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from the European Archives of Oto-Rhino-Laryngology
Abstract The aim of this study was to evaluate the influence of timing of tracheoesophageal puncture (TEP)with indwelling voice prosthesis insertion regarding long-term success rate and postoperative complication. We conducted a Retrospective clinical study at tertiary academic center. There were 75 patients with primary TEP (80.6%) and 18 with secondary TEP (19.3%). Long-term success rate was 81.7%, with 80.0% in primary TEP and 88.9% in secondary TEP. No significant difference in Harrison-Robillard-Schultz Rating Scale success assessment were observed between patients with primary and secondary TEP (P = .596). The use of postoperative radiotherapy did not significantly influence the success rate. The age of patients who were older or younger than 60 years significantly influence the success rate in primary TEP (P = .012). The higher rate of complications in primary TEP was not statistically significant. These findings suggest that primary and secondary TEP are equally safe and effective procedures. Primary TEP should be prefered because of avoiding a second surgical intervention and allowing early voice restoration with a considerable psychological impact.
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from the European Archives of Oto-Rhino-Laryngology
Abstract We aimed to investigate if there is a concordance between summation potential (SP)/action potential (AP) ratio and unilateral weakness in patients with definite-Meniere’s disease. There were two groups, a group of unilateral definite-Meniere patients who received no treatment and another group of control subjects. Twenty-six patients were identified as complying with the defined criteria. Fifteen healthy subjects with no hearing and balance disorders were assigned to the control group. Arithmetic mean of the four-tone average of thresholds at 0.5, 1, 2, and 3 or 4 kHz, SP/AP ratio and degree of unilateral weakness were calculated. The number of patients was tabulated based on the presence of abnormal SP/AP ratio and unilateral weakness. Co-occurrence of unilateral weakness and elevated-SP/AP ratio was investigated with reference to the stage of the disease. A correlation was sought among pure-tone average, SP/AP ratio and degree of unilateral weakness in a pair-wise manner. Unilateral weakness and abnormal SP/AP ratio were identified in 53.8% and 38.4% of the patients, respectively. Co-occurrence of unilateral weakness and abnormal SP/AP ratio was observed in 34.6% of the patients. However, it was noticed that this co-occurrence gradually increased when the disease progressed. Mean SP/AP ratio also gradually increased as the stage progressed. Of pair-wise correlations among pure-tone average, SP/AP ratio and degree of unilateral weakness, a weak correlation (r = 0.383) was found only between SP/AP ratio and degree of unilateral weakness with marginal significance (P = 0.053). We concluded that co-occurrence of unilateral weakness and elevated SP/AP ratio increases when the disease progresses. This co-occurrence is less encountered in earlier stages. This difference might be resulted from a difference in distension capability of the endolymphatic space of the cochlea and the vestibule. Albeit weak, there was a correlation between mean SP/AP ratio and degree of unilateral weakness, which suggests that the disease parallelly disturbs the lateral semicircular or cochlear functions especially in advanced stages.
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from Clinical Linguistics and Phonetics
The comparison of cognitive and linguistic skills in individuals with developmental disorders is fraught with methodological and psychometric difficulties. In this paper, we illustrate some of these issues by comparing the receptive vocabulary knowledge and non-verbal reasoning abilities of 41 children with Williams syndrome, a genetic disorder in which language abilities are often claimed to be relatively strong. Data from this group were compared with data from typically developing children, children with Down syndrome, and children with non-specific learning difficulties using a number of approaches including comparison of age-equivalent scores, matching, analysis of covariance, and regression-based standardization. Across these analyses children with Williams syndrome consistently demonstrated relatively good receptive vocabulary knowledge, although this effect appeared strongest in the oldest children.
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from Clinical Linguistics and Phonetics
Individuals with the rare genetic disorder, Williams syndrome, have an unusual cognitive profile with relatively good language abilities but poor non-verbal and spatial skills. This study explored the interaction between linguistic and spatial functioning in Williams syndrome by investigating individuals' comprehension of spatial language. A group of 17 individuals with Williams syndrome and a control group of typically developing children were given two types of picture-matching task in which they were asked to select a picture to match a spoken sentence describing the spatial relation between two items. In the first task this matching could be done on the basis of existing semantic knowledge. In the second, we argue that a mental representation of the spatial relations was required. Results demonstrated that individuals with Williams syndrome were selectively impaired on the second task relative to controls. The study therefore provides support for previous work demonstrating impaired comprehension of spatial language in this population. Furthermore, the results suggest that such impairments reflect a fundamental problem with processing spatial descriptions rather than merely a poor understanding of the semantics of spatial terms, which in turn has implications for the interaction between spatial abilities and language processing in general.
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from Clinical Linguistics and Phonetics
This study investigated knowledge of binding and raising in two groups of children with Williams syndrome (WS), 6-12 and 12-16-years-old, compared to typically developing (TD) controls matched on non-verbal MA, verbal MA, and grammar. In typical development, difficulties interpreting pronouns, but not reflexives, persist until the age of around 6, while raising is not mastered until about the age of 8 or 9. If grammar in WS is delayed, but develops in a fashion parallel to TD population, similar patterns of difficulties may be expected, although it has not been established whether the grammatical development is ever complete in the individuals with this disorder. Knowledge of the principle of binding which states that a reflexive must have a c-commanding antecedent, was found to be intact in all the participants, in line with previous reports in the literature. In contrast, children with WS younger than 12 showed a poorer performance on personal pronouns, like two groups of younger matched TD controls, suggesting a previously unreported delay in the acquisition of constraints regulating coreferential interpretation of pronouns. Both groups of children with WS showed an extremely limited comprehension of raised, as opposed to unraised structures. The revealed patterns indicate that, like in unimpaired populations, different aspects of grammar mature at distinct stages of language development in WS: reflexive binding is acquired earlier than constraints governing coreference. However, development of raising seems exceptionally delayed, and perhaps even unattainable, as data from several adults with WS studied in Perovic and Wexler (2006) show. If, as hypothesized by Hirsch and Wexler, the late development of raising is related in TD children to lack of maturation of the knowledge of A-chains or defective phases, it seems reasonable to hypothesize that the even later development of these structures in WS is related to an even later (if ever) maturation of the knowledge of these grammatical forms.
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from Medical News Today.com
Doctors at Columbus Children's Hospital performed a clinical research study using spirometry in Children's Emergency Department to try to identify adolescents who had findings suggestive of VCD compared to an acute asthma attack. The year-long study (February 2005-February 2006) included patients 12-21-years-old who suffered from acute episodes of respiratory distress. The manuscript was published in the July issue of Pediatric Pulmonology.
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from Audiology & Neuro-Otology
A randomised control prospective study was carried out examining patient outcomes after performing a 10-week vestibular home exercise programme. Thirty-two adults with vestibular dysfunction who reported vestibular symptoms negatively affecting daily life were enrolled. Test subjects were provided with an individualised vestibular rehabilitation programme designed by a physiotherapist. Control subjects received a set of strength and endurance exercises only. All subjects performed their exercises 3 times a day for 10 weeks. Subjective and objective patient measures were collected at 0, 6, 10 and 26 weeks. Results showed that both groups improved after beginning exercise, and that test subjects significantly benefited compared to the controls. These benefits were long term and measurable 6 months later. This study provides evidence that individualised vestibular exercises promote better outcomes for patients with vestibular dysfunction.
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from Audiology & Neuro-Otology
The use of maximum length sequence (MLS) stimuli to elicit an auditory brainstem response (ABR) has been limited, in part, by the observation that these stimuli reduce ABR wave amplitudes. This study recorded ABR waveforms from 14 normally hearing adults using MLS click stimuli (maximum stimulus rate = 250 clicks per second) at stimulus levels of 70, 60, 50, 40, 30 and 20 dB nHL, with a vertical and then an ipsilateral electrode montage. The vertical electrode montage produced significantly larger (p < 0.05) wave V amplitudes, with no change in wave V latencies (p > 0.05), at all stimulus levels. This result suggests a vertical electrode montage could be used to counter some of the loss in wave V amplitude observed when using MLS stimuli.
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from Audiology & Neuro-Otology
Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant progressive myopathy, characteristically associated with a 4q35 deletion. In the unusual infantile-onset form of this degenerative disease, sensorineural hearing loss is a frequent clinical manifestation, whereas in patients with typical late-onset FSHD, investigations regarding hearing impairment yielded controversial results. We describe the findings of a multicenter investigation on possible auditory impairment in a series of 73 FSHD patients with a genetically confirmed diagnosis. Among them, 49 cases with no risk factors for deafness, aside from the disease, were identified by a clinical questionnaire and otoscopic examination (mean age 37.8 years, 31 males and 18 females). These subjects were evaluated by pure-tone audiometry. None were aware of hearing loss, while 4 had raised unilateral or bilateral pure-tone audiometric thresholds at 4000 and 8000 Hz, when evaluated by standardized tables. However, the mean raw pure-tone audiometric threshold values for these 49 cases were not significantly different from those of 55 controls (mean age 37.1 years, 32 males and 23 females). Moreover, by statistical analysis, age of onset, degree of muscular weakness and 4q35 EcoRI fragment size made no significant difference to auditory thresholds in our FSHD patients. Overall, the results of our multicenter study suggest that hearing loss in typical FSHD is not more prevalent than in the normal population.
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from Audiology & Neuro-Otology
Healthy patients with asymmetric sensorineural hearing loss who had received examination of auditory brainstem responses (ABR) were gathered for retrospective analysis. The effects of sex, age and hearing asymmetry on the interaural differences of ipsilateral ABR were determined by multivariant linear regression. Our results showed that the interaural differences of ABR wave III and wave V latencies were significantly affected by hearing asymmetry but not by sex or age. However, in female subjects younger than 50 years, differences of III-V intervals could be negatively correlated with hearing asymmetry. We suggest that plasticity in the auditory brainstem in younger females might account for asymmetrical peripheral hearing in this group.
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from Audiology & Neuro-Otology
The effect of noise on auditory steady-state response (ASSR) has not been systematically studied, despite the fact that ASSR thresholds are sometimes measured in noisy environments. This study examined the effects of noise (speech babble) on the ASSR thresholds obtained from 31 normal hearing adults aged from 17 to 36 years (mean = 25 years). The ASSR thresholds at 0.5, 1, 2 and 4 kHz were measured in the right ear only using the Biologic MASTER system twice in quiet and in the presence of 55 dB A and 75 dB A of speech babble. The results showed no change in mean ASSR thresholds across the test-retest conditions in quiet. The mean ASSR thresholds obtained in the quiet conditions were 23.8, 22.5, 18.2 and 20.4 dB HL at 0.5, 1, 2 and 4 kHz, respectively. No significant shift in ASSR thresholds across all test frequencies was found when 55 dB A of speech babble was presented. However, when 75 dB A of noise was applied, the mean ASSR thresholds were significantly shifted by 9.5, 3.8, 4.2 and 5.8 dB at 0.5, 1, 2 and 4 kHz, respectively.
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from Clinical Linguistics and Phonetics
Recent brain mapping studies have provided new insights into the cortical systems that mediate human speech perception. Electrocortical stimulation mapping (ESM) is a brain mapping method that is used clinically to localize cortical functions in neurosurgical patients. Recent ESM studies have yielded new insights into the cortical systems that mediate speech perception and how these systems vary as a function of individual differences. ESM methods are described and findings from recent ESM studies of speech perception are reviewed. The clinical implications of these findings are discussed as they relate to current understanding of how individual differences in listening abilities are reflected in the underlying cortical representations.
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from Clinical Linguistics and Phonetics
In a previous study, Parisse suggested that subject dislocations in French language (e.g. "la fille elle dort") could be considered as a marker of morphosyntactic development in children with normal language development. The present study aimed to develop this proposition and to confirm it with experimental data, more specifically the fact that this development would go through a four-step process. Our prediction was that children could produce forms that correspond to successive steps in the developmental process (for example, forms [1] and [2], or [2] and [3]), but not forms that were very different (for example, forms [1] and [4], or [2] and [4]). In order to test this hypothesis, a sentence repetition task was administrated to 27 children aged 4 to 5. The results confirm the presence of a developmental trend in the use of dislocation in spontaneous language. At age 4, dislocations were frequent (30%), and tended to respect the gender (stage 3 and 4). At age 5, dislocations were rare (stage 4). Previous stages (1 and 2) would be observed in younger children.
