L., Bollich, A. M., Corey, D. M., Hurley, M., & Heilman, K. M. (2001). Anomalous anatomy of speech-language areas in adults with persistent developmental stuttering. Neurology, 57, 207–215; Foundas, A. L., Corey, D. M., Angeles, V., Bollich, A. M., Crabtree-Hartman, E., & Heilman, K. M. (2003). Atypical cerebral laterality in adults with persistent developmental stuttering. Neurology, 61, 1378–1385; Foundas, A. L., Bollich, A. M., Feldman, J., Corey, D. M., Hurley, M., & Lemen, L. C. et al., (2004). Aberrant auditory processing and atypical planum temporale in developmental stuttering. Neurology, 63, 1640–1646; Jancke, L., Hanggi, J., & Steinmetz, H. (2004). Morphological brain differences between adult stutterers and non-stutterers. BMC Neurology, 4, 23], in particular a reduction of the white matter anisotropy underlying the left sensorimotor cortex [Sommer, M., Koch, M. A., Paulus, W., Weiller, C., & Buchel, C. (2002). Disconnection of speech-relevant brain areas in persistent developmental stuttering. Lancet, 360, 380–383] could be at the origin of persistent developmental stuttering (PDS). Because neural connections between the motor cortex and basal ganglia are implicated in speech motor functions, PDS could also be associated with a dysfunction in basal ganglia activity [Alm, P. (2004). Stuttering and the basal ganglia circuits: a critical review of possible relations. Journal of Communication Disorders, 37, 325–369]. This fMRI study reports a correlation between severity of stuttering and activity in the basal ganglia and shows that this activity is modified by fluency shaping therapy through long-term therapy effects that reflect speech production improvement. A model of dysfunction in stuttering and possible repair modes is proposed that accommodates the data presented here and observations previously made by us and by others."

• Auditory event-related potentials and cognitive function of preterm children at five years of age
  from Clinical Neurophysiology
  "Objective In our previous study, auditory event-related potentials (AERPs) in preterm 1-year-old children had a positive deflection at 150–350 ms that correlated positively with their 2-year neurodevelopmental outcome. In a study of the same subjects at age 5, our aim was to assess AERPs and their relationship to neuropsychological test results. Methods Preterm small (SGA, n = 13), appropriate for gestational age (AGA, n = 15), and control (n = 13) children were assessed with an Easy paradigm presenting a large frequency change accompanied with occasional novel sounds, and a Challenging paradigm presenting small frequency and duration changes with a rapid rate. The preterm children underwent neurocognitive tests. Results Easy paradigm. The P1 response to frequency deviant was smaller and MMN larger in the preterm than in the control children. Challenging paradigm. The P1 response to standard, frequency, and duration deviants was smaller in the preterm than in the control children. The N2 response to frequency deviant was larger in the preterm than in the control children. AGA and SGA children had similar AERPs. The P1, N2, and MMN amplitudes correlated with verbal IQ and NEPSY language subtests. Conclusions Small P1 response(s) appears to be typical for preterm children. Significance Small P1 response in preterm children may suggest altered primary auditory processing."

• Mapping the English language -- from cockney to Orkney
  from EurekAlert.org
  "If they were Scousers they’d be "made up"; from the Black Country they’d be "bostin". But researchers from the University of Leeds are naturally "well chuffed" to receive a £460,000 grant to examine and catalogue the dialects and diversities of the English language. The team will mine a huge volume of material collected by the BBC Voices project, a survey of regional English which amassed 700 hours of sound recordings."

• Aerodynamic characteristics of the Nijdam voice prosthesis in relation to tracheo-esophageal wall thickness
  from the European Archives of Oto-Rhino-Laryngology
  "Abstract Tracheo-esophageal speech using various prostheses is currently the most successful form of voice and speech rehabilitation for laryngectomees. Main inter-device differences are durability and trans-device pressure loss during speech. The valveless indwelling Nijdam voice prosthesis is a new voice prosthesis. A barrier mechanism is created by a combination of the esophageal mucosa and the umbrella-like “hat” of the prosthesis that covers the esophageal side of the tracheo-esophageal fistula. The Nijdam prosthesis can be used clinically for longer periods of time when compared to such other indwelling voice prostheses as the Provox prosthesis and the low-resistance Groningen prosthesis. However, trans-device pressure loss during speech has been unknown. Adjustment of the shaft length of the Nijdam voice prosthesis to tracheo-esophageal wall thickness was expected to affect trans-device pressure loss during speech. We report the results of in vitro tests to quantify the effect of tracheo-esophageal wall thickness on trans-device pressure loss. In the present study pressure loss was measured at different air flow rates in relation to tracheo-esophageal wall thickness. Findings demonstrated that when shaft length of the Nijdam prosthesis corresponded exactly to tracheo-esophageal wall thickness, trans-device pressure loss was comparable to that of the Provox prosthesis. If a relatively shorter Nijdam prosthesis was chosen to prevent aspiration from occurring, the pressure loss across the prosthesis increased to that of the low-resistance Groningen prosthesis."

• Hybrid Cochlear Implantation: Clinical Results and Critical Review in 13 Cases
  from Otology and Neurotology
  "Objective: To substantiate the benefits of hybrid cochlear implantation (CI) in patients with residual low-frequency hearing. Study Design: Prospective study of patients in a manufacturer-sponsored clinical trial. Setting: Independent referral center for CI. Patients: Thirteen patients who met candidacy criteria for a hybrid CI. The 10 women and 3 men had a mean age of 51 years. Intervention: Preoperative evaluation, CI with a Nucleus Hybrid cochlear implant, subsequent programming, and diagnostic testing. Main Outcome Measures: Benefits of high-frequency electrical stimulation from the hybrid CI as measured by conventional audiometry, consonant-nucleus-consonant monosyllabic word and Bamford-Kowal-Bench sentence in noise testing at quarterly intervals per protocol. Results: Follow-up ranged from 3 to 24 months. All 13 patients had preserved hearing immediately postoperative. However, one lost residual hearing 7 days postoperatively, and 2 patients had delayed hearing losses at 2 and 24 months, the latter apparently due to barotrauma; however, this was not conclusive. Another had a bilateral symmetrically progressive hearing loss. Six patients showed changes in low-frequency hearing less than 10 dB; 2 showed changes in the range 11 to 20 dB; 2, 21 to 30 dB; and 3, more than 50 dB. Eleven of 13 had improved consonant-nucleus-consonant words ranging up to 83% when tested with hearing aid + CI in the operated ear. Four subjects exhibited improvement in Bamford-Kowal-Bench sentence in noise testing, although only one subject showed a significant decline associated with bilateral progression in hearing impairment. Conclusion: Combined electrical and acoustical hearing can result in significant improvement in speech understanding. Only one patient lost residual hearing as a direct result of surgery. Two others had delayed losses. There are no absolute predictive factors as to success with hybrid CI, just as there are none for conventional CI. Similarly, wide variation in results may occur. Further studies may clarify factors involved in such variation."

• Effect of Atorvastatin on Progression of Sensorineural Hearing Loss and Tinnitus in the Elderly: Results of a Prospective, Randomized, Double-Blind Clinical Trial
  from Otology and Neurotology
  "Objective: To test whether the 3-hydroxy-3-methylglutaryl- coenzyme A reductase inhibitor atorvastatin can slow down the progression of presbycusis. Patients: Fifty patients 60- to 75-years-old with presbycusis and moderately elevated serum cholesterol. Intervention(s): In a double-blind design, patients were randomly assigned to treatment with either atorvastatin (40 mg/d orally) or placebo. Main Outcome Measure(s): Pure-tone audiometry and tinnitus evaluation at enrolment and after 7 and 13 months. Results: Development of hearing thresholds after 7 and 13 months showed no significant differences between the groups. Tinnitus score continuously improved in the atorvastatin group (34.8 at 7 and 27.6 at 13 mo), whereas it slightly deteriorated in the placebo group (24.8 at 7 and 26.8 at 13 mo). The effect on tinnitus was a tendency without statistic significance (p = 0.0833). Conclusion: Atorvastatin had no effect on the development of hearing thresholds, but resulted in a trend toward a relief of tinnitus."

• Hope for autism
  from the Wessex Online Scene
  "Children with autism showed an improvement in language and daily living skills and also in their levels of Intelligence Quotient (IQ) following the implementation of Early Intensive Behavioural Intervention (EIBI). The home-based programme was tried for 25 hours per week over a two-year period, with the cooperation of trained staff and the parents of autistic children. The courses were individualised to meet the needs of each child and this proved to be beneficial. IQ levels improved significantly, with two-thirds of the children showing an increase. Indeed, one child saw their IQ leap from 30 to 70, while another showed an improvement from 72 to 115. This is particularly impressive considering the general population have an average IQ of between 85 and 115."

• NCCU, Chinese in joint venture: Speech therapy training planned
  from Topix.net
  "Communication therapists at N.C. Central University are forging relationships with Chinese universities to provide formal speech training to college students half a world away. Faculty in NCCU's communication disorders department, in the School of Education, plan to use distance education to offer formal speech therapy to English-speaking Chinese students."

• Transient Deafness in Young Candidates for Cochlear Implants
  from Audiology & Neuro-Otology
  "This study describes 5 infants who were diagnosed with auditory neuropathy (AN) associated with severe to profound neural hearing loss shortly after birth. However, on repetition of the tests 7-12 months later, all infants showed full or partial recovery. The follow-up electrophysiological patterns were characterized by the appearance of wave I, followed by wave III and V, reflecting synchronization of auditory pathways and improvement in auditory nerve function. Suspected causative or contributory factors were neonatal hyperbilirubinemia, hypoxia, ischemia, and central nervous system immaturity, alone or in combination. These findings indicate that lack of an auditory brain stem response does not necessarily mean no hearing and that the situation where AN exists can improve. Thus, clinicians should be made aware that although cochlear implants may yield better auditory performance when applied early, they should be considered a therapeutic option only after repeated measures have proved persistent AN, and no child should be considered for an implant until a behavioral measure of hearing has been obtained."

• Spatial Unmasking and Binaural Advantage for Children with Normal Hearing, a Cochlear Implant and a Hearing Aid, and Bilateral Implants
  from Audiology & Neuro-Otology
  "The aims of this study were to: (1) determine if spatial unmasking existed and differed for children with normal hearing, a hearing aid and a cochlear implant (CIHA), and bilateral implants (BICI); (2) determine if binaural advantage and headshadow effect differed between children with CIHA and BICI. Results indicated that most of the CIHA and BICI children demonstrated spatial unmasking, though to a lesser degree than children with normal hearing. Results also indicated that the children with BICI demonstrated greater headshadow effect than those with CIHA. The CIHA and BICI children also differed in binaural advantage, which could be due to the differences in headshadow effect and in detection abilities with the hearing aid versus the second implant."

• Quantitative Evaluation of New Bone and Fibrous Tissue in the Cochlea following Cochlear Implantation in the Human
  from Audiology & Neuro-Otology
  "The formation of new bone and fibrous tissue in the human inner ear following cochlear implantation was evaluated by computer-assisted 3-D reconstruction. Seven temporal bones from patients who in life had undergone cochlear implantation were prepared for histological study with the implant in situ. The specimens were sectioned in the axial plane at a thickness of 20 µm. At least every tenth section was digitally reconstructed in three dimensions and volumes of new bone and fibrous tissue were calculated per millimeter length of the cochlea. New bone and fibrous tissue were found in all seven specimens, particularly at the cochleostomy site. In addition, new bone and fibrous tissue had extended to variable lengths along the track of the cochlear implant and in some cases extended beyond the distal end of the implanted electrode. This methodology provides a quantitative tool for evaluation of new bone and fibrous tissue in the inner ear following implantation. This should assist in correlating psychophysical and speech perception tests with intracochlear pathology, evaluating both electrode design and the techniques of preserving residual auditory function."

• Effects of Computer-Assisted Speech Training on Mandarin-Speaking Hearing-Impaired Children
  from Audiology & Neuro-Otology
  "The present study investigated whether moderate amounts of computer-assisted speech training can improve the speech recognition performance of hearing-impaired children. Ten Mandarin-speaking children (3 hearing aid users and 7 cochlear implant users) participated in the study. Training was conducted at home using a personal computer for half an hour per day, 5 days per week, for a period of 10 weeks. Results showed significant improvements in subjects' vowel, consonant, and tone recognition performance after training. The improved performance was largely retained for 2 months after training was completed. These results suggest that moderate amounts of auditory training, using a computer-based auditory rehabilitation tool with minimal supervision, can be effective in improving the speech performance of hearing-impaired children."

• Cochlear Implant Channel Separation and Its Influence on Speech Perception - Implications for a New Electrode Design
  from Audiology & Neuro-Otology
  "There are a variety of factors which can influence cochlear implantation outcome. Channel interaction is one of the variables responsible for audiological performance deterioration in multichannel implants. Electrode design is - among others - one way to decrease the incidence of channel interaction. At present, electrodes differ in overall length, diameter, contact design and distribution, but none of the electrodes available have a distinct variability in the amount of space between contacts across the length of the electrode. The aim of this study was to investigate whether a new electrode design featuring larger contact spacing in the apical part of deeply inserted electrodes would lead to an increase in speech perception. Eighteen postlingually deafened patients fitted with MedEl Combi 40+ or MedEl Pulsar cochlear implants using the MedEl implementation of continuous interleaved sampling participated in this study. Patients were tested in 6 conditions, in which the channel spacing and distribution of electrode contacts in each patient were artificially varied by activating or deactivating different channels. Performance was tested immediately after each change in setup with a monosyllable and sentence test (Hochmaier, Schultz and Moser). Our results showed that the condition with the highest distance between contacts in the apical part (up to 6.4 mm instead of 2.4 mm) is the most effective for the matched map condition: the results improved statistically significantly for the sentence test from 72% in the standard 12-channel condition to 83.2% and from 40.8 to 50% for the monosyllable test. Based on these findings, we present a new electrode design which can help achieve further increases in speech perception with cochlear implants."

• Aging Effects on the Activation of the Auditory Cortex during Binaural Speech Listening in White Noise: An fMRI Study
  from Audiology & Neuro-Otology
  "The functional significance of age-related pathology of the auditory cortex is not well established. The purpose of this study was to elucidate the activation pattern of the auditory cortex in aged subjects in response to speech signals. Functional magnetic resonance imaging was performed on 12 elderly subjects with normal hearing acuity during selective listening with both ears to speech sounds in quiet and in white noise. Twelve young, normal-hearing subjects served as controls. Our results showed that activation of the auditory cortex during selective listening to speech decreased in elderly subjects compared to young subjects, especially in noise. Reduced activation occurred in the anterior and posterior regions of the bilateral superior temporal gyrus (STG), but mainly in the posterior part of the left STG. In addition, background noise had a greater masking effect on speech perception in the elderly subjects than in the young ones. These findings suggest that early functional changes associated with central presbycusis occur mainly in the posterior part of the left STG."

May 25, 2007

Today's stories come from: Medical News Today, EurekAlert, Reuters, Clinical Linguistics and Phonetics, Developmental Science, and the International Journal of Audiology.

• Babies Can Tell When You Switch Languages By Watching Your Face
  from Medical News Today.com
  "Researchers at the University of British Columbia (UBC) in Canada have shown that at four months babies can tell when a person switches to a different language just by watching their face."