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from Journal of Learning Disabilities
The majority of high-stakes tests from elementary school through postsecondary education include the timed impromptu essay as a measure of writing performance. For adolescents with writing disorders, this type of evaluation often presents a significant barrier. The purpose of the current study was twofold. First, we investigated the influence of handwritten, typed, and typed/edited formats of an expository essay on the quality scores received by students with (n = 65) and without (n = 65) dyslexia. Second, we examined the contribution of spelling, handwriting, fluency, and vocabulary complexity to the quality scores that students with and without dyslexia received on the same writing task. Analyses indicated that vocabulary complexity, verbosity, spelling, and handwriting accounted for more variance in essay quality scores for writers with dyslexia than for their typically achieving peers. Both group and individual student outcomes are reported to better understand the needs of struggling writers with dyslexia. Implications for assessment, instruction, and accommodations are discussed with an eye toward reform efforts that target improved teaching and learning.
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from Journal of Learning Disabilities
The double-deficit hypothesis acknowledges both phonological processing deficits and serial naming speed deficits as two dimensions associated with reading disabilities. The purpose of this study was to examine these two dimensions of reading as they were related to the reading skills of 29 Spanish average readers and poor readers (mean age 9 years 7 months) who met the criteria for either single phonological deficit (PD), double deficit (DD), or no deficit. DD children were the slowest readers and had the weakest orthography processing skills. No significant differences were found between PD and DD groups on word and pseudoword reading. Word reading and reading comprehension skills were average or above average in the three studied groups. As in previous studies in transparent orthographies, word reading was not a salient problem for Spanish poor readers, whereas for the DD group, reading speed and orthographic recognition skills were significantly affected.
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from Journal of Learning Disabilities
In this study, we aimed to ascertain whether it is possible to create reading contexts that eliminate the impact of word recognition on reading comprehension and permit pupils with reading disabilities (RD) to attain a level of comprehension similar to that of their peers without RD. Specifically, the study compared a traditional reading situation with one of reading with aids (joint reading). In both situations, pupils' comprehension level was assessed by means of a summary and a series of inferential questions, and we controlled the effect on comprehension of word recognition, previous knowledge, rhetorical competence, and working memory. The results showed that the aids provided during reading do not eliminate the effect of word recognition, but they do permit readers with RD to attain a comprehension level similar to that of their peers.
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from Clinical Neurophysiology
Objective
The effects of within stimulus presentation rate and rise time on basic auditory processing were investigated in children with reading disabilities and typically reading children.
Methods
Children with reading disabilities (RD; N = 19) and control children (N = 20) were studied using event-related potentials (ERPs). Paired stimuli were used with two different within-pair-intervals (WPI; 10 and 255 ms) and two different rise times (10 and 130 ms). Each stimulus was presented with equal probability and long between-pair inter-stimulus intervals (1–5 s). The study focused on N1 and P2 components.
Results
The P2 responses to the first tone in the pair showed differences between children with RD and control children. Also, children with RD had larger N1 response than control children to stimuli with short WPI and long rise time.
Conclusions
These results provide evidence for basic auditory processing abnormalities in children with RD. This processing difference could be related to extraction of stimulus features from sounds or to attentional mechanisms.
Significance
Our results show support for behavioral findings that children with RD and control children process rise times differently. More than half of children with RD showed atypical auditory processing.
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from the Journal of Neurosphysiology
Attending to a visual or auditory stimulus often requires irrelevant information to be filtered out, both within the modality attended, and in other modalities. For example, attentively listening to a phone conversation can diminish our ability to detect visual events. We used functional magnetic resonance imaging to examine brain responses to visual and auditory stimuli while subjects attended visual or auditory information. Although early cortical areas are traditionally considered uni-modal, we found that brain response to the same ignored information depended on the modality attended. In early visual area V1, responses to ignored visual stimuli were weaker when attending another visual stimulus, as compared to attending an auditory stimulus. The opposite was true in more central visual area MT+, where responses to ignored visual stimuli were weaker when attending an auditory stimulus. Furthermore, fMRI responses to the same ignored visual information depended on the location of the auditory stimulus, with stronger responses when the attended auditory stimulus shared the same side of space as the ignored visual stimulus. In early auditory cortex, responses to ignored auditory stimuli were weaker when attending a visual stimulus. A simple parameterization of our data can describe the effects of redirecting attention across space within a modality (spatial attention) or across modalities (cross-modal attention), and the influence of spatial attention across modalities (cross-modal spatial attention). Our results suggest that the representation of unattended information depends on whether attention is directed to another stimulus in the same modality, or the same region of space.
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from Otology and Neurotology
"Objectives: To validate the prognostic capacity of several preoperative and intraoperative parameters of hearing preservation after vestibular schwannoma surgery.
Study Design: A retrospective study of a consecutive series of 29 patients treated with the enlarged middle cranial fossa approach. Quantitative parameters were tumor volume, linear tumor size, pure-tone and speech audiometry, pure-tone average, speech discrimination score, speech reception threshold, auditory brainstem response (ABR; intra-aural interpeak latency I-V, interaural wave V latency difference), and the vestibular caloric test (speed and frequency). Qualitative parameters were fundus involvement by the tumor (in magnetic resonance imaging and surgical record), nerve of tumor origin (in magnetic resonance imaging and surgical record), ABR parameters (well-shaped ABRs: waves I, III, and V present; presence of wave V).
Methods: All patients were divided into 2 groups on the basis of postoperative hearing: preserved hearing (55%) or nonpreserved hearing (45%). The Kolmogorov-Smirnov test was used to evaluate normality of distribution for continuous data. The t test was applied for normally distributed continuous data and the Mann-Whitney test for nonnormally distributed continuous data. The [chi]2 test was used for comparisons of categoric data.
Results: Tumor volume was found to be the only statistically significant prognostic parameter for hearing preservation (p = 0.007). The cutoff point for the "critical" tumor volume for hearing preservation was calculated to 0.20 cm3. None of the other parameters reached statistical significance.
Conclusion: Tumor size is a predictive factor for hearing preservation after vestibular schwannoma surgery, and patients with smaller tumors, based on volume measurement, have significantly better chances for retaining hearing. This has an impact on decision making and timing of surgery."
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from Otology and Neurotology
"Objective: To evaluate the efficiency of the rehabilitative protocols in patients with labyrinthine hypofunction, focusing on computerized dynamic visual acuity test (DVAt) and Gaze stabilization test (GST) specifically evaluating the vestibulo-oculomotor reflex (VOR) changes due to vestibular rehabilitation.
Design: Consecutive sample study.
Setting: Day hospital in Ears, Nose, and Throat Rehabilitation Unit.
Subjects: Thirty-two patients with chronic dizziness with a mean age of 60.74 years.
Intervention: Patients performed one cycle of 12 daily rehabilitation sessions (2 h each) consisting of exercises aimed at improving VOR gain. The rehabilitation program included substitutional and/or habitudinal exercises, exercises on a stability platform, and exercises on a moving footpath with rehabilitative software.
Main Measures: Dizziness Handicap Inventory and Activities-specific Balance Confidence Scale. Computerized dynamic posturography, computerized DVAt, and GST.
Results: The patients significantly improved in all the tests.
Conclusion: Vestibular rehabilitation improved the quality of life by reducing the handicap index and improving the ability in everyday tasks. The recovery of the vestibular-ocular reflex and vestibular-spinal reflex efficiency was objectively proven by instrumental testing. The DVAt and the GST allow to objectively quantify the fixation ability at higher frequencies and speeds (main VOR function). Moreover, these new parameters permit to completely evaluate vestibular rehabilitation outcomes, adding new information to the generally used tests that only assess vestibulospinal reflex."
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from NIH
The purpose of this RFA is to promote multidisciplinary collaborative research teams to investigate tinnitus, and not research that consists of only one discipline. Applications that do not demonstrate a collaborative approach across two or more disciplines are not being solicited under this RFA and will be returned.
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from Otology and Neurotology
Objective: To compare the initial referral rate, the accurate identification rate of congenital hearing loss, and the cost between one step with transient evoked otoacoustic emissions (TEOAEs), two steps with TEOAE and automated auditory brainstem response (AABR), and one step with AABR in newborn hearing screening program. The aim of this study is to compare their efficacy between our three different protocols and to see which one is most cost-effective.
Study Design: From November 1998 to April 2006, 25,588 healthy newborns were screened for hearing loss in Mackay Memorial Hospital, Taipei. In the periods from November 1998 to January 2004, from February 2004 to February 2005, and from March 2005 to April 2006, the screening tools used were TEOAE alone (n = 18,260), TEOAE plus AABR (n = 3,540), and AABR (n = 3,788), respectively.
Results: A statistically significant decrease in referral rate was achieved in the group using AABR as screening tools when compared with TEOAE plus AABR and TEOAE alone (0.8 versus 1.6 versus 5.8%). The accurate identification rate of congenital hearing loss was 0.42% in AABR protocol, 0.25% in TEOAE and AABR protocol, and 0.45% in TEOAE protocol, which was not statistically significant. The total direct costs (including predischarge screening and postdischarge follow-up costs) per screening were US $10.04 for the program using TEOAE alone, US $8.60 for TEOAE plus AABR, and US $7.33 for AABR. The intangible cost (parental anxiety) was much higher in the earlier program due to higher referral rate.
Conclusion: In the efficacy of the hearing screening program using the one-step TEOAE, two-step TEOAE and AABR, and one-step AABR programs, the latter significantly decreased the referral rate from 5.8, to 1.6, and to 0.8%. No significant difference was noted between their accurate identification rates of congenital hearing loss. The total costs, including expenditures and intangible cost, were much lower in the protocol with AABR due to reduction in false positives.
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from Otology and Neurotology
Objective: To identify patients developing positional vertigo after cochlear implantation.
Study Design: Prospective study on a cohort of patients undergoing cochlear implantation.
Setting: Academic tertiary referral center.
Patients: The study included 70 consecutive patients who underwent vestibular evaluation before and after cochlear implantation.
Intervention: Medical record review.
Main Outcome Measure: Recorded vestibular symptoms after cochlear implantation. Patients with positional vertigo were considered case subjects, whereas those without vestibular symptoms were considered case controls.
Results: Benign paroxysmal positional vertigo (BPPV) occurred in 8 patients (on the cochlear implant [CI] side in 7 patients, and in the other ear in 1). One patient had BPPV of the lateral semicircular canal on the implanted side, and 7 patients had BPPV of the posterior semicircular canal (on the same CI side in 6 patients, and on the opposite side in 1), which were detected and presented during the last examination. In 5 patients, the onset of symptoms varied from 7 to 130 days after implant activation; in 2 patients, the onset occurred before activation.
Conclusion: Three different mechanisms are proposed for the occurrence of BPPV in patients with CI. The first focuses on the fall of bone dust particles into the cochlea during cochleostomy. In the second, the vibration caused by drilling the cochlea would be sufficient to dislodge otoconia into the labyrinth. The third hypothesis suggests dislodging of an otolith because of the electric stimulation. In our patients, conservative approaches have been used with a minimal invasive cochleostomy and without perilymph suction. Thus, the vibratory trauma affecting the cochlea during cochleostomy seems to play a fundamental role in the development of paroxysmal vertigo in patients with implant.
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from Otology and Neurotology
Objectives: To follow changes in transient evoked and distortion product otoacoustic emissions (TEOAEs, DPOAEs) as they relate to pure-tone audiometry (PTaud) thresholds during the first 2 years of occupational noise exposure.
Design: Prospective controlled.
Methods: Pure-tone audiometry thresholds, TEOAE and DPOAE amplitudes, and contralateral medial olivocochlear reflex strength were repeatedly evaluated during 2 years and compared between and within a cohort of 135 ship engine room recruits and a control group of 100 subjects with no noise exposure.
Results: Pure-tone audiometry thresholds for 2,000, 3,000 and 4,000 Hz in both ears were significantly elevated in the study group after 2 years of noise exposure. Significantly lower TEOAE amplitudes were found at 2,000 Hz in the right ear and 2,000 and 4,000 Hz in the left ear. Longitudinal intrasubject analysis of the study group revealed significant reductions of TEOAE amplitudes at 2,000 to 4,000 Hz in both ears and reduced DPOAE amplitudes for 5,957 Hz in the right ear and 3,809, 4,736, and 5,957 Hz in the left ear in the second follow-up evaluation. Baseline medial olivocochlear reflex strength showed no correlation to PTaud thresholds after 2 years of noise exposure. Poor to moderate negative linear correlations (r = -0.07 to -0.37) were found between the DPOAE-averaged amplitudes at 2,979 to 5,957 Hz and PTaud threshold means at 3,000 to 6,000 Hz. Abnormal TEOAE parameters after the first year of noise exposure had high sensitivity (86-88%) and low specificity (33-35%) for the prediction of noise-induced hearing loss (NIHL) after 2 years.