• DMD may affect mind as well as body
  from Reuters
  "Duchenne's muscular dystrophy (DMD) is known to delay children's development of movement and coordination, but now new research indicates that it may also slow language development. DMD occurs in roughly 1 of every 3500 male births, according to the report in The Journal of Pediatrics. The disease is thought of as mainly affecting muscles, because children become progressively weaker. However, slowness with words has been described in children and adolescents with the disease."

• Spatial and facial processing in the signed discourse of two groups of deaf signers with clinical language impairment
  from Clinical Linguistics and Phonetics
  "The linguistic and cognitive profiles of five deaf adults with a sign language disorder were compared with those of matched deaf controls. The test involved a battery of sign language tests, a signed narrative discourse task and a neuropsychological test protocol administered in sign language. Spatial syntax and facial processing were examined in detail and correlated with language and cognitive findings. The battery clearly differentiated the performance of the clinical participants from that of the normal controls. Further, test performance of the clinical individuals was distinct and showed marked correlations with neurological history, as well as with cognitive profiles. The important role of narrative discourse as a clinically sensitive diagnostic tool is described."

• Effects of visual information on intelligibility of open and closed class words in predictable sentences produced by speakers with dysarthria
  from Clinical Linguistics and Phonetics
  "This study examined the independent and interactive effects of visual information and linguistic class of words on intelligibility of dysarthric speech. Seven speakers with dysarthria participated in the study, along with 224 listeners who transcribed speech samples in audiovisual (AV) or audio-only (AO) listening conditions. Orthographic transcriptions from listeners were scored for the number of words identified correctly. Correctly identified words were then coded into two linguistic classes, open and closed. Results showed that across all speakers and listeners, the AV presentation mode resulted in significantly higher intelligibility scores than the AO mode. However, the difference was significant for only three of seven individual speakers. Results also showed that across all speakers and listeners, closed class words were more intelligible than open class words. The difference between linguistic classes was significant for six of seven individual speakers. The interaction between linguistic class and mode of presentation was not significant, indicating that the margin of benefit for closed class words was consistent across presentation modalities."

• Aspects of spatio-temporal variability during consonant production by Greek speakers with hearing impairment
  from Clinical Linguistics and Phonetics
  "This paper investigates spatio-temporal variability during the production of the lingual consonants /t, k, s, x, n, l, / by four Greek speakers with profound hearing impairment and with differences in the intelligibility of their speech. It examines important factors that have been documented to influence intelligibility, i.e. durational variability, articulatory (token-to-token) variability, and coarticulatory patterns. The technique of electropalatography was used to record tongue-palate contact patterns during consonant production in order to examine differences in articulatory variability among speakers and in V-to-C coarticulatory effects. The study reports durational differences in consonant production between speakers with hearing impairment and normal hearing and investigates the relationship between token-to-token variability in tongue-palate contact patterns and duration. The results indicate a negative relationship between duration and variability, i.e. as segmental duration decreases there is an increase in variability in tongue-palate contact patterns. Significant speaker-dependent differences in duration, articulatory variability and coarticulatory patterns are reported and are discussed in relation to differences in intelligibility among the speakers with hearing impairment."

• Comparability of Lexical Corpora: Word frequency in phonological generalization
  from Clinical Linguistics and Phonetics
  "Statistical regularities in language have been examined for new insight to the language acquisition process. This line of study has aided theory advancement, but it also has raised methodological concerns about the applicability of corpora data to child populations. One issue is whether it is appropriate to extend the regularities observed in the speech of adults to developing linguistic systems. The purpose of this paper is to establish the comparability of lexical corpora in accounting for behavioural effects of word frequency on children's phonological generalization. Four word frequency corpora were evaluated in comparison of child/adult and written/spoken sources. These were applied post-hoc to generalization data previously reported for two preschool children. Results showed that the interpretation of phonological generalization was the same within and across children, regardless of the corpus being used. Phonological gains were more evident in low than high frequency words. The findings have implications for the design of probabilistic studies of language acquisition and clinical treatment programmes."

• Non-word repetition: An investigation of phonological complexity in children with Grammatical SLI
  from Clinical Linguistics and Phonetics
  "We investigate whether children with Grammatical Specific Language Impairment (G-SLI) are also phonologically impaired and, if so, what the nature of that impairment is. We focus on the prosodic complexity of words, based on their syllabic and metrical (stress) structure, and investigate this using a novel non-word repetition procedure, the Test of Phonological Structure (TOPhS). Participants with G-SLI (aged 12-20 years) were compared to language-matched, typically developing children (aged 4-8 years). The results reveal that, in contrast to the controls, the accuracy with which the G-SLI group repeated non-words decreased as prosodic complexity increased, even in non-words with only one- and two-syllables. The study indicates that, in G-SLI, complexity deficits in morphology and syntax can extend to prosodic phonology. The study highlights the importance of taking into account prosodic complexity in phonological assessment and the design of non-word repetition procedures."

• Children with autistic spectrum disorders and speech-generating devices: Communication in different activities at home
  from Clinical Linguistics and Phonetics
  "The communication of four children with autistic spectrum disorder was investigated when they were supplied with a speech-generating device (SGD) in three different activities in their home environment: mealtime, story reading and "sharing experiences of the preschool day". An activity based communication analysis, in which collective and individual background factors for the activities were outlined, was used as a basis for the discussion of linguistic coding data derived from video-recordings made before and during SGD intervention. The coded communicative behaviours were engagement in activity, role in turn-taking, communicative form, function and effectiveness. An increase in communicative effectiveness was more noticeable when the SGDs could be used to fulfil goals and roles within the activity. The instruction to the parents to use the SGDs in their communication with the child had an important influence on the activities."

• Temporal features of articulation from childhood to adolescence: An electropalatographic investigation
  from Clinical Linguistics and Phonetics
  "This study was designed to investigate the development of articulatory timing from mid-childhood to late adolescence. Productions of sentences containing /t/, /l/, /s/, and /k/ were produced by 48 children and adults (aged 6-38 years) and captured using the Reading Electropalatography3 (EPG3) system. Mean duration of the sentences and the approach, closure/stable constriction, and release phases of consonant articulation were calculated. In addition, temporal coordination of lingual gestures and the intra-subject articulatory timing variation were investigated across the ages. Results reveal some distinct differences in duration and temporal coordination of lingual gestures between 6- to 7-year-olds and mature speakers, with continual refinement of articulatory control indicated into late adolescence. Differences in articulatory stability, in contrast, were not significant. The present findings may form a platform for development of a more descriptive model of motor speech development."

• Essential tones of music rooted in human speech
  from EurekAlert.org
  "The use of 12 tone intervals in the music of many human cultures is rooted in the physics of how our vocal anatomy produces speech, according to researchers at the Duke University Center for Cognitive Neuroscience. The particular notes used in music sound right to our ears because of the way our vocal apparatus makes the sounds used in all human languages, said Dale Purves, the George Barth Geller Professor for Research in Neurobiology. It's not something one can hear directly, but when the sounds of speech are looked at with a spectrum analyzer, the relationships between the various frequencies that a speaker uses to make vowel sounds correspond neatly with the relationships between notes of the 12-tone chromatic scale of music, Purves said."

• Sensitivity to sampling in Bayesian word learning
  from Developmental Science
  "We report a new study testing our proposal that word learning may be best explained as an approximate form of Bayesian inference (Xu & Tenenbaum, in press). Children are capable of learning word meanings across a wide range of communicative contexts. In different contexts, learners may encounter different sampling processes generating the examples of word–object pairings they observe. An ideal Bayesian word learner could take into account these differences in the sampling process and adjust his/her inferences about word meaning accordingly. We tested how children and adults learned words for novel object kinds in two sampling contexts, in which the objects to be labeled were sampled either by a knowledgeable teacher or by the learners themselves. Both adults and children generalized more conservatively in the former context; that is, they restricted the label to just those objects most similar to the labeled examples when the exemplars were chosen by a knowledgeable teacher, but not when chosen by the learners themselves. We discuss how this result follows naturally from a Bayesian analysis, but not from other statistical approaches such as associative word-learning models."