Conclusion: The DP-gram is not significantly correlated with PTaud and cannot be used as an objective measure of pure-tone thresholds in early NIHL. Medial olivocochlear reflex strength before the beginning of chronic exposure to occupational noise has no relation to individual vulnerability to NIHL. Although TEOAEs changes after 1 year showed high sensitivity in predicting NIHL after 2 years of exposure, they cannot be recommended as an efficient screening tool due to high false-positive rates.
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from Otology and Neurotology
Hypothesis: Different methods of pure-tone audiometry analysis in sudden hearing loss studies show a lack of agreement with respect to outcome, and the choice of outcome measure influences sample size calculation.
Background: There is an increasing number of clinical reports on the treatment of sudden hearing loss. For comparison of efficacy between different therapies and for meta-analysis, it is important to consider the outcome measures in different studies. Statistical analysis for comparison of different outcome measures is used in this study.
Materials and Methods: Controlled clinical studies on the therapy for idiopathic sudden sensorineural hearing loss (ISSHL) were reviewed with respect to their choice of measurement method for the primary endpoint based on pure-tone audiometry. A selection of outcome measures, including different frequencies evaluated, absolute and relative hearing improvement, and different criteria for success, were compared by applying them on the same patient population treated for ISSHL. Agreement between different clinical outcome measures was assessed by using a method described by Bland and Altman. Based on the change in hearing level in the patient population, sample sizes were calculated for various outcome measures and for different criteria of hearing improvement.
Results: In 52 controlled studies on the systemic treatment of ISSHL, more than 40 different outcome measures for the primary endpoint were identified. Comparison of measurement methods showed no acceptable agreement between most absolute and relative measures of hearing improvement and between endpoints on the basis of different criteria of success. The differences in outcome in the treatment of ISSHL were more affected by the definition of success than by frequencies included in the pure-tone average. Estimated sample sizes for controlled clinical trials varied substantially with the choice of outcome measure.
Conclusion: The lack of an acceptable agreement between most measurement methods assessed in this report prevents a meaningful comparison of published clinical studies on ISSHL. For comparison of efficacy between different treatments in ISSHL and for the planning of controlled clinical trials, it is necessary to agree on standardized outcome measures, including the frequencies averaged and the criteria of success.
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from Otology and Neurotology
Objective: To describe a simple technique for implant receiver/stimulator (ICS) fixation that uses a seat for the device and suture fixation through the native cranial periosteum. This technique has been used through minimal-access surgical techniques in children since 2003.
Patients: One hundred sixty pediatric cochlear implant recipients.
Intervention: Implantation using the described technique for ICS fixation.
Main Outcome Measure: Postoperative complications related to ICS fixation.
Results: No complications have been observed.
Conclusion: This report describes a simple and effective technique to secure the ICS package for pediatric cochlear implant surgery.
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from Otology and Neurotology
Objective: To assess the impact and the subjective benefit of Bone-anchored Hearing Aid (BAHA) implementation in patients with hearing impairment combined with moderate mental retardation.
Study Design: Case control study using two validated patient-oriented instruments.
Setting: Tertiary referral center.
Patients: Twenty-two patients with moderate mental retardation and conductive or mixed hearing loss.
Intervention: Rehabilitative.
Main Outcome Measures: Subjective benefit, listening and learning capabilities.
Results: BAHA implementation in patients with moderate mental retardation, by using the Glasgow Children's Benefit Inventory and the Listening Inventory for Education, showed a subjective benefit, which was comparable with that of the control group and was consistent with the results of earlier studies.
Conclusion: The use of BAHA proved beneficial in most patients with hearing impairment and moderate mental retardation. Extending the indications for BAHA application to this special patient group shows to be a very valuable option.
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from Otology and Neurotology
Objective: The aim of this study was to assess the incidence of balance problems after acoustic neuroma surgery, evaluating whether disequilibrium is disabling.
Study Design: Retrospective observational study.
Setting: Rehabilitation center.
Patients: A group of 386 patients who underwent acoustic neuroma surgery.
Interventions: Patients were selected from a population of 459 subjects who had undergone surgery for acoustic neuroma.
Mean Outcome Measures: The Dizziness Handicap Inventory, The Activities-specific Balance Confidence Scale (ABC), and a specific questionnaire on oscillopsia.
Results: The specific questionnaire emphasized that 39 patients (10.10%) perceived disequilibrium as disabling, and the oscillopsia handicap score result was moderate in 73.32% of the sample, mild in 21.50%, and severe in 5.18% of patients.
The Dizziness Handicap Inventory and ABC scales revealed the presence of handicap and disability due to disequilibrium and the influence of some variables such as sex and a higher oscillopsia handicap score. Dizziness Handicap Inventory and ABC scores were higher in symptomatic patients.
Conclusion: Disequilibrium influences handicap and disability after acoustic neuroma surgery. This symptom is also present after several years since surgery, and some patients perceived disequilibrium as disabling.
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from Otology and Neurotology
Objective: The goals of this study were to validate the clinical diagnosis of autonomic dizziness as a cause of chronic nonvertiginous dizziness that may be exacerbated by physical exertion or orthostatic challenges, estimate its prevalence in a tertiary referral population, and investigate the usefulness of three autonomic challenges as objective tests for this condition.
Study Design: Laboratory investigation of autonomic activity.
Setting: Tertiary care balance center.
Patients: Fifteen men and women with symptoms indicative of autonomic dizziness. Subjects with other causes of dizziness, histories of syncope, or psychiatric disorders were excluded.
Interventions: Autonomic tests included 45 minutes of head upright tilt (HUT), 20 minutes of 5% CO2 inhalation and then HUT, and 2 minutes of voluntary hyperventilation and then HUT.
Main Outcome Measures: Patterns of cardiovascular and respiratory responses and subjective ratings of dizziness, autonomic symptoms, and anxiety during autonomic challenges.
Results: Twelve subjects had evidence of autonomic dysfunction, including 10 with abnormal heart rate, blood pressure, or respiratory responses to HUT. Two other subjects had prolonged hypocarbia after voluntary hyperventilation. Many of these abnormalities would have been missed by current autonomic testing paradigms. In one subject, CO2 inhalation revealed latent anxiety. In two subjects, the presence of high symptom ratings without objective autonomic dysfunction prompted a successful search for other diagnoses.
Conclusion: Study results validated the clinical syndrome of autonomic dizziness. Autonomic testing protocols may have to be updated to detect clinically relevant abnormalities in patients with dizziness.
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from the Indian Journal of Medical Research
BACKGROUND & OBJECTIVE: Hearing impairment is one of the associated problems seen particularly in children with cleft palate rather than cleft lip alone. This has received very little attention in the area of cleft care although research shows that hearing impairment affects language development The present study was carried not to find out the type and pattern of audiogram in cases attending a speech camp, average degree of hearing loss and its relation to the side of cleft, and the acoustic immittance findings and its relation to the otological evaluation. The parental awareness about the hearing problem was also assessed. METHODS: The study was conducted on cleft palate patients attending a speech camp. In all, there were 43 patients (19 males and 24 females) in the age range of 3-22 yr. All had undergone audiological assessment, speech and language evaluation, and otological evaluation using standard procedures. RESULTS: Hearing loss was seen in 38 (88.38%) patients. It was the first audiological assessments they ever had. The average pure tone Thresholds revealed a reverse-ski pattern with a wide air-bone gap. The degree of hearing loss ranged from 25 to 68 dB indicating that untreated otitis media resulted in moderate to moderately severe degree of hearing loss. The immittance findings supported the extent of extracranial complications identified on otoscopic examination. There were more patients with unilateral cleft of the left side with greater hearing loss in the ear alongside the cleft. INTERPRETATION & CONCLUSION: Hearing loss is prevalent in more than three - forth of the patients attending the speech camp. There is a need for early identification and intervention of middle ear effusion for all cleft palate cases.
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from Clinical Neurophysiology
Abstract
Objective
We aimed to examine relationships between the phase of narrow-band electroencephalographic (EEG) activity at stimulus onset and the resultant event-related potentials (ERPs) in active vs. passive auditory oddball tasks, using a novel conceptualisation of orthogonal phase effects.
Methods
This study focused on the operation of three recently-reported phase-influenced mechanisms, and ERP responses to the standard stimuli were analysed. Prestimulus narrow-band EEG activity (in 1 Hz bands from 1 to 13 Hz) at Cz was assessed for each trial using digital filtering. For each frequency, the cycle at stimulus onset was used to sort trials into four phases, for which ERPs were derived from both the filtered and unfiltered EEG activity at Fz, Cz and Pz.
Results
Preferred brain states at various frequencies were indicated by approximately 20% differential occurrence within the orthogonal phase dimensions explored.
Conclusions
The preferred states were associated with more efficient processing of the stimulus, as reflected in differences in latency and/or amplitude of various ERP components, and provided evidence for the operation of the three separate phase-influenced mechanisms.
Significance
Both the occurrence of preferred brain states, and the mechanisms linking them to ERP outcomes focused on here, appeared relatively invariant across tasks, suggesting that they largely reflect reflexive brain processes
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from NeuroReport
Abstract:
Single case and anatomo-correlative studies of aphasic participants have indicated that lesions in temporal regions cause predominant noun impairment, whereas lesions in frontal areas affect verb processing. These studies, however, relied mostly on arbitrary cut-offs, grouping participants according to whether or not they showed a noun or a verb deficit. Here, instead, we applied a recent anatomo-correlation technique, voxel-based lesion symptom mapping (VLSM) to a group of 16 left-hemisphere stroke participants tested on noun and verb naming tasks. Behavioral and lesion data were collected continuously without establishing a priori two different groups of participants. Noun naming was associated with regions located in the left superior temporal areas, whereas verb naming involved a larger region extending from the left prefrontal to the superior temporal areas. The differences and similarities of the two networks are discussed.
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from Docuticker
Despite the theoretical importance mother’s time with children plays in the literature on children’s intellectual development, few studies have identified a significant relationship between the time children spend with mothers and their cognitive outcomes. This study uses children’s time diaries from the Child Development Supplement of the Panel Study of Income Dynamics to investigate the effect of the quantity and intensity of maternal care during early childhood on children’s later cognitive test scores (N = 1,008). Results show that the time mothers spend with children is positively correlated with verbal scores for children with verbally skilled mothers and that the influence of early maternal care has a persistent effect on later test scores even after lagged tests are controlled. The intensity of care or the percentage of total care devoted to active engagement is positively associated with development of analytic skills for children with skilled mothers. The findings suggest that children of mothers with better verbal skills benefit the most from spending more time with mothers. The findings also suggest that children can acquire verbal skills through passive interaction with verbally skilled mothers as well as through active interactions. On the other hand, the development of analytical skills may require more intense and direct involvement. Taken together, the results point to time use as a means of social reproduction—time with children is a pathway though which highly skilled mothers impart their human capital to their children.
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from Brain and Language
In 1906, Pierre Marie triggered a heated controversy and an exchange of articles with Jules Déjerine over the localization of language functions in the human brain. The debate spread internationally. One of the timeliest responses, that appeared in print 1 month after Marie’s paper, came from Christofredo Jakob, a Bavarian-born neuropathologist working in Buenos Aires. The present study comprises an English translation of Jakob’s 1906 paper and a discussion of Jakob’s ideas on the localizationist–holistic approach regarding the role of Broca’s area. This issue is still at the core of scientific debate in the light of current neuropsychological and neuroimaging findings.
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from Brain and Language
This paper investigates stress assignment in Dutch aphasic patients in non-word repetition, as well as in real-word and non-word reading. Performance on the non-word reading task was similar for the aphasic patients and the control group, as mainly regular stress was assigned to the targets. However, there were group differences on the real-word reading and non-word repetition tasks. Unlike the non-brain-damaged group, the patients showed a strong regularization tendency in their repetition of irregular patterns. The patients’ stress error patterns suggest an impairment in retention or retrieval of targets with irregular stress patterns. Limited verbal short-term memory is proposed as a possible underlying cause for the stress difficulties.