• On the relation between the acquisition of singular–plural morpho-syntax and the conceptual distinction between one and more than one
  from Developmental Science
  "We investigated the relationship between the acquisition of singular–plural morpho-syntax and children's representation of the distinction between singular and plural sets. Experiment 1 tested 18-month-olds using the manual-search paradigm and found that, like 14-month-olds (Feigenson & Carey, 2005), they distinguished three objects from one but not four objects from one. Thus, they failed to represent four objects as ‘plural’ or ‘more than one’. Experiment 2 found that children continued to fail at the 1 vs. 4 manual-search task at 20 months of age, even when told, via explicit morpho-syntactic singular–plural cues, that one or many balls are being hidden. However, 22- and 24-month-olds succeeded both with and without verbal cues. Parental report data indicated that most 22- and 24-month-olds, but few 20-month-olds, had begun producing plural nouns in their speech. Also, the success among the older children was due to those children who had reportedly begun producing plural nouns. We discuss a possible role for language acquisition in children's deployment of set-based quantification and the distinction between singular and plural set."

• A novel service delivery model for infant hearing screening in developing countries
  from International Journal of Audiology
  "Newborn hearing screening is the procedure of choice for ensuring optimal outcomes for infants with hearing loss, whether in a developed or developing country. Unfortunately, apart from a small number of recent exceptions, newborn hearing screening has been a practice reserved for the developed world. Despite the prevailing challenges towards implementing hearing screening in developing countries, there are existing structures in these countries that need to be investigated as possible platforms from which programs can be actualized. Immunization clinics, constituting part of a primary healthcare approach characteristic of developing countries, offer one such a platform. A novel service delivery model, based on initial results from a pilot study, was developed for infant hearing screening at immunization clinics in South Africa as an integrated part of primary, secondary, and tertiary levels of healthcare. This type of model is a first step toward ensuring that infants with hearing loss in developing communities are afforded opportunities for optimal development and societal integration through accountable and contextually relevant early hearing detection and intervention services."

• Maturation of the auditory system: 1. Transient otoacoustic emissions as an index of inner ear maturation
  from International Journal of Audiology
  "The transiently evoked otoacoustic emission amplitude of 42 preterm babies (84 ears; post-conceptional age [PCA] 30-36 weeks) was compared with the TEOAE amplitude of 39 full-term babies (78 ears; PCA 37-45 weeks) in order to trace the inner ear maturation characteristics. An ILO-92 otoacoustic emission recording system was used with linear clicks of 70 dB peak equivalent SPL. The results obtained indicated: (1) There was no statistically significant difference between preterm and full-term ears; (2) There was no significant difference between males and females; (3) There was a significant difference between left and right ear TEOAE amplitude; (4) The interaction of ear with age in relation to TEOAE amplitude was statistically significant; (5) Noise and stimulus parameters did not reveal any significant differences between right and left ears; (6) A positive correlation existed between birthweight and TEOAE amplitude; and (7) A negative correlation existed between aminoglycoside treatment and TEOAE amplitude. The results indicate subtle changes in TEOAE amplitude over time, showing a natural development of the inner ear function during the process of maturation."

• Maturation of the auditory system: 2. Transient otoacoustic emission suppression as an index of the medial olivocochlear bundle maturation
  from International Journal of Audiology
  "Contralateral suppression of transient otoacoustic emissions in 42 premature babies (84 ears; post-conceptional age [PCA] 30-36 weeks) was compared to that of 39 full-term babies (78 ears; PCA: 37-45 weeks). Eighteen healthy adults and ten young children (5-14 years old) were studied as controls. Risk factors for hearing loss were registered in both preterm and full-term groups. An ILO-92 otoacoustic emission recording system was used to deliver linear clicks to the ear examined and broadband noise to the contralateral ear in an alternating on and off mode. Suppression in full-term babies was statistically higher than in preterms, whereas no differences existed between children and adults and children and full-terms. Peripheral auditory lateralization was evident in adults but was observed only as a trend in newborns. Only prematurity at the time of examination and aminoglycoside treatment for more than seven days had a negative impact on suppression. The results support the conclusion that maturation of the efferent system takes place from 30 to 45 weeks PCA. The exact age at which this maturation is accomplished has not yet been clearly determined."

• The role of hope in adjustment to acquired hearing loss
  from International Journal of Audiology
  "This study investigated the relationship between individual and disability characteristics and adjustment to acquired hearing loss, and the role hope has in that relationship. A sample of 114 adults with sensorineural hearing loss who had accessed hearing therapy services participated in the study. The mean age of the participants was 67 years. A survey of individual and disability characteristics, hope and adjustment was conducted. Multiple regression analyses were applied to examine possible moderating and mediating models. The results indicate that the degree of loss was the only statistically significant individual and disability characteristic related to adjustment. The trait of hope was found to serve as a mechanism by which the degree of loss affects adjustment. Hearing loss affects hope which in turn affects adjustment. Hope was found to account for 45% of the relationship between the degree of loss and adjustment. Additionally, the study found that self-efficacy and personal meaning may influence hope and despair dimensions in different ways. Discussion centres on the implication of these findings for intervention strategies used in rehabilitation programmes for those with a significant hearing loss."

• Aided auditory steady-state responses in infants
  from International Journal of Audiology
  "Infants with hearing loss routinely receive hearing aids several months before reliable behavioral responses to amplified sound can be observed. This necessitates objective measures to validate hearing-aid fittings. A single report has demonstrated the use of ASSRs to determine aided thresholds in children but data in young infants is still lacking. The current study explored aided ASSR compared to unaided ASSR thresholds and subsequent behavioral thresholds in a group of six young infants with hearing loss who received hearing aids between three and six months of age. Aided ASSR thresholds were obtained in 83% of frequencies where aided behavioral thresholds were obtained, with a mean threshold difference of 13±13 dB. The aided ASSR-based threshold estimates were within 15 dB of behavioral thresholds in 63% of cases, indicating a moderate correlation (r = 0.55). Comparing aided and unaided ASSR measurements revealed an average functional gain of 36±15 dB. These results indicate that ASSRs can provide the first evidence of robust hearing aid benefit in young infants several months before behavioral responses are observed"

• Using transposition to improve consonant discrimination and detection for listeners with severe high-frequency hearing loss
  from International Journal of Audiology
  "Transposition of high-frequency information to lower frequencies may help people with high-frequency hearing loss associated with a 'dead region' (DR) to detect and identify certain consonants, such as 's'. Conventional high-frequency amplification is often not beneficial in such cases. We designed and evaluated a new transposition algorithm which was adapted to each subject's high-frequency DR. Frequency components from well within the DR were transposed to just within the DR without applying frequency compression. Low-frequency components were amplified, but unaffected by transposition. Transposition only occurred if there was significant high-frequency energy, preventing high-frequency background noise of moderate level from being transposed. Consonant discrimination was tested using vowel-consonant-vowel (VCV) stimuli, and the detection of word-final 's' and 'z' was assessed using word pairs. Seven subjects with high-frequency DRs were tested in quiet using a transposed and a control condition. Following transposition, two subjects improved significantly and none performed significantly worse on the VCV-test overall. The perception of affricates was consistently improved. Averaged across subjects, the detection of word-final 's' and 'z' was significantly improved, with five subjects improving significantly individually."

May 24, 2007

• Effects of Voice Therapy: A Systematic Review
  from the Journal of Voice
  "Medical as well as paramedical treatments should be evaluated by scientific methods. This systematic review focuses on the effects of voice therapy, excluding pharmacological or surgical treatments. In general, statistically significant positive but modest and varying therapy effects are found. Many of these effect studies cope with diverse methodological problems. Furthermore, the conclusions of most studies cannot be generalized easily or compared to one another. As a consequence, many issues in the field of effects of voice therapy have yet been unanswered.