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from the International Journal of Pediatric Otorhinolaryngology
Objective
This study compares etiological factors for hearing loss, relevant neuro-sensory impairments and demographics between two groups of children referred for early hearing habilitation in Israel. Group I was referred in the years 1986–1987 (n = 73) and group II was referred during 2001 (n = 73).
Methods
Family history, pregnancy, risk factors, developmental milestones, medical history, auditory brainstem response, tympanometry, otoacoustic emissions and behavioral audiometric results were retrospectively retrieved in 2003 from medical records at the MICHA Society for Deaf Children in Israel.
Results
New referrals per year have doubled themselves over the 15 years that elapsed between 1986–1987 and 2001. No changes in gender and age at time of admission were found. The prevalence of mild-to-moderate hearing loss was higher in Group II while severe and profound hearing loss was more prevalent in Group I. Assisted reproductive technologies were involved only in Group II. There were more twin births and post-natal hypoxia in Group II. Rh incompatibility was reported only in Group I. Severe hearing loss was associated with younger age at admission. No significant associations were found between age at admission and etiology with the exception of the fact that children with genetic background were admitted at an earlier age. Since no significant association between genetic background and severity of hearing loss was found, it is conclude that the association between severity of hearing loss and age at admission did not account for changes in etiology in our sample.
Conclusions
Classic risk factors for hearing loss among infants and toddlers have not changed much over time, and the few changes that have been noticed are probably due to expanded medical knowledge and improved technologies.
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from the International Journal of Pediatric Otorhinolaryngology
We present a pediatric case report of cisplatin-induced ototoxicity with subsequent recovery. The patient experienced tinnitus and fluctuating mild high-frequency sensorineural hearing loss (SNHL) with a concomitant decrease in distortion product otoacoustic emissions (DPOAE). There was recovery of hearing loss and return of DPOAE at 1 year after completion of cisplatin therapy. Reports of recovery from cisplatin-induced ototoxicity in humans are limited in the literature, especially in the pediatric population. A review of cisplatin ototoxicity and mechanisms of recovery are discussed, with an emphasis on the particular chemotherapy regimen and dosing schedule in this case, given at 4–11 week intervals.
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from Neurobiology of Learning and Memory
Learning modifies the primary auditory cortex (A1) to emphasize the processing and representation of behaviorally relevant sounds. However, the factors that determine cortical plasticity are poorly understood. While the type and amount of learning are assumed to be important, the actual strategies used to solve learning problems might be critical. To investigate this possibility, we trained two groups of adult male Sprague–Dawley rats to bar-press (BP) for water contingent on the presence of a 5.0 kHz tone using two different strategies: BP during tone presence or BP from tone-onset until receiving an error signal after tone cessation. Both groups achieved the same high levels of correct performance and both groups revealed equivalent learning of absolute frequency during training. Post-training terminal “mapping” of A1 showed no change in representational area of the tone signal frequency but revealed other substantial cue-specific plasticity that developed only in the tone-onset-to-error strategy group. Threshold was decreased 10 dB and tuning bandwidth was narrowed by 0.7 octaves. As sound onsets have greater perceptual weighting and cortical discharge efficacy than continual sound presence, the induction of specific learning-induced cortical plasticity may depend on the use of learning strategies that best exploit cortical proclivities. The present results also suggest a general principle for the induction and storage of plasticity in learning, viz., that the representation of specific acquired information may be selected by neurons according to a match between behaviorally selected stimulus features and circuit/network response properties.
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from Noise and Health
Industrial hearing loss has generally been associated with noise exposure, but there is a growing awareness that industrial solvents can have an adverse effect on the auditory and vestibular systems in man. Both animal experiments and human studies point to an ototoxic effect of industrial solvents, as well as some central auditory and vestibular disturbances. This review examines the research from the last four decades in an attempt to get an overview of the available evidence. Research shows that industrial solvents are ototoxic in rats. The majority of the solvents studied cause a loss of auditory sensitivity in the mid-frequencies in rats, affecting outer hair cells in the order OHC 3 > OHC 2 > OHC 1 . Inner hair cells are generally unaffected. Spiral ganglion cells are most vulnerable to trichloroethylene. Simultaneous exposure to solvents and noise results in a synergistic effect; the pattern of trauma mirrors that due to solvent exposure rather than noise, but is more enhanced. There is a critical level when synergy occurs. The effects of solvents on the vestibular system are neurotoxic and influence the vestibulo-oculomotor system in both animals and humans; humans also present with problems in postural sway. There is a strong suggestion from human studies that solvents are ototoxic in man, but findings show that both the peripheral and central auditory pathways can be affected. Hearing losses can be in the high frequency region or can affect a wider range of frequencies. Hearing loss and balance disturbances can occur at levels below permitted levels of exposure. The synergistic effect of combined exposure to solvents and noise has also been noted in humans, resulting in greater hearing losses than would be expected from exposure to noise and solvents alone. The findings from both human and animal studies indicate that exposure to industrial solvents or to industrial solvents and noise can have an adverse effect on hearing and balance. The implications for industry and hearing conservation are far reaching.
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from Acta Acoustica united with Acustica
In speech recognition under a noisy environment, a system is needed that can reduce noise, while enhancing speech. The human auditory system has an excellent analytical spectrum mechanism for speech enhancement. Accordingly, this paper proposes an adaptive method which is inspired by known human auditory mechanism, called lateral inhibition. This method first estimates noise intensity using a neural network, then adjusts frame by frame the coefficients of both the lateral inhibition and the amplitude component according to the noise intensity for each input frame. The proposed system is compared with the results of a conventional spectral subtraction method and minimum mean-square error log-spectral amplitude (MMSE-LSA) estimator at different noise levels. Experiments confirm that the proposed system is effective for speech degraded by various noises using objective (global SNR and spectral distortion) and subjective mean opinion score (MOS) evaluations.
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from Medical News Today.com
Quark Pharmaceuticals, Inc., a clinical-stage biopharmaceutical company focused on discovering and developing novel RNA interference-based therapeutics, announced that it has expanded its relationship with the State University of New York at Buffalo, Center for Hearing & Deafness, which is the Company's primary site for the pre-clinical studies of its product candidate, AHLi-11, for the treatment of acute hearing loss. Quark initiated its collaboration with the State University of New York in 2005.
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from the American Journal of Alzheimer's Disease and Other Dementias
Reported here is a new missense mutation V363I in exon 12 of the microtubule-associated protein tau (MAPT) gene associated with progressive nonfluent aphasia, with onset at the age of 69 years in a woman. Although near mute, she maintained complex activities and had no discernible deficits outside of language until the age of 75 years, when progressive gait and swallowing disturbances appeared. There was a history of late-onset aphasia and apraxia in her father. All of her children were asymptomatic adults, but psycholinguistic abnormalities were detected in those bearing the mutation, consisting of difficulties in comprehension, both reading (symbol discrimination and comprehension of oral spelling) and oral (matching sentences to pictures and comprehension of locative relationships). A mutation-bearing sibling showed no abnormalities at 70 years old, consistent with the limited penetrance expected in late-onset disease. The mutation, corresponding to a highly conserved residue in the fourth tubulin-binding repeat, was not present in 194 normal individuals with the same genetic background.
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from EurekAlert.org
A major function of speech is the communication of intentions. In everyday conversation between adults, intentions are conveyed through multiple channels, including the syntax and semantics of the language, but also through nonverbal vocal cues such as pitch, loudness, and rate of speech.
The same thing occurs when we talk to infants. Regardless of the language we speak, most adults, for example, raise their voices to elicit the infant’s attention and talk at a much slower rate to communicate effectively. In the scientific community, this baby talk is termed “infant-directed speech.”
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from the Journal of Geriatric Psychiatry and Neurology
Primary Progressive Aphasia (PPA) is a clinical dementia syndrome in which language functions decline over time while other cognitive domains remain relatively preserved for at least 2 years. Because PPA patients suffer progressive interference with communication despite relatively preserved memory, reasoning, and insight, there is reason to believe they may experience depression. Geriatric Depression Scale (GDS) scores from PPA patients and normal controls were compared, the relationship between GDS and neuropsychological test scores was examined, and responses to items on the GDS were explored and grouped by the GDS factor structure. A significant proportion of PPA patients scored in the clinically depressed range. Although PPA patients as a group were not clinically depressed, they reported more symptoms of depression than controls, and the number of symptoms correlated with severity of naming impairment in depressed PPA patients. Symptoms of social withdrawal and lack of mental and physical energy were most common, suggesting that patients with PPA should be evaluated for depression so that they may be appropriately treated. (J Geriatr Psychiatry Neurol 2007;20:153-160)
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from Trends in Amplification
During the last decade, cochlear implantation has evolved into a well-established treatment of deafness, predominantly because of many improvements in speech processing and the controlled excitation of the auditory nerve. Cochlear implants now also feature telemetry, which is highly useful to monitor the proper functioning of the implanted electronics and electrode contacts. Telemetry can also support the clinical management in young children and difficult cases where neural unresponsiveness is suspected. This article will review recent advances in the telemetry of the electrically evoked compound action potential that have made these measurements simple and routine procedures in most cases. The distribution of the electrical stimulus itself sampled by "electrical field imaging" reveals general patterns of current flow in the normal cochlea and gross abnormalities in individual patients; models have been developed to derive more subtle insights from an individual electrical field imaging. Finally, some thoughts are given to the extended application of telemetry, for example, in monitoring the neural responses or in combination with other treatments of the deaf ear.
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from Trends in Amplification
There are now many recipients of unilateral cochlear implants who have usable residual hearing in the non-implanted ear. To avoid auditory deprivation and to provide binaural hearing, a hearing aid or a second cochlear implant can be fitted to that ear. This article addresses the question of whether better binaural hearing can be achieved with binaural/bimodal fitting (combining a cochlear implant and a hearing aid in opposite ears) or bilateral implantation. In the first part of this article, the rationale for providing binaural hearing is examined. In the second part, the literature on the relative efficacy of binaural/bimodal fitting and bilateral implantation is reviewed. Most studies on comparing either mode of bilateral stimulation with unilateral implantation reported some binaural benefits in some test conditions on average but revealed that some individuals benefited, whereas others did not. There were no controlled comparisons between binaural/bimodal fitting and bilateral implantation and no evidence to support the efficacy of one mode over the other. In the third part of the article, a crossover trial of two adults who had binaural/bimodal fitting and who subsequently received a second implant is reported. The findings at 6 and 12 months after they received their second implant indicated that binaural function developed over time, and the extent of benefit depended on which abilities were assessed for the individual. In the fourth and final parts of the article, clinical issues relating to candidacy for binaural/ bimodal fitting and strategies for bimodal fitting are discussed with implications for future research.
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from Trends in Amplification
Learning electrically stimulated speech patterns can be a new and difficult experience for cochlear implant (CI) recipients. Recent studies have shown that most implant recipients at least partially adapt to these new patterns via passive, daily-listening experiences. Gradually introducing a speech processor parameter (eg, the degree of spectral mismatch) may provide for more complete and less stressful adaptation. Although the implant device restores hearing sensation and the continued use of the implant provides some degree of adaptation, active auditory rehabilitation may be necessary to maximize the benefit of implantation for CI recipients. Currently, there are scant resources for auditory rehabilitation for adult, postlingually deafened CI recipients. We recently developed a computer-assisted speech-training program to provide the means to conduct auditory rehabilitation at home. The training software targets important acoustic contrasts among speech stimuli, provides auditory and visual feedback, and incorporates progressive training techniques, thereby maintaining recipients' interest during the auditory training exercises. Our recent studies demonstrate the effectiveness of targeted auditory training in improving CI recipients' speech and music perception. Provided with an inexpensive and effective auditory training program, CI recipients may find the motivation and momentum to get the most from the implant device.
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from the Australian and New Zealand Journal of Audiology
The aim of this study was to examine the pattern of changes in distortion product otoacoustic emissions (DPOAEs) in children with ototoxic hearing loss during chemotherapy. The participants included a control group of 15 normal hearing children (3–12 years) and an experimental group of 7 paediatric oncology patients (1–13 years). Participants were tested using pure tone audiometry (PTA), tympanometry, and DPOAEs (primaries 65/55 dB SPL). The results revealed no perfect match between PTA and DPOAE results with respect to frequency and pattern of decrease/increase of DPOAE amplitudes. Further analysis of DPOAEs in the experimental group revealed three main patterns of change: (1) Concurrent decreases in DPOAEs that matched pure tone threshold (PTT) changes at approximately the same frequencies; (2) DPOAE changes prior to PTT change, suggesting possible predictive power in DPOAE testing and (3) DPOAE and PTT changes not related in terms of test frequency and direction of change, noted in a patient with a high cumulative carboplatin dose.
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from the Australian and New Zealand Journal of Audiology
Otitis media and associated hearing loss is endemic in Northern Territory Indigenous Australian children. While this ear disease is often preventable, it continues at prevalence rates estimated as high as 80%. In many cases, the use of a hearing aid is the best-practice intervention and often allows the wearer to hear family, friends and teachers. Yet, the use of hearing aids among Indigenous Australians is extremely low. This is the first study to investigate the ‘Hearing Aid Effect’ (HAE), which is the stigma associated with wearing a hearing aid, in an Indigenous Australian population. Participants in this study included 5 to 12-year-old Indigenous Australian children. Children viewed pictures of Indigenous children, of similar age, with and without visible hearing aids, and then rated their perceptions on an attitude scale. Participants were also involved in a learning-based intervention on the importance of wearing hearing aids. The results indicated a strong HAE. Indigenous Australian children had a more negative attitude towards peers who wore hearing aids in comparison to peers who did not wear hearing aids. Additionally, females tended to rate males more negatively than females on most questions. Males rated females more negatively on questions regarding friendship, sport and whether they can attend the same school. The intervention had a significant effect on the children's attitude toward hearing aids. The study results indicate that children of this early age have constructed characteristic stigmatisations concerning their peer's use of hearing aids.
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from the Australian and New Zealand Journal of Audiology
This article aims to (1) examine the impact of newborn hearing screening on age of hearing aid fitting, and (2) estimate the prevalence of permanent childhood hearing impairment and its profile across age and degree of impairment in Australia. The data were drawn from the Australian Hearing national database on all aided children under 21 years of age as at December 2006. The results indicated that children who were screened and diagnosed soon after birth were fitted by a median age of 3.4 months in New South Wales. The prevalence of moderate and more severe hearing loss (three-frequency average in the better ear of = 40 dB HL) rises from 1.04/1000 live births at 3 years of age to 1.57/1000 live births for children between 9 and 16 years of age. The prevalence of mild degrees of hearing loss (three-frequency average in the better ear < 40 dB HL) rises from 0.28/1000 live births at 3 years of age to 1.68/1000 live births at 9 years of age and older. The findings show that early detection leads to early amplification. The change in prevalence with age implies that newborn hearing screening needs to be supplemented by hearing screening at later ages of early childhood so that timely amplification can be provided.
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from the Australian and New Zealand Journal of Audiology
This study examined the effects of sleep on the slow and fast components of the auditory brainstem response (ABR) in a human subject. ABR waveforms, electroencephalogram and rectal temperature were recorded from 1 adult male during overnight sleep, and the slow and fast components of the ABR were extracted using a six-level over-complete discrete wavelet transform (OCDWT). Initial results suggested ABR wave V, and its corresponding slow and fast components, increased in latency during sleep stages 2 and 4 relative to the awake state, but autoregressive integrated moving average (ARIMA) time series analyses showed these increases were best explained by decreases in body temperature. These results support suggestions that decreases in body temperature during sleep result in an increase in both synaptic transmission and axonal conduction times in the 8th cranial nerve and auditory brainstem, and that these changes are reversible.
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from the Australian and New Zealand Journal of Audiology
Cortical auditory evoked potentials (CAEP) were recorded from ten normal-hearing infants, aged 3 to 7 months, using the natural speech segments /m/ and /t/. The aim was to investigate the effect of selected stimulus durations and inter-stimulus intervals (ISIs) on infant responses. In the first experiment, various stimulus durations were used but the ISI was fixed. Results showed no significant difference in the latency of the first positive peak (P1) with changes in stimulus duration, but there was a minor increase in amplitude when duration increased from short to medium length. In the second experiment, medium length stimuli were presented with various ISIs. Results showed that as the ISI increased, P1 latency was constant but its amplitude increased nonlinearly for /t/ only. It appears therefore, that for the selected speech stimuli there was no clear advantage in using stimulus durations beyond 35 ms and ISIs beyond 1125 ms in infant assessments.
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from the Australian and New Zealand Journal of Audiology
To date, most studies of bone anchored hearing Aid (BAHA) fitting in children have focused on long-term maintenance of osseointegration and objective audiological outcomes, with little attention given to more qualitative outcomes relating to day-to-day use. This study involved 8 participants, aged between 12 and 21 years, all of whom had worn a unilateral BAHA for at least 1 year. The aims of the study were to examine audiological, physical and psychosocial outcomes. Evaluation included audiometric testing, a semistructured interview, and two questionnaires (i.e., Glasgow Benefit Inventory and International Outcomes Inventory–Hearing Aids). Results revealed improvements in speech discrimination, sound quality and comfort for all participants. Improvements in confidence, self-image, and socialisation were also experienced. Participants expressed some dissatisfaction with localisation abilities, phone usage, and the lack of availability of ongoing service and support. Findings indicate that the BAHA offers audiological, physical and psychosocial benefits for paediatric wearers, resulting in high levels of satisfaction.
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from Archives of Otolaryngology--Head and Neck Surgery
Objective To compare the hearing results in patients with otosclerosis who underwent a stapedotomy with either a platinum wire prosthesis or a commercially available, heat-activated nitinol stapes piston prosthesis.
Design Retrospective medical chart review.
Setting Academic tertiary care medical center.
Patients Seventy-nine consecutive patients diagnosed as having otosclerosis who underwent primary stapedotomy (33 men and 46 women) were included in this study (41 ears per group).
Intervention Stapedotomy.
Main Outcome Measures The operative records of the senior surgeon (B.J.G.) were retrospectively reviewed, and hearing results were obtained. The hearing results of the patients who received a platinum wire prosthesis were compared with those who received a nitinol prosthesis.
Results Results for the platinum wire prosthesis group revealed a postoperative mean (SD) air-bone gap (ABG) of 7 (6) dB, a mean (SD) ABG closure of 21 (12) dB, and a postoperative mean (SD) speech reception threshold of 25 (16) dB. Results for the nitinol prosthesis group revealed a postoperative ABG of 8 (6) dB, an ABG closure of 25 (10) dB, and a postoperative speech reception threshold of 25 (12) dB.
Conclusions These data show that the nitinol prosthesis is equivalent to the platinum wire prosthesis in closing the ABG in patients with otosclerosis. Comparable efficacy combined with the ease and safety of heat-activated crimping supports the continued use of this prosthesis for stapes surgery.
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from Brain and Language
This paper investigates stress assignment in Dutch aphasic patients in non-word repetition, as well as in real-word and non-word reading. Performance on the non-word reading task was similar for the aphasic patients and the control group, as mainly regular stress was assigned to the targets. However, there were group differences on the real-word reading and non-word repetition tasks. Unlike the non-brain-damaged group, the patients showed a strong regularization tendency in their repetition of irregular patterns. The patients’ stress error patterns suggest an impairment in retention or retrieval of targets with irregular stress patterns. Limited verbal short-term memory is proposed as a possible underlying cause for the stress difficulties.
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from ORL--Journal for Oto-Rhino-Laryngology and Its Related Specialties
Aim: To compare bilateral (BSSHL) with unilateral (USSHL) sudden sensorineural hearing loss. Methods and Subjects: Two hundred and thirty-two patients with USSHL, 11 with simultaneous BSSHL and 7 with sequential BSSHL, who were older than 15 years had onset of hearing loss <30 days, no head injuries or history of acoustic trauma. All patients received the same treatment (prednisolone). Results: Hearing loss was more severe in simultaneous BSSHL in comparison to sequential BSSHL (p = 0.01) or USSHL (p = 0.03). Autoimmune diseases were far more common in simultaneous BSSHL (36% of patients) than USSHL. Positive antinuclear antibody was found in half of BSSHL patients and in only 8% of unilateral cases (p = 0.01). The frequency of hearing improvement was much lower in simultaneous BSSHL than in USSHL (p = 0.001). Complete or partial improvement was noted in 74% of unilateral cases versus 27% in simultaneous bilateral cases. Patients with sequential BSSHL improved in a similar way to unilateral cases. Conclusions: Simultaneous BSSHL, sequential BSSHL and USSHL may have a completely different profile and should not be managed as one disease. Hearing loss, underlying autoimmune diseases, antinuclear antibodies, and improvement/recovery of hearing loss vary in a degree that implies different pathophysiology and prognosis.
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from Child Language Teaching and Therapy
Early triadic interaction, the reciprocal action between mother—father—child, is described in the family of a girl diagnosed with autistic spectrum disorder (DSM 299.00) and learning difficulties at seven years. By chance, the family participated in a longitudinal study examining triadic interaction in 20 Swedish families using the Lausanne Triadic Play method. Quantitative and qualitative observations were made when the children were three, nine, 18 and 48 months of age. Compared with the other families, deviation was noted in early triadic synchronization, most clearly when the girl was nine months old. At three months, the girl took more turns and participated in more turn-taking sequences than the other children. However, at nine months, she gave more attention to objects. At 18 months, she had less eye contact with her parents and less shared focus and at 48 months her language skills were poorly developed. The mother showed more frequent contributions and more frequent turns at the two observations during infancy. The father showed deviations in attention to the child and affirmation at nine months and negative vocalization at 18 months. These findings are discussed in terms of their importance with regard to early intervention. Assessment of the family interaction using home observations seems to be of special importance.
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from Child Language Teaching and Therapy
The importance of collaborative practice between those who provide services to children with special educational needs is now regarded as essential and is supported strongly by the UK government. However, joint working is often difficult to implement, despite the goodwill of all involved. This paper describes a pilot study aimed at developing collaboration between a local education authority and a National Health Service (NHS) Trust. It reports on the results of the evaluation and discusses aspects of the project that facilitated collaborative working between the various parties involved.
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from Child Language Teaching and Therapy
The Structured Observation System (SOS) is a data collection method developed to document changes in the communication behaviours of children identified with speech and language delays. The system employs a rating scale which reflects the occurrence of communication behaviours as well as the amount of assistance needed for behaviours to occur. Pre- and post-treatment rating scores may be compared to measure changes in communication behaviours. The Structured Observation System is an effective, efficient and practical method to record clinical data. It was designed to be used frequently during a treatment programme and it may be adapted by others for the same purpose.
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from Child Language Teaching and Therapy
Children with developmental disorders may present with listening and/or speech discrimination difficulties. This study explores whether teachers can identify these difficulties, using a questionnaire that rates children's listening, speech discrimination and comprehension abilities. The questionnaire was given to class-teachers of 52 pupils, aged four to five years, who had failed at least one of two formal assessments of comprehension and speech discrimination. Results showed significant correlation between teacher ratings of verbal comprehension and attentive listening and test scores for verbal comprehension. There was no significant correlation between ratings and test scores for speech discrimination skills. The questionnaire's internal consistency was found to be reliable overall, but validity in measuring speech discrimination was poor.
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from Behavioral and Brain Functions
Background
It is known that the orthographic properties of linguistic stimuli are processed within the left occipitotemporal cortex at about 150-200 ms. We recorded event-related potentials (ERPs) to words in standard or mirror orientation to investigate the role of visual word form in reading. Word inversion was performed to determine whether rotated words lose their linguistic properties.
Methods
About 1300 Italian words and legal pseudo-words were presented to 18 right-handed Italian students engaged in a letter detection task. EEG was recorded from 128 scalp sites.
Results
ERPs showed an early effect of word orientation at ~150 ms, with larger N1 amplitudes to rotated than to standard words. Low-resolution brain electromagnetic tomography (LORETA) revealed an increase in N1 to rotated words primarily in the right occipital lobe (BA 18), which may indicate an effect of stimulus familiarity. N1 was greater to target than to non-target letters at left lateral occipital sites, thus reflecting the first stage of orthographic processing. LORETA revealed a strong focus of activation for this effect in the left fusiform gyrus (BA 37), which is consistent with the so-called visual word form area (VWFA). Standard words (compared to pseudowords) elicited an enhancement of left occipito/temporal negativity at about 250-350 ms, followed by a larger anterior P3, a reduced frontal N400 and a huge late positivity. Lexical effects for rotated strings were delayed by about 100 ms at occipito/temporal sites, and were totally absent at later processing stages. This suggests the presence of implicit reading processes, which were pre-attentive and of perceptual nature for mirror strings.