• Dimensionality in Voice Quality
  from the Journal of Voice
  "This study concerns speaking voice quality in a group of male teachers (n = 35) and male actors (n = 36), as the purpose was to investigate normal and supranormal voices. The goal was the development of a method of valid perceptual evaluation for normal to supranormal and resonant voices. The voices (text reading at two loudness levels) had been evaluated by 10 listeners, for 15 vocal characteristics using VA scales. In this investigation, the results of an exploratory factor analysis of the vocal characteristics used in this method are presented, reflecting four dimensions of major importance for normal and supranormal voices. Special emphasis is placed on the effects on voice quality of a change in the loudness variable, as two loudness levels are studied. Furthermore, the vocal characteristics Sonority and Ringing voice quality are paid special attention, as the essence of the term “resonant voice” was a basic issue throughout a doctoral dissertation where this study was included."

• Computational Simulations of Vocal Fold Vibration: Bernoulli Versus Navier–Stokes
  from the Journal of Voice
  "The use of the mechanical energy (ME) equation for fluid flow, an extension of the Bernoulli equation, to predict the aerodynamic loading on a two-dimensional finite element vocal fold model is examined. Three steady, one-dimensional ME flow models, incorporating different methods of flow separation point prediction, were compared. For two models, determination of the flow separation point was based on fixed ratios of the glottal area at separation to the minimum glottal area; for the third model, the separation point determination was based on fluid mechanics boundary layer theory. Results of flow rate, separation point, and intraglottal pressure distribution were compared with those of an unsteady, two-dimensional, finite element Navier–Stokes model. Cases were considered with a rigid glottal profile as well as with a vibrating vocal fold. For small glottal widths, the three ME flow models yielded good predictions of flow rate and intraglottal pressure distribution, but poor predictions of separation location. For larger orifice widths, the ME models were poor predictors of flow rate and intraglottal pressure, but they satisfactorily predicted separation location. For the vibrating vocal fold case, all models resulted in similar predictions of mean intraglottal pressure, maximum orifice area, and vibration frequency, but vastly different predictions of separation location and maximum flow rate."

• When Does a Sung Tone Start?
  from the Journal of Voice
  "Although the consonant is mostly considered as the start of a syllable in phonetics and orthography, musicians generally agree that the vowel onset in singing should be synchronized with the beat. As a test of this assumption, the current investigation analyzes the time interval between vowel onsets and piano accompaniment onsets in a set of songs performed by international vocal artists and published on commercial CD recordings. The results show that, most commonly, the accompanists synchronized their tones with the singers' vowel onsets. Nevertheless, examples of lead and lag were found, probably made for expressive purposes. The lead and lag varied greatly between songs, being smallest in a song performed in a fast tempo and longest in a song performed in a slow tempo."

• A Novel Treatment for Hypophonic Voice: Twang Therapy
  from the Journal of Voice
  "A hypophonic voice, characterized perceptually as weak and breathy, is associated with voice disorders such as vocal fold atrophy and unilateral vocal fold paralysis. Although voice therapy programs for hypophonia typically address the vocal folds or the sound source, twang voice quality was examined in this study as an alternative technique for increasing vocal power by altering the epilarynx or the sound filter. Objective: This study investigated the effect of twang production on physiologic, acoustic, and perceived voice handicap measures in speakers with hypophonia. Design/Methods: This prospective pilot study compared the vocal outcomes of six participants with hypophonia at pre- and posttreatment time points. Outcome measures included mean airflow rate, intensity in dB sound pressure level (SPL), maximum phonation time, and self-report of voice handicap. Results: All subjects improved in at least three of the four vocal outcome measures. Wilcoxon signed-rank test of paired differences revealed significant differences between pre- and posttherapy group means for airflow rate, SPL, and Voice Handicap Index scores. Conclusion: The twang voice quality as a manipulation of the sound filter offers a clinical complement to traditional voice therapies that primarily address the sound source."

• Intonation Drift in A Capella Soprano, Alto, Tenor, Bass Quartet Singing With Key Modulation
  from the Journal of Voice
  "Objectives/Hypothesis: When a soprano, alto, tenor, bass (SATB) quartet sings unaccompanied, or a capella, the members of the group will tend to make use of non-equal-tempered intonation to govern their tuning. If the music they are performing visits different keys and they do maintain non-equal-tempered tuning, then the pitch center will have to shift from its starting point, which is a necessary consequence of the physics behind the use of a non-equal-tempered tuning system. The implication of this shift for tuning in a capella singing is that it is not possible both to maintain accurate non-equal-tempered tuning and to stay in pitch throughout music that modulates in key. Methods: To test this notion, a set of four-part exercises were written by the author that visit several different key chords in sequential progression. In each case, the starting and finishing chords were either identical or exactly an octave apart. Mean fundamental frequency values for each note were measured using four electrolaryngographs (one per singer), and the f0 data were normalized and plotted with respect to equal-tempered tuning to enable any overall tuning shift to be observed. Results: The results indicate that singers do (1) tend to non-equal-tempered tuning and (b) do consequentially shift their intonation with modulation. Conclusions: These data indicate that pitch drift is potentially a necessary part of staying in-tune. Further work is required to identify items in the choral repertoire for which this effect is likely and then to inform the choral conducting and singing communities appropriately."

• Psychosocial Impact of the Teacher's Voice Throughout the Career
  from the Journal of Voice
  "It is generally accepted that vocal performance decreases with age. This decrease can be expected to be more pronounced in voice loading professions, which may lead to occupational dysphonia. The aim of this study was to investigate the course of voice complaints, experienced handicap, and absenteeism of work due to voice problems throughout the teaching years. Questionnaires were distributed among teachers of primary and secondary education, and 1875 were analyzed. The questionnaire was designed in such a way that personal aspects and questions about periods with symptoms and absence from work were included. The Voice Handicap Index (VHI) developed by Jacobson et al was sent along with the questionnaire. Surprisingly, a significant decrease of voice complaints during the career of the teachers was observed. The expectation that the percentage of teachers with a history of voice problems should experience more psychosocial impact, measured with the VHI, along their professional career could not be confirmed by this study. These results indicate that serious attention has to be paid to teachers with voice complaints. The fact that teachers in the beginning of their career complain more than in the end of their career emphasizes the importance of adequate aimed prevention programs for future teachers and for starting teachers with regard to their voice."

• The Voice Handicap of Student-Teachers and Risk Factors Perceived to Have a Negative Influence on the Voice
  from the Journal of Voice
  "A cross-sectional questionnaire survey was performed. The objectives of the study were to assess the psychosocial impact of current voice complaints as perceived by student-teachers with voice complaints in comparison with student-teachers without voice complaints, and to observe the pattern of risk factors in relation to their voice handicap. Subjects in the general population without a voice-demanding profession were selected as a reference group for limited comparison with the total group of student-teachers (future professional voice users). The respondents to the questionnaires were anonymous. Among the student-teachers, 17.2% reported current voice complaints in comparison with 9.7% of the reference group, and the odds ratio was 1.94, which showed the relative risk. Student-teachers had significantly greater total Voice Handicap Index (VHI) scores than the reference group (P = 0.034). The VHI subscale scores were not significantly different (P > 0.05). Student-teachers who reported current voice complaints had a significantly higher total VHI and subscale scores than student teachers without voice complaints (P < 0.001). Of the student-teachers without voice complaints, 17.0% had VHI scores greater than the 75th percentile. These persons may be neglecting their voice handicap and probably represent the false-negative cases in the estimation of voice complaints. Logistic regression analysis of each of the given risk factors with the VHI as the independent variable showed that the perceived negative influence of the given risk factors on their voices was significantly greater with increasing VHI scores across the VHI range. A significant correlation was observed between the number of perceived risk factors and increasing VHI scores across the VHI range. An increased awareness of risk factors in relation to their voice handicap would serve to motivate student-teachers to change factors that contributed to their voice problem. Attention to all risk factors, which the subjects perceive to be a risk, would aid in effective management of their voice handicap."