Conclusions
The contrast between inverted and standard words did not lead to the identification of a purely linguistic brain region. This finding suggests some caveats in the interpretation of the inversion effect in subtractive paradigms.
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from the International Tinnitus Journal
Acoustic trauma not only produces temporary and permanent hearing loss but is a common cause of chronic tinnitus. Recent work indicated a possible role for the transient receptor potential channel vanilloid subfamily type 1 (TRPV1) in modulating the effects of cochlear injury. In our research, we investigated the effects of acoustic damage on TRPV1 expression in spiral ganglion neurons of adult rats. After exposing them unilaterally to noise, we extracted cochleas and processed the spiral ganglion for TRPV1 expression at four posttrauma intervals (2 hours, 24 hours, 12 days, and 16.9 months). We measured TRPV1 immunodensity in the apical, middle, and basal turns of the cochlea. We found a significant interaction (p = .039) between posttrauma interval and regional cochlear receptor expression: For survival intervals between 24 hours and 2 weeks, TRPV1 density increased in all cochlear regions; at the longest survival interval (16.9 months), TRPV1 density was dramatically reduced in the basal region. We also psychophysically tested the long-survival subjects, which showed evidence of 20-kHz tonal tinnitus. These results suggest that TRPV1 may participate after cochlear injury in a signal cascade that is responsible for the neuroplastic events leading to tinnitus and hyperacusis.
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from the International Tinnitus Journal
Transcranial-cerebral sonography (TCCS) is a noninvasive technique that allows clinicians to detect nanoliter (billionths of a liter) displacements of the tympanic membrane. This technique was developed to assess cerebrospinal fluid (CSF) pressure in cases of shunted hydrocephalus; it takes advantage of the CSF connection to the inner ear through the cochlear aqueduct. The movements of the tympanic membrane that are observed in TCCS are those evoked by the acoustic stapedius reflex and those spontaneous movements generated by intracranial arterial, venous, and respiratory pulses transmitted through the inner ear to the stapes and thence to the tympanic membrane. Analysis of the amplitude and direction of these displacements has enabled neurosurgeons and neurologists to estimate CSF pressures accurately in patients evaluated by TCCS. TCCS allows for applications in neurootology, particularly in those patients who present with symptoms of pulsating tinnitus, dizziness and imbalance, or hearing loss. This preliminary report describes the test and its application in a series of patients whose diagnoses included pulsating tinnitus, idiopathic intracranial hypertension, Ménière's disease, perilymphatic fistula, perilymphatic hypertension, arterial stenosis, and Arnold-Chiari syndrome. We conclude that TCCS is a valuable addition to the armamentarium of neurootologists.
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from the International Tinnitus Journal
This article presents accounts of two patients with cholesteatoma of the tympanic part of the temporal bone, located immediately lateral to the tympanic annulus (and with an intact tympanic membrane). The lesions were located deep in the anterior and inferior walls of the canal, especially in the vaginal process of the tympanic part. These more severe cases required surgical correction (removal of the sac of cholesteatoma) with very good results. Pathogenesis and differential diagnosis are discussed.
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from the International Tinnitus Journal
GOAL: Our goal was to establish the efficacy, in a 12-week period, of Clear Tinnitus for tinnitus relief in patients with tinnitus of the severe, disabling type. HYPOTHESIS: We hypothesized that tinnitus relief with Clear Tinnitus reflects improvement in the sensory component of the tinnitus complaint by controlling the factor of aeration of the middle ears and improving eustachian tube function. METHOD: In a prospective clinical trial of a homeopathic preparation--Clear Tinnitus--we attempted to identify in 15 tinnitus patients (14 male, 1 female; mean age, 47.6 years) its clinical efficacy for establishing tinnitus relief for a 3-month period. We employed a descriptive data analysis method across dimensions of risk to evaluate a base of multidimensional evidence and establish support for our hypothesis. A medical-audiological tinnitus patient protocol completed by each patient identified the clinical type of tinnitus as predominantly cochlear, with a central and middle-ear component bilaterally. We identified fluctuation in middle-ear pressure (MEP) via patients' clinical history, supported by physical examination and established with tympanometry, as a factor influencing the clinical course of the tinnitus in each patient. RESULTS: Eleven of 15 patients completed the study. Seven responders reported tinnitus relief; four did not respond. Descriptive data analysis failed to detect any trends in a change in response with audiometric tests across the hearing spectrum; thus, we could derive no coefficients of hearing change. Evaluation revealed high-frequency tinnitus in 11 patients. The Feldmann masking curve comparison at the start and end of the study showed no significant change in the 11 patients. There was no significant alteration in the minimum masking levels or loudness discomfort levels before and after the study. Tympanometry and MEP measurement indicated a significant difference in MEP with an improvement on average of -58.18 in the right ear and -40.90 in the left ear for the 11 patients. Quantitative electroencephalography analysis revealed a marked difference in the number of significant abnormal recordings between the different frequency bands, with the delta band significantly higher than the theta, alpha, and beta bands for both the overall cohort of patients (n = 11) and those reporting tinnitus relief (n = 7). The tinnitus outcome questionnaires--the tinnitus intensity index, the tinnitus annoyance index, and the tinnitus reaction questionnaire--revealed a significant difference for the patients (7 of 11) obtaining tinnitus relief. Results of the tinnitus stress test, the tinnitus handicap index, and the measurement of depression scale before and after the study were not statistically significant. CONCLUSIONS: Patients who completed the study demonstrated with tympanometry a statistical and clinical significance in MEP improvement or maintenance of MEP (or both). Patients with tinnitus of the severe disabling type selected for this study and responding to Clear Tinnitus reported tinnitus relief accompanied by improvement in or maintenance of MEP of the middle ears. The statistical and clinical significance of Clear Tinnitus for establishing tinnitus relief remains to be established with a larger cohort of tinnitus patients.
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from the International Tinnitus Journal
We performed three maneuvers of the positional test in supine patients: (1) body maneuver, in which patients turned only the body to one side while keeping the head as still as possible; (2) head-only maneuver, in which patients turned only the head to one side while keeping the body still; and (3) head and body maneuver, in which patients turned the head and body together to one side. The nystagmus provocation rates of those three maneuvers among 86 vertiginous patients were 9% in the body maneuver, 16% in the head-only maneuver, and 33% in the head and body maneuver, respectively. We proved that performing the positional test by turning the head and body together is very effective in provoking positional nystagmus.
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from the International Tinnitus Journal
Intense airborne ultrasound has been associated with hearing loss, tinnitus, and various nonauditory subjective effects, such as headaches, dizziness, and fullness in the ear. Yet, when people detect ultrasonic components in music, ultrasound adds to the pleasantness of the perception and evokes changes in the brain as measured in electroencephalograms, behavior, and imaging. How does the airborne ultrasound get into the ear to create such polar-opposite human effects? Surprisingly, ultrasound passes first through the eyes; thus, the eye becomes but another window into the inner ear.
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from the International Tinnitus Journal
Our objective was to determine the high-frequency hearing thresholds of women with multiple sclerosis (MS) and to investigate the presence of side dominance for high-frequency perception. We submitted 19 affected and 106 nonaffected women (controls) to high-frequency audiometry and classified them in subgroups according to their age (30-40, 40-50, and 50-60 years). We analyzed data through selected statistical tests. We could detect no consistent effect of side dominance and observed a general increase in the hearing sensitivity for high frequencies in MS patients. We concluded that high-frequency sounds seemed to be detected more easily by MS patients than by controls.
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from the International Tinnitus Journal
We compared the horizontal component of nystagmus of the right and left eyes using monocular recording of electronystagmography. We examined the eye movements of 135 patients during bithermal caloric testing and those of 50 patients during the rotation test. We measured the number of nystagmic beats, the slow-phase velocities, and the amplitudes during 10 seconds of the culmination phase of caloric response. We also measured the number of nystagmic beats during the first 30 seconds in postrotatory nystagmus. The eye on the cold-irrigated side moved significantly more strongly than did the eye on the nonirrigated side, whereas a warm irrigation did not induce a significant difference between the irrigated and nonirrigated eyes. The summated activities of each eye during the four different stimulations under bithermal caloric testing did not show any significant differences. The activities of postrotatory nystagmus were almost equal in both eyes in 50 patients. We concluded that the inhibitory effect of cold caloric stimulation is probably transmitted more intensively to the eye on the irrigated side.
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from the International Tinnitus Journal
Pathologies from childhood to adolescence carry physical, cognitive, motor, linguistic, perceptual, social, emotional, and neurosensory characteristics. The ages between 8 and 14 or 15 especially carry very special traits of a rollover in data processing with respect to balance regulation. Data acquisition of neurootological function provides us with a network of information about the sensory status of our young patients. Major neurootological complaints leading to functional neurootological investigations are vertigo (including giddiness), dizziness, and nausea. These complaints may occur acutely but also are present in some patients at a young age as longer-lasting complaints. Physiological and clinical vertigo syndromes are commonly found as a combination of four principal phenomena: perceptual (vertigo), oculomotor (nystagmus), postural (dystaxia), and vegetative (nausea, vomiting). These four cardinal manifestations of vertigo are related to different levels of the vestibular analyzer and require different methods of investigation. The focus of our study is the phase of restructuring of equilibrium regulation in children between the ages of 8 and 15 years.
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from the International Tinnitus Journal
Head trauma is being more frequently recognized as a causative agent in balance disorders. Most of the published literature examining traumatic brain injury (TBI) after head trauma has focused on short-term prognostic indicators and neurocognitive disorders. Few data are available to guide those individuals who see patients with balance disorders secondary to TBI. Our group has previously examined balance disorders after mild head trauma. In this study, we study all classes of head trauma. We provide a classification system that is useful in the diagnosis and management of balance disorders after head trauma and we examine treatment outcomes. As dizziness is one of the most common outcomes of TBI, it is essential that those who study and treat dizziness be familiar with this subject.
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from the International Tinnitus Journal
Stress is a significant factor influencing the clinical course of tinnitus. The auditory system is particularly sensitive to the effects of various stress factors (chemical, oxidative, emotional, etc.). Different stages of reaction (alarm, resistance, exhaustion) lead to different characteristics of tinnitus and to different therapeutic approaches. Individual characteristics of stress reaction may explain different aspects of tinnitus in various patients with different responses to treatment, despite similar audiological and etiological factors. A model based on individual reactions to stress factors (stress-reaction tinnitus model, or SRTM) could explain tinnitus as an alarm signal. In each patient, stressors have to be identified during the alarm phase to prevent an evolution toward the resistance and exhaustion phases. In the exhaustion phase, chronic tinnitus is due to the organization of a paradoxical auditory memory and a pathologically shifted attention to tinnitus. The aim of our study is to describe a therapeutic proposal based on the SRTM by taking an educational approach to management of chronic tinnitus. The educational aspect is emphasized; thus, we named our approach tinnitus school. Selection of appropriate patients and follow-up is based on psychometrics of tinnitus and stress questionnaires, including a tinnitus reaction questionnaire, a tinnitus cognitive questionnaire, and a 20-item perceived stress questionnaire. Tinnitus school is a three-phase program: counseling, training, and home training. Training is based on a tinnitus-fitted physiotherapeutic protocol.
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from Infant Behavior and Development
This experiment examined how parents’ verbal and non-verbal behavioral cues cause infants to shift and share attention within environments where many objects compete for infants’ attention. Fifteen- and 21-month-old infants played with toys while their parent periodically shifted attention to a distal object within a larger array. Parents’ attention-shifts were indicated by a change in direction of gaze, a pointing gesture, and/or verbalizations. Verbalizations were either attention-eliciting or attention-directing. In some trials parents covered their eyes to occlude line-of-gaze. Both ages seldom followed simple gaze shifts, but frequently followed gaze with-points or gaze-with-directing verbalizations. Attention-eliciting verbalizations increased infants’ looks to the parent. Gaze occlusion reduced infants’ responses to directing verbalizations. Responses to eliciting verbalizations increased with age. Infant receptive vocabulary did not predict attention-sharing, even when parents named objects (i.e., directing verbalizations). Implications for development of attention-sharing, language and understanding of visual attention are discussed.
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from the International Journal of Pediatric Otorhinolaryngology
Objectives
To compare preverbal behaviors of deaf children implanted under 1 year of age with age-matched hearing children.
Methods
The study assessed 20 children; 10 deaf children implanted under 1 year of age and 10 normally hearing children of the same age. Preverbal skills were measured before, 6 months, and 1 year after implantation, using Tait Video Analysis that is able to predict later speech outcomes in young implanted children.
Results
Regarding vocal turns, the normally hearing group outperformed the implanted group although the latter children became quite vocal, nearly 60% of their turns being taken in this way. The mean vocal autonomy in implanted children, 1 year after implantation, was very close to the respective of hearing children (38.5 versus 43.5). Regarding the non-looking vocal turns, by the 12-month interval, hearing children had somewhat higher scores than implanted children, but the difference was not significant and the increase in implanted children was much higher (40-fold increase versus 4-fold increase). However, implanted children were more likely to use silent communication than hearing children, although gestural turns were decreasing with time.
Conclusions
The small numbers in this study, although two of the largest European cochlear implant centers were combined to recruit such young implantees, led us to be cautious in interpreting the results. However, it seems that in deaf implanted children under 1 year of age, some preverbal communication behaviors are developing to an extent (although at a somewhat lower level) not significantly different from those of age-matched normally hearing children.
Keywords: Language development; Cochlear implant; Vocal; Auditory; Communication; Preverbal; Observation; Interaction; Deaf; Young; Children; Outcome; Early; Implantation under 1
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from Medical News Today.com
Student musicians who protect their hearing may still hear the beat of the drum after graduation, says a Purdue University audiologist.
"A number of famous musicians, old and young, are living with hearing loss," says Lata Krishnan, a clinical associate professor of audiology and a band parent. "One study found that three out of every four rock and jazz musicians have a hearing disorder, and it's estimated that 15 percent of American teenagers have permanently lost some hearing. Temporary hearing loss can happen after a person has been exposed to loud music for as little as 15 minutes, and repeated exposure can lead to permanent hearing loss."
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from Clinical Pediatrics
Preschool-aged children with speech-sound disorders may be at risk for associated deficits in fine motor function. The objectives of this study were 2-fold: (1) to determine whether abnormalities in fine motor function could be detected in 2- to 5-year-old children with speech-sound disorders and (2) to determine whether there was a correlation between abnormal oral-motor imitation skills and abnormal fine motor function. Thirty-two children with speech-sound disorders (6 female, 26 male) were prospectively evaluated from July 2003 to July 2005, and the Peabody Developmental Motor Scales and the Kaufman Speech Praxis Test for Children were administered. The presence of abnormal oral-motor imitation skills as measured by the Kaufman Speech Praxis Test was associated with below-average fine motor performance. This finding has important implications for evaluation and treatment of preschool children with severe speech-sound disorders.
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from Neurorehabilitation and Neural Repair
Objectives. The effectiveness of 2 different types of gait training in stroke rehabilitation, rhythmic auditory stimulation (RAS) versus neurodevelopmental therapy (NDT)/Bobath– based training, was compared in 2 groups of hemiparetic stroke patients over a 3-week period of daily training (RAS group, n = 43; NDT/Bobath group =35). Methods. Mean entry date into the study was 21.3 days poststroke for the RAS group and 22.3 days for the control group. Patients entered the study as soon as they were able to complete 5 stride cycles with handheld assistance. Patients were closely equated by age, gender, and lesion site. Motor function in both groups was pre-assessed by the Barthel Index and the Fugl-Meyer Scales. Results. Pre- to posttest measures showed a significant improvement in the RAS group for velocity (P = .006), stride length (P = .0001), cadence (P = .0001) and symmetry (P = .0049) over the NDT/Bobath group. Effect sizes for RAS over NDT/Bobath training were 13.1 m/min for velocity, 0.18 m for stride length, and 19 steps/min for cadence. Conclusions. The data show that after 3 weeks of gait training, RAS is an effective therapeutic method to enhance gait training in hemiparetic stroke rehabilitation. Gains were significantly higher for RAS compared to NDT/Bobath training.
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from Clinics in Plastic Surgery
Individuals undergoing conventional maxillary advancement surgery or maxillary distraction should have perceptual and instrumental assessment of speech and velopharyngeal function, pre- and postsurgically. They should be counseled on the risk of deterioration in velopharyngeal function, particularly for those who have repaired cleft palate presenting with characteristics of borderline velopharyngeal function. These individuals should also be counseled that there may be a positive change in speech articulation, with normalization of the maxillary-mandibular relationship, especially for the highly sibilant /s/ and /z/ sounds. This article highlights speech errors often seen in individuals who have dentofacial skeletal deformities, and discusses the impact of conventional orthognathic surgery and distraction osteogenesis on speech production. Methods of assessing speech production, including perceptual assessment and instrumentation are also reviewed.
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from the Italian Journal of Neurological Sciences
Abstract Alteration of the pharyngoesophageal musculature is a common finding in patients with myotonic dystrophy (MD), regardless of the presence of dysphagia. The aim of the present study was to determine whether a specific pattern of swallowing abnormalities could be identified in MD patients, and the possible correlation with the size of CTG repeats. Fifteen MD patients, 8 of whom were asymptomatic for dysphagia, underwent a videofluoroscopic study of swallowing. Alterations of the pharyngoesophageal phase of swallowing were detected in 12 of 15 patients, 6 without clinical evidence of dysphagia. Incomplete relaxation of the upper esophageal sphincter (UES) and esophageal hypotonia were the most common alterations. We found a significant correlation between the number of radiological alterations and the size of CTG repeats. A typical radiological pattern of swallowing has also been identified. The role of videofluoroscopy in evaluation of MD patients is briefly discussed.
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from Evaluation and the Health Professions
This review identifies key issues associated with the design of future longitudinal studies of human development. Sixteen international studies were compared for initial response and retention rate, sample size, type of data collected, and sampling frames. The studies had little information about the influences of fathers, extended family members, childcare, and educational institutions; the effects of peers; children's use of time; the needs of disabled children; urban versus rural environments; or the influence of genetic factors. A contemporary longitudinal study should include measures of physical and mental health, cognitive capacity, educational attainment, social adjustment, conduct and behavior, resiliency, and risk-taking behaviors. It needs to address genetic and intergenerational factors, cultural identity, and the influences of neighborhood, community, and wider social and political environments and to encompass outcomes at all life stages to systematically determine the role each factor plays in individuals' lives, including interactions within and across variables.
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from Evaluation and the Health Professions
Health care providers depend on the findings of observational intervention studies and systematic reviews of those studies to make evidence-based decisions about their clients' care. The nonrandom methods of group formation in observational studies necessitate carefully assessing threats to the validity of conclusions. Regression to the mean is a source of change in clinical outcome measures that has escaped widespread notice as a potential threat to the accuracy of conclusions from observational studies and systematic reviews thereof. Failure to assess the degree to which regression confounds study results elevates the risk of making clinical decisions using biased estimates of intervention effectiveness. Because the change in average outcome scores due to regression can be quantified, it is a type of bias whose direct influence can be known. Yet determining and reporting change due to regression is uncommon in observational studies or systematic reviews thereof. The means to quantify change due to regression in average outcome scores is illustrated by example in this article.
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from Current Opinion in Clinical Nutrition and Metabolic Care
Purpose of review: This review examines recent studies of the evaluation and treatment of oropharyngeal dysphagia as well as papers investigating oropharyngeal dysphagia and nutritional management.
Recent findings: There continue to be difficulties in accurate diagnosis of some disorders in oropharyngeal swallow, accounting for the patient's dysphagic symptoms and in identifying optimal treatment strategies for each patient. The efficacy of new techniques for the treatment of oropharyngeal dysphagia have been examined in various populations. Exercise programs have been showing increased efficacy in particular patient groups.
Summary: Articles in this past year have focused largely on identifying new procedures for assessment of oropharyngeal swallowing and defining treatment effects. Relatively little work has examined nutritional management in patients with oropharyngeal dysphagia. Most studies that have investigated nutritional management do not carefully define the patient's medical diagnosis or specific swallowing disorders. Similarly, those that study oropharyngeal dysphagia do not relate these data to nutritional management of these patients.
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from Behavioral and Brain Functions
Background
We investigated whether individual differences in baseline executive control capacity could predict state anxiety during a potentially life-threatening situation
Methods
19 Swedish military conscripts were assessed during two measurement occasions. During a baseline measurement, data regarding performance on a verbal fluency task and state anxiety were assessed. During a second measurement, performed immediately prior to participation in a live hand-grenade throwing exercise, data regarding state anxiety was assessed. All participants were male, right-handed and had fulfilled 12 years of education.
Results
The level of state anxiety was significantly increased between the two measurement occasions (p < .01). Both the number of words produced (Beta = -.37; p <.05) and the number of perseveration made (Beta = .43; p <.05) on the verbal fluency task predicted, while controlling for state anxiety at baseline, the level of experienced state anxiety during the threatening situation.
Conclusions
Although more research is needed the present finding suggests that individual differences in executive control capacity might be related to emotion regulation ability during acute stressor exposure.
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from Brain and Language
The study reported here compares two linguistically informed hypotheses on agrammatic sentence production, the TPH [Friedmann, N., & Grodzinsky, Y. (1997). Tense and agreement in agrammatic production: Pruning the syntactic tree. Brain and Language, 56, 397-425.] and the DOP [Bastiaanse, R., & van Zonneveld, R. (2005). Sentence production with verbs of alternating transitivity in agrammatic Broca's aphasia. Journal of Neurolinguistics, 18, 59-66]. To explain impaired production of non-canonical sentences in agrammatism, the TPH basically relies on deleted or pruned clause structure positions in the left periphery, whereas the DOP appeals to limitations in the application of movement rules. Certain non-canonical sentences such as object-questions and object-relative clauses require the availability of nodes in the left periphery as well as movement to these nodes. In languages with relatively fixed word order such as English, the relevant test cases generally involve a coincidence of left periphery and movement, such that the predictions of the TPH and the DOP are identical although for different reasons. In languages with relatively free word order such as German, on the other hand, it is possible to devise specific tests of the different predictions due to the availability of scrambling. Scrambled object sentences, for example, do not involve the left periphery but do require application of movement in a domain below the left periphery. A study was conducted with German agrammatic subjects which elicited canonical sentences without object movement and non-canonical scrambled sentences with object movement. The results show that agrammatic speakers have a particular problem with the production of scrambled sentences. Further evidence reported in the study from spontaneous speech, elicitation of object relatives, questions and passives and with different agrammatic subjects confirms that non-canonical sentences are generally harder to produce for agrammatics. These findings provide evidence in favor of the DOP and it will be argued that a cross-modal explanation of agrammatic deficits is possible if two factors-movement and canonicity-are taken into consideration.
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from Medical News Today.com
Children in the UK with speech and language difficulties are prone to loneliness, feelings of frustration and poor self-esteem, a new Department of Health study has revealed.
The study is the first scientific examination of quality of life for children with speech and language difficulties (SaLD). It was carried out by the University of Portsmouth as part of a £200 K Researcher Development Fellowship Award from the Department of Health.
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from Medical News Today.com
Despite marketing claims, parents who want to give their infants a boost in learning language probably should limit the amount of time they expose their children to DVDs and videos such as "Baby Einstein" and "Brainy Baby." Rather than helping babies, the over-use of such productions actually may slow down infants eight to 16 months of age when it comes to acquiring vocabulary, according to a new study by researchers at the University of Washington and Seattle Children's Hospital Research Institute.
The scientists found that for every hour per day spent watching baby DVDs and videos, infants understood an average of six to eight fewer words than infants who did not watch them. Baby DVDs and videos had no positive or negative effect on the vocabularies on toddlers 17 to 24 months of age. The study was published in the Journal of Pediatrics. "The most important fact to come from this study is there is no clear evidence of a benefit coming from baby DVDs and videos and there is some suggestion of harm," said Frederick Zimmerman, lead author of the study and a UW associate professor of health services. "The bottom line is the more a child watches baby DVDs and videos the bigger the effect. The amount of viewing does matter."
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from Topix.net
"Ballastexistenz brought up an interesting subject today - namely the abilities of people with autism spectrum disorders to receive and process non-verbal information . via Axinar.blogspot.com"
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from MedGadget.com
Northwestern University scientists are looking into using lasers that can trigger nerve firings, in order to increase audio quality in cochlear implants over the traditional electric discharge method.