• Validation of the Voice Handicap Index Using Rasch Analysis
  from the Journal of Voice
  "Background: The Voice Handicap Index is a tool for measuring the psychosocial consequences of voice disorders and consists of three dimensions. Previous psychometric evaluation of the VHI focused on the classic evaluation of reliability and validity, which is sample dependent. The authors used Rasch analysis to re-examine the dimensionality of the VHI and to produce item and scale statistics that are less sample dependent. In addition, they provide estimates of VHI item and person severities that are reported on the same logit unit scale, allowing a more straightforward interpretation of a VHI test score. Patients: Dysphonic patients (N = 530), who were referred for phoniatric examination, filled out the VHI. Results: Rasch analysis revealed two truly uni-dimensional constructs: the 20-item psychosocial scale and the 9-item physical-functional scale. Logit item severity measures ranged from –2.1 to +2.7. Person severity scores ranged from –4.4 to + 4.4 logits. The internal consistency of the reduced scales was similar to that of the original total VHI (0.95 and 0.84). The VHI consisted of two uni-dimensional constructs. Raw test scores can be transformed into logit unit severity measures, making the VHI more suitable for evaluating the effectiveness of voice-related therapy."

• Laser Doppler Measurements of the Vocal Fold Blood Micro-Circulation
  from the Journal of Voice
  "The authors have developed a laser Doppler method, referred to as LDF+LS (laser Doppler flowmetry by laryngostereometry), for measuring the vocal fold micro-circulation. The vocal folds of 103 patients were examined during general anesthesia. A laser Doppler probe was placed on defined positions at the vocal fold edge: midmembranous position (MP), 2 mm and 4 mm behind, and 1 mm anterior to MP. Three parameters were derived, ie, the concentration (CMBC) and velocity (V) of moving blood cells, and the product of both resulting in perfusion: P = CMBCxV. The results of 53 subjects with normal vocal fold status showed that the V at MP was significantly lower than 2 mm behind MP (P < 0.05). Men had significantly higher velocity than women (P < 0.05). Subjects older than 65 years had higher perfusion and CMBC as compared with younger subjects (P < 0.01). Smokers with normal vocal folds had higher velocity than non-smokers (P < 0.05). Measurements of healthy vocal folds were compared with benign vocal fold pathology. Vocal fold polyps had significantly higher perfusion than normal vocal folds (P < 0.01). In conclusion, the laser Doppler measurement is a sensitive tool estimating superficial blood flow in both normal and pathological vocal folds. The blood flow in normals differs with respect to gender and age probably due to variations in micro-circulation of the mucosa and lamina propria. Vocal fold pathology and external factors such as smoking result in blood flow changes."

• Voice and Upper Airway Symptoms in People With Chronic Cough and Paradoxical Vocal Fold Movement
  from the Journal of Voice
  "Chronic cough (CC) and paradoxical vocal fold movement (PVFM) share several common features; however, there has been no systematic comparison of these two conditions. The aims of this study were to contrast and compare the symptom profiles of CC and PVFM, to clarify the relationship between the two conditions, and to explore how symptom characteristics could be used to design an individualized treatment program. Participants included 55 people with a combination of PVFM and CC that was refractory to medical treatment, 8 people with PVFM alone, 56 people with CC alone, 25 people with voice disorders, and 27 normal controls. Symptoms and descriptive features of CC, PVFM, and voice disorders were assessed via structured case history interview, symptom frequency, and severity ratings, ratings of activity limitation, and anxiety/depression ratings. Results indicated consistent overlap in the symptom profile between people with CC and those presenting with a combination of CC and PVFM. Participants with PVFM without cough and those with voice disorders overlapped with the participants with CC on some dimensions; however, there were still some significant differences between them. These data suggest that CC and PVFM are related and manifestations of a common underlying condition but that voice disorders are a discrete entity. Most participants had normal ratings on screening for anxiety and depression. Results indicated that there were no consistent psychiatric symptoms in any of the groups studied, and they do not support the label of psychogenic cough for CC that is refractory to medical treatment. Characteristics of CC such as nature and timing of the cough provide important information for developing behavioral treatment programs for individual patients who have exhausted medical options. A template has been provided that is a practical method of designing an integrated behavioral treatment program based on those individual patient characteristics."

• Metalinguistic Awareness and Reading Performance: A Cross Language Comparison
  from the Journal of Psycholinguistic Research
  "Abstract The study examined two questions: (1) do the greater phonological awareness skills of billinguals affect reading performance; (2) to what extent do the orthographic characteristics of a language influence reading performance and how does this interact with the effects of phonological awareness. We estimated phonological metalinguistic abilities and reading measures in three groups of first graders: monolingual Hebrew speakers, bilingual Russian–Hebrew speakers, and Arabic-speaking children. We found that language experience affects phonological awareness, as both Russian–Hebrew bilinguals and the Arabic speakers achieved higher scores on metalinguistic tests than Hebrew speakers. Orthography affected reading measures and their correlation with phonological abilitites. Children reading Hebrew showed better text reading ability and significant correlations between phonological awareness and reading scores. Children reading Arabic showed a slight advantage in single word and nonword reading over the two Hebrew reading groups, and very weak relationships between phonological abilities and reading performance. We conclude that native Arabic speakers have more difficulty in processing Arabic orthography than Hebrew monolinguals and bilinguals have in processing Hebrew orthography, and suggest that this is due to the additional visual complexity of Arabic orthography."

• Acquiring Explicit Grammatical Knowledge Using the Spanish Verbs Ser and Estar as Examples
  from the Journal of Psycholinguistic Research
  "Abstract The role of explicit and implicit acquisition of grammatical rules in second language learning was examined by assessing high school students performance after several years of study on the correct use of the Spanish verbs ser and estar. These two verbs are essentially equivalent in use to the English verb “to be,” but there is a complex set of statements that specifies when each is to be used. A 100-item two-choice test in which students from several different high schools receiving instruction in the explicit principles of these two Spanish verbs or receiving immersion training in which no instruction in their grammatical principles was given were examined for the following five factors: (a) general achievement level, (b) comparison of grade level achievement, (c) time allotted to complete the 100-item test, (d) grammatical instruction prior to taking the 100-item test, and (e) comparison of instructional methodology. The results indicated that students receiving explicit instruction in the rules of ser and estar beyond the first year of study achieved slightly higher scores, but that the level of achievement was considered to be poor. Differences between groups for the remaining factors were not significant. It was concluded that successful application of explicitly learned grammatical rules, such as the rules for ser and estar, may not be achievable in the time frame of a two-year high school foreign language course. Considerations regarding implicit and explicit acquisition of grammatical rules in second language learning were presented."

• Perceptual Bias in Speech Error Data Collection: Insights from Spanish Speech Errors
  from the Journal of Psycholinguistic Research
  "Abstract This paper studies the reliability and validity of naturalistic speech errors as a tool for language production research. Possible biases when collecting naturalistic speech errors are identified and specific predictions derived. These patterns are then contrasted with published reports from Germanic languages (English, German and Dutch) and one Romance language (Spanish). Unlike findings in the Germanic languages, Spanish speech errors show many patterns which run contrary to those expected from bias: (1) more phonological errors occur between words than within word; (2) word-initial consonants are less likely to participate in errors than word-medial consonants, (3) errors are equally likely in stressed and in unstressed syllables, (4) perseverations are more frequent than anticipations, and (5) there is no trace of a lexical bias. We present a new corpus of Spanish speech errors collected by many theoretically naïve observers (whereas the only corpus available so far was collected by two highly trained theoretically informed observers), give a general overview of it, and use it to replicate previous reports. In spite of the different susceptibility of these methods to bias, results were remarkably similar in both corpora and again contrary to predictions from bias. As a result, collecting speech errors “in the wild” seems to be free of bias to a reasonable extent even when using a multiple-collector method. The observed contrasting patterns between Spanish and Germanic languages arise as true cross-linguistic differences."

• Morphological Analogies in Hebrew-Speaking University Students with Dyslexia Compared with Typically Developing Gradeschoolers
  from the Journal of Psycholinguistic Research
  "Abstract Little attention has been devoted to date to the study of morphological knowledge in individuals with developmental dyslexia. The current study compares the ability of Hebrew-speaking adult dyslexic students and gradeschool children to analyze written words into their morphological components, using a linguistic analogy task. Two sets of monolingual Hebrew-speaking participants—152 typically developing gradeschool children and 38 undergraduate students diagnosed with reading disabilities—were administered the Morphological Analogies Task. Results indicate an early ability of normally developing children to perform morphological analogies, while the adult dyslexic group performed on par with 3rd and 4th grade. Error analysis revealed that the overwhelming majority of the erroneous responses in all grades involved morphological strategies rather than the associative semantic strategy. However, the adult dyslexic students had many more associative responses than the graderschoolers. This testifies to the reduced written morphological abilities of adult dyslexic students."

• Learning-Induced Plasticity in Auditory Spatial Representations Revealed by Electrical Neuroimaging
  from Journal of Neuroscience
  "Auditory spatial representations are likely encoded at a population level within human auditory cortices. We investigated learning-induced plasticity of spatial discrimination in healthy subjects using auditory-evoked potentials (AEPs) and electrical neuroimaging analyses. Stimuli were 100 ms white-noise bursts lateralized with varying interaural time differences. In three experiments, plasticity was induced with 40 min of discrimination training. During training, accuracy significantly improved from near-chance levels to 75%. Before and after training, AEPs were recorded to stimuli presented passively with a more medial sound lateralization outnumbering a more lateral one (7:1). In experiment 1, the same lateralizations were used for training and AEP sessions. Significant AEP modulations to the different lateralizations were evident only after training, indicative of a learning-induced mismatch negativity (MMN). More precisely, this MMN at 195–250 ms after stimulus onset followed from differences in the AEP topography to each stimulus position, indicative of changes in the underlying brain network. In experiment 2, mirror-symmetric locations were used for training and AEP sessions; no training-related AEP modulations or MMN were observed. In experiment 3, the discrimination of trained plus equidistant untrained separations was tested psychophysically before and 0, 6, 24, and 48 h after training. Learning-induced plasticity lasted <6 h, did not generalize to untrained lateralizations, and was not the simple result of strengthening the representation of the trained lateralizations. Thus, learning-induced plasticity of auditory spatial discrimination relies on spatial comparisons, rather than a spatial anchor or a general comparator. Furthermore, cortical auditory representations of space are dynamic and subject to rapid reorganization."

• Reduction in auditory distraction by retrieval strategy
  from Memory
  "Most research on auditory distraction on task performance focuses on those features of the sound that determine a drop in efficiency, with scant regard for examining the processing properties inherent in the focal task. We report how one such property, retrieval strategy, can also influence the degree of disruption by background sound. Using a task that called for the retrieval of realistic train journey information, we showed that retrieval by categories of verbal sequences was not susceptible to disruption by office sound - 65-75 dB(A). However, versions of the task requiring either free or serial recall showed evidence of disruption, a pattern of results consistent with the changing-state account of the irrelevant sound effect, which highlights the key role of serial rehearsal in determining disruption."

• Incomplete inhibition of emotion in specific autobiographical memories
  from Memory
  "Emotional inhibition in recollection of specific autobiographical memories (Conway & Pleydell-Pearce, 2000) is investigated in two experiments. Less complete emotional inhibition was hypothesised to correspond to a reduced sense of psychological closure. Emotional inhibition was identified by comparing the effect of emotion words relative to lifetime period words as primes. In Experiment 1, emotion words facilitated recognition judgements of descriptions of remembered experiences rated low in closure. In Experiment 2, emotion words facilitated recognition judgements of descriptions of a laboratory experience made lower in closure. A sense of psychological closure may therefore be a prerequisite for strategic emotional inhibition. Implications for adjustment and goal pursuit are discussed."

• Pragmatics and Adult Language Disorders: Past Achievements and Future Directions
  from Seminars in Speech and Language
  "In this article, the current state of our knowledge of pragmatic disorders in adults with language impairment is assessed. A brief historical background of clinical pragmatics is presented, and the place of adult language pathology within the development of this field is discussed. A comprehensive review is undertaken of pragmatic deficits in adults with language impairments of diverse etiologies. Specifically, pragmatic deficits are examined in adults with left-hemisphere damage, often resulting in aphasia, and in adults with right-hemisphere damage, traumatic brain injury, schizophrenia, and neurodegenerative disorders (principally, Alzheimer's disease). Although many pragmatic phenomena have been examined in these clinical populations, studies have also tended to neglect important areas of pragmatic functioning in adults with these disorders. Several such areas are identified within a wider discussion of how researchers and clinicians can best pursue future investigations of pragmatics in adults with language impairment."

• Cognitive Pragmatics of Language Disorders in Adults
  from Seminars in Speech and Language
  "Cognitive pragmatics is the study of the mental structures and processes involved in the use of language in communicative contexts. Paradigms of cognitive psychology (off-line and on-line) have been applied to the study of the abilities to go beyond the literal (inference) and derive meaning in relation to context (e.g., metaphor and sarcasm). These pragmatic functions have been examined for the involvement of processes of meaning activation, embellishment, and revision. Clinical investigators have explored abilities and deficits in acquired aphasia, right hemisphere dysfunction, and closed head injury. This article reviews and provides some analysis of clinical studies that are consistent with the themes constituting cognitive pragmatics."

• Using Conversation Analysis to Assess and Treat People with Aphasia
  from Seminars in Speech and Language
  "This article gives an overview of the application to aphasia of conversation analysis (CA), a qualitative methodology for the analysis of recorded, naturally occurring talk produced in everyday human interaction. CA, like pragmatics, considers language use in context, but it differs from other analytical frameworks because the clinician is not making interpretations about how an aspect of language should be coded or judging whether an utterance is successful or adequate in terms of communication. We first outline the CA methodology before discussing its application to the assessment of aphasia, principally through the use of two published assessment tools. We then move on to illustrate applications of CA in the field of aphasia therapy by discussing two single case study interventions. Key conversation behaviors are illustrated with transcripts from interactions recorded by the person with aphasia and the person's habitual conversation partner in the home environment. Finally, we explore the implications of using CA as a tool for assessment and treatment in aphasia."

• Pragmatics in Discourse Performance: Insights from Aphasiology
  from Seminars in Speech and Language
  "This article examines the preservation of pragmatic abilities of individuals with aphasia, as manifested in the discourse they produce. The construct of coherence is used as a framework for understanding this pragmatic preservation. Discourse coherence is largely derived from the structure, selection, and highlighting of information expressed in a discourse. Personal narratives, as one type of discourse, represent an extended turn-in-conversation on a topic of personal relevance to the speaker, common in everyday life. As such, they provide a valuable source of information about a speaker's pragmatic ability. Examples of personal narratives told by individuals with aphasia are used to illustrate and discuss the means by which discourse coherence is achieved. These include a tightly structured temporal-causal event line, development of theme, and evaluation of information. Possible approaches to clinical assessment are considered, including use of global rating systems."

• Non-word repetition: An investigation of phonological complexity in children with Grammatical SLI
  from Clinical Linguistics and Phonetics
  "We investigate whether children with Grammatical Specific Language Impairment (G-SLI) are also phonologically impaired and, if so, what the nature of that impairment is. We focus on the prosodic complexity of words, based on their syllabic and metrical (stress) structure, and investigate this using a novel non-word repetition procedure, the Test of Phonological Structure (TOPhS). Participants with G-SLI (aged 12-20 years) were compared to language-matched, typically developing children (aged 4-8 years). The results reveal that, in contrast to the controls, the accuracy with which the G-SLI group repeated non-words decreased as prosodic complexity increased, even in non-words with only one- and two-syllables. The study indicates that, in G-SLI, complexity deficits in morphology and syntax can extend to prosodic phonology. The study highlights the importance of taking into account prosodic complexity in phonological assessment and the design of non-word repetition procedures."

• Temporal features of articulation from childhood to adolescence: An electropalatographic investigation
  from Clinical Linguistics and Phonetics
  "This study was designed to investigate the development of articulatory timing from mid-childhood to late adolescence. Productions of sentences containing /t/, /l/, /s/, and /k/ were produced by 48 children and adults (aged 6-38 years) and captured using the Reading Electropalatography3 (EPG3) system. Mean duration of the sentences and the approach, closure/stable constriction, and release phases of consonant articulation were calculated. In addition, temporal coordination of lingual gestures and the intra-subject articulatory timing variation were investigated across the ages. Results reveal some distinct differences in duration and temporal coordination of lingual gestures between 6- to 7-year-olds and mature speakers, with continual refinement of articulatory control indicated into late adolescence. Differences in articulatory stability, in contrast, were not significant. The present findings may form a platform for development of a more descriptive model of motor speech development."

• Comparability of Lexical Corpora: Word frequency in phonological generalization
  from Clinical Linguistics and Phonetics
  "Statistical regularities in language have been examined for new insight to the language acquisition process. This line of study has aided theory advancement, but it also has raised methodological concerns about the applicability of corpora data to child populations. One issue is whether it is appropriate to extend the regularities observed in the speech of adults to developing linguistic systems. The purpose of this paper is to establish the comparability of lexical corpora in accounting for behavioural effects of word frequency on children's phonological generalization. Four word frequency corpora were evaluated in comparison of child/adult and written/spoken sources. These were applied post-hoc to generalization data previously reported for two preschool children. Results showed that the interpretation of phonological generalization was the same within and across children, regardless of the corpus being used. Phonological gains were more evident in low than high frequency words. The findings have implications for the design of probabilistic studies of language acquisition and clinical treatment programmes."

• Aspects of spatio-temporal variability during consonant production by Greek speakers with hearing impairment
  from Clinical Linguistics and Phonetics
  "This paper investigates spatio-temporal variability during the production of the lingual consonants /t, k, s, x, n, l, / by four Greek speakers with profound hearing impairment and with differences in the intelligibility of their speech. It examines important factors that have been documented to influence intelligibility, i.e. durational variability, articulatory (token-to-token) variability, and coarticulatory patterns. The technique of electropalatography was used to record tongue-palate contact patterns during consonant production in order to examine differences in articulatory variability among speakers and in V-to-C coarticulatory effects. The study reports durational differences in consonant production between speakers with hearing impairment and normal hearing and investigates the relationship between token-to-token variability in tongue-palate contact patterns and duration. The results indicate a negative relationship between duration and variability, i.e. as segmental duration decreases there is an increase in variability in tongue-palate contact patterns. Significant speaker-dependent differences in duration, articulatory variability and coarticulatory patterns are reported and are discussed in relation to differences in intelligibility among the speakers with hearing impairment."

• Children with autistic spectrum disorders and speech-generating devices: Communication in different activities at home
  from Clinical Linguistics and Phonetics
  "The communication of four children with autistic spectrum disorder was investigated when they were supplied with a speech-generating device (SGD) in three different activities in their home environment: mealtime, story reading and "sharing experiences of the preschool day". An activity based communication analysis, in which collective and individual background factors for the activities were outlined, was used as a basis for the discussion of linguistic coding data derived from video-recordings made before and during SGD intervention. The coded communicative behaviours were engagement in activity, role in turn-taking, communicative form, function and effectiveness. An increase in communicative effectiveness was more noticeable when the SGDs could be used to fulfil goals and roles within the activity. The instruction to the parents to use the SGDs in their communication with the child had an important influence on the activities."

• The Use of Ultrasound in Remediation of North American English /r/ in 2 Adolescents
  from American Journal of Speech-Language Pathology
  "Purpose: Ultrasound can provide images of the tongue during speech production. The present study set out to examine the potential utility of ultrasound in remediation of North American English /r/. Method: The participants were 2 Canadian English-speaking adolescents who had not yet acquired /r/. The study included an initial period without ultrasound and 13 treatment sessions, each 1 hr long, using ultrasound. Speech samples were recorded at screening and immediately before and after treatment. Samples were analyzed acoustically and with listener judgments. Ultrasound images were obtained before, during, and after the treatment period. Results: Three speech-language pathologists unfamiliar with the participants rated significantly more posttreatment tokens as accurate [r]s in single words and some phrases. Acoustic analyses showed an expected lowering of the third formant after treatment. A qualitative observation of posttreatment ultrasound images for accurate [r] tokens showed tongue shapes to be more similar to those of typical adults than had been observed before treatment. Participants needed continued practice of their newly acquired skills in sentences and conversation. Conclusion: Two-dimensional dynamic ultrasound appears to have potential utility for remediation of /r/ in speakers with residual /r/ impairment. Further research is needed with larger numbers of participants to establish the relative efficacy of ultrasound in treatment."

• Speech and Language Skills of Parents of Children With Speech Sound Disorders
  from American Journal of Speech-Language Pathology
  "Purpose: This study compared parents with histories of speech sound disorders (SSD) to parents without known histories on measures of speech sound production, phonological processing, language, reading, and spelling. Familial aggregation for speech and language disorders was also examined. Method: The participants were 147 parents of children with SSD (58 fathers and 89 mothers) who were directly tested and interviewed for family history of disorders. Results: Thirty-six parents (18 mothers and 18 fathers) reported enrollment in speech therapy as children for SSD. Parents with a history of speech therapy obtained lower scores on the Multisyllabic Word Repetition, Nonword Repetition, and Tongue Twister tasks than parents without such histories. These parents also had poorer reading, spelling, and receptive language skills. Parents with histories of SSD and additional language impairments (LI) performed worse than parents with isolated SSD on all measures except Pig Latin and oral motor skills. Familial aggregation for SSD and LI was supported. In addition, the likelihood of SSD in a family member increased by a factor of 1.9 over rates of SSD found in individuals without additional family members with SSD, and the odds of LI increased by a factor of 4.1 over rates of LI found in individuals without additional family members with LI for each additional family member with SSD or LI, respectively. Conclusions: The results documented both residual effects in adulthood of childhood SSD and familial aggregation for SSD. These residual difficulties do not appear to affect educational and occupational outcomes."

• Clinician–Child Interactions: Adjustments in Linguistic Complexity
  from American Journal of Speech-Language Pathology
  "Purpose: This pilot study examined the extent and nature of associations in the linguistic complexity used by child and clinician within conversational interactions. Method: Correlation analyses focused on semantic and morphosyntactic language sample measures from an experienced speech-language clinician and 29 children with language impairment. Results: Positive associations emerged between a variety of child and clinician measures, even when the effect of child age was removed. The most robust effect related to clinician adjustments in both morphosyntactic complexity and vocabulary diversity associated with differences in children's developmental sentence scores. Conclusions: Within a conversational exchange, the clinician in this study made significant adjustments in her linguistic complexity that were due, at least in part, to the linguistic complexity used by the children with whom she was interacting. Associations were similar to adjustments reported in prior studies of parent and teacher interactions with children with differing language abilities. However, the extent to which these findings generalize to other clinicians needs to be examined. Results from the present study challenge clinicians to dedicate conscious thought toward how their linguistic input should be structured, taking into consideration both the goal of the interaction and each child's profile of linguistic strengths and weaknesses. Directions for future research are also provided."

• Effects of Verbal Cue on Bolus Flow During Swallowing
  from American Journal of Speech-Language Pathology
  "Purpose: To e