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from Noise and Health
A review of the literature studying possible correlations between hearing function and cardiovascular disease (CVD) reveals a complex and somewhat contradictory picture. Most studies favor the concept of an association between hearing loss and CVD. The issue of interactions between noise-induced hearing loss and CVD, as well as between age-related hearing loss and CVD, has been discussed in numerous publications. The present study utilizes information from an epidemiological study of elderly people in Gothenburg, Sweden. We found a probable correlation between high systolic blood pressure and hearing loss in the low and mid frequencies in elderly women, 79 years old. A tendency of a similar correlation was also found in a group of 85-year-old women. An association between high diastolic blood pressure and low- and mid-frequency hearing loss was also found in the group of women aged 85 years. No consistent associations between blood pressure or hypertension and auditory function were found in 70- and 75-year-old women or in men 70 to 85 years old.
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from Noise and Health
Traffic noise (road noise, railway noise, aircraft noise, noise of parking cars), is the most dominant source of annoyance in the living environment of many European countries. This is followed by neighbourhood noise (neighbouring apartments, staircase and noise within the apartment). The subjective experience of noise stress can, through central nervous processes, lead to an inadequate neuro-endocrine reaction and finally lead to regulatory diseases. Within the context of the LARES-survey (Large Analysis and Review of European housing and health Status), noise annoyance in the housing environment was collected and evaluated in connection with medically diagnosed illnesses. Adults who indicated chronically severe annoyance by neighbourhood noise were found to have an increased health risk for the cardiovascular system and the movement apparatus, as well as an increased risk of depression and migraine. Furthermore adults with chronically strong annoyance by traffic noise additionally showed an increased risk for respiratory health problems. With regards to older people both neighbourhood and traffic noise indicated in general a lower risk of noise annoyance induced illness than in adults. It can be assumed that the effect of noise-induced annoyance in older people is concealed by physical consequences of age (with a strong increase of illnesses). With children the effects of noise-induced annoyance from traffic, as well as neighbourhood noise, are evident in the respiratory system. The increased risk of illness in the respiratory system in children does not seem to be caused primarily by air pollutants, but rather, as the results for neighbourhood noise demonstrate, by emotional stress.
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from Noise and Health
The causal association between occupational noise exposure and permanent hearing loss is well-documented and well-founded primary preventive approaches have been developed. However, documentation of the impact on the present prevalence of noise-induced hearing loss in the working population is limited. This study reports on the prevalence of noise-induced hearing loss in a population sample of 788 workers from 11 trades with expected high noise exposure levels and a reference group examined according to the same protocol. Full-shift A-weighted equivalent sound levels were recorded and pure tone audiometric examinations were conducted at the work sites in soundproof booths. Data were analyzed with multivariate regression techniques and adjusted for age, sex, ear disease, smoking and environmental noise exposure. An overall two-fold increased risk of hearing handicap (hearing threshold above 20 dB averaged across 2, 3 and 4 kHz for either ear) was observed in the noise exposed workers [odds ratio (OR) 1.99, 95% confidence interval (CI) 0.91-4.34]. Workers exposed for more than 20 years to an exposure level above 85 dB(A) had a three-fold increased risk (OR 3.05, 95% CI 1.33-6.99). Workers starting in noisy work during the last 10-15 years or workers below 30 years of age showed no increased risk of hearing handicap. This indicates that preventive measures enforced during the past 10-15 years to reduce noise exposure may have borne fruit. Systematic surveillance of noise and hearing levels in appropriate populations should still be included in an efficient hearing conservation program.
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from HealthFinder.gov
U.S. researchers hope to develop pliable, new vocal cord tissue to replace damaged tissue that can alter or silence a person's voice.
The five-year project is funded by a $1.8 million grant from the U.S. National Institute on Deafness and Other Communication Disorders.
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from Reuters
A subtle difference in responses on a newborn hearing screening test may identify babies who are at risk for sudden infant death syndrome (SIDS), according to a new study.
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from Human Genetics
Abstract Pendred syndrome (PS) and non-syndromic enlarged vestibular aqueduct (EVA) are two recessive disorders characterized by the association of sensorineural hearing loss (SNHL) with inner ear malformations that range from isolated EVA to Mondini Dysplasia, a complex malformation that includes a cochlear dysplasia and EVA. Mutations in the SLC26A4 gene, coding for the protein pendrin, have been implicated in the pathophysiology of both disorders. In order to determine whether SLC26A4 genotypes can be correlated to the complexity and severity of the phenotypes, we ascertained 1,506 deaf patients. Inner ear abnormalities were present in 474 patients (32%). Mutation screening of SLC26A4 detected two mutations in 16% of patients, one mutation in 19% of patients and zero mutation in 65% of patients. When the distribution of SLC26A4 genotypes was compared across phenotypes, a statistically significant difference was found between PS patients and non-syndromic EVA–Mondini patients (P = 0.005), as well as between EVA patients and Mondini patients (P = 0.0003). There was a correlation between phenotypic complexity of inner ear malformations and genetic heterogeneity—PS patients have the most severe phenotype and the most homogeneous etiology while EVA patients have the least severe phenotype and the most heterogeneous etiology. For all patients, variability in the degree of hearing loss is seen across genotypes implicating other genetic and/or environmental factors in the pathogenesis of the PS–Mondini–EVA disease spectrum.
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from Human Genetics
Abstract We ascertained three consanguineous Pakistani families (PKDF291, PKDF335 and PKDF793) segregating nonsyndromic recessive hearing loss. The hearing loss segregating in PKDF335 and PKDF793 is moderate to severe, whereas it is profound in PKDF291. The maximum two-point LOD scores are 3.01 (D19S1034), 3.85 (D19S894) and 3.71 (D19S894) for PKDF291, PKDF335 and PKDF793, respectively. Haplotype analyses of the three families define a 1.16 Mb region of overlap of the homozygous linkage intervals bounded by markers D19S216 (20.01 cM) and D19S1034 (20.75 cM). These results define a novel locus, DFNB72, on chromosome 19p13.3. There are at least 22 genes in the 1.16 Mb interval, including PTPRS, ZNRF4 and CAPS. We identified no pathogenic variants in the exons and flanking intronic sequences of these three genes in affected members of the DFNB72 families. DFNB72 is telomeric to DFNB68, the only other known deafness locus with statistically significant support for linkage to chromosome 19p.
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from the Journal of Intellectual Disability Research
Background Children with cerebral palsy (CP) and accompanying disabilities are prone to reading difficulties. The aim of the present study was to examine the foundations of phonological awareness in pre-school children with CP in comparison with a normally developing control group. Rhyme perception was regarded as an early indicator of phonological awareness, whereas non-verbal reasoning, speech ability, auditory perception, auditory short-term memory and vocabulary were regarded as foundation measures.
Methods A number of tasks were administrated to examine group differences in rhyme perception and its foundation measures. Correlations between the tasks were analysed for both groups followed by multiple regression analyses wherein rhyme perception was predicted by its foundation measures.
Results Children with CP scored below their normally developing peers on emergent phonological awareness and its foundation measures. Regarding the prediction of phonological awareness, non-verbal reasoning followed by pseudoword articulation, were found to predict phonological awareness, i.e. rhyme perception, in the group of children with CP. In the control group, auditory perception was a significant predictor of emergent phonological awareness. The CP group was further split up into two groups according to the children's non-verbal reasoning skills, i.e. general IQ. The below-average IQ group scored below the average IQ group on phonological awareness and on most foundation measures. In addition, the average IQ group of the children with CP scored lower than the control group.
Conclusion The results of this study indicate that general intelligence and speech ability (i.e. pseudoword articulation) can be seen as important facilitators of emergent phonological awareness in children with CP. These findings support the role of intelligence in the emergence of phonological awareness in children with CP. Children with CP with intellectual disabilities seem to have a disadvantage in acquiring phonological awareness, especially when their speech abilities are also impaired. However, general intelligence is not enough to predict phonological awareness as other foundation measures are also important for phonological awareness independent of general intelligence.
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from Journal of Neuroscience
The inferior colliculus central nucleus (ICC) has potential as a new site for an auditory prosthesis [i.e., auditory midbrain implant (AMI)] for deaf patients who cannot benefit from cochlear implants (CIs). We have previously shown that ICC stimulation achieves lower thresholds, greater dynamic ranges, and more localized, frequency-specific primary auditory cortex (A1) activation than CI stimulation. However, we also observed that stimulation location along the caudorostral (isofrequency) dimension of the ICC affects thresholds and frequency specificity in A1, suggesting possible differences in functional (output) organization within the ICC. In this study, we electrically stimulated different regions along the isofrequency laminas of the ICC and recorded the corresponding A1 activity in ketamine-anesthetized guinea pigs using multisite probes to systematically assess ICC stimulation location effects. Our results indicate that stimulation of more rostral and somewhat ventral regions within an ICC lamina achieves lower thresholds, smaller discriminable level steps, and larger evoked potentials in A1. We also observed longer first spike latencies, which correlated with reduced spiking precision, when stimulating in more caudal and dorsal ICC regions. These findings suggest that at least two spatially distinct functional output regions exist along an ICC lamina: a caudal–dorsal region and a rostral–ventral region. The AMI will be implanted along the tonotopic axis of the ICC to achieve frequency-specific activation. However, stimulation location along the ICC laminas affects response properties that have shown to be important for speech perception performance, and needs to be considered when implanting future AMI patients.
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from Technology Review
About 100,000 profoundly deaf people now hear with cochlear implants, which work by stimulating the auditory nerve with a string of electrodes implanted in the inner ear. While the devices enable many users to converse easily and use telephones, they still fall short of restoring normal hearing. Now scientists at Northwestern University are exploring whether laser-based implants could one day outperform today's electrical version.
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from Brain Research Bulletin
The cognitive mechanisms and neuroantomical substrates used by the brain to effortlessly generate morphologically complex words (write + ing ? writing) are little understood. The left inferior frontal gyrus (LIFG, including Broca's area) is often implicated as being involved, although its specific role is unclear. Data from brain damaged individuals, particularly those with Broca's aphasia, are often used as evidence to support or refute various theoretical perspectives. Typically, performance on two types of morphologically complex verbs, regulars (walk-walked, slip-slipped) and irregulars (sing-sang, sleep-slept) is contrasted for evidence of single or double dissociations. The question of how Broca's aphasic individuals dissociate in their production of inflectional morphology is important to our understanding of how the brain is organized to compute morphologically complex words. This article is a synthesis of research studies investigating the production of morphologically complex regular and irregular verbs in individuals with Broca's aphasia. The question being asked is if there is a robust and consistent dissociation, and if this dissociation can be tied to lesions of the left frontal lobe. This meta-analysis of 75 patients failed to show a single consistent dissociation pattern and over half the datasets had no significant difference between regulars and irregulars. There was also no relationship of any performance pattern to frontal lobe lesions, highlighting the difficulty of identifying any single neuroanatomical lesion for regular–irregular verb production deficits. The implications for various theoretical and neuroanatomical hypotheses are discussed. The role of neuropsychological dissociations in constraining hypothesis of normal neuroanatomical organization is evaluated.
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from Developmental Science
The auditory event-related potential (ERP) is obtained by averaging electrical impulses recorded from the scalp in response to repeated stimuli. Previous work has shown large differences between children, adolescents and adults in the late auditory ERP, raising the possibility that analysis of waveform shape might be useful as an index of brain maturity. We reanalysed auditory ERPs from samples previously described by Albrecht, von Suchodoletz and Uwer (2000) and Uwer, Albrecht and von Suchodoletz (2002), using the intraclass correlation (ICC) as a global measure of similarity of an individual's waveform to a grand average comparison waveform for each age band. Three developmental periods were clearly distinguished: 5 to 12 years, 13 to 16 years, and adulthood. However, within each of these periods, there was no evidence of any developmental progression with age.
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from Developmental Science
The confluence of an anomaly such as a growth spurt or a temporary regression on the one hand and a temporary increase in intra-individual variability on the other hand, forms a strong indicator of a major transition in early language development. Data concern one-word (W1), two- and three-word (W2–3), and four-and-more-word (W4+) utterances from two French children during their second and third years. A dynamic growth model was fitted, based on a structure of supportive, conditional and competitive relationships. Using a statistical simulation method, we showed two striking peaks of variability in addition to a temporary regression or rapid growth in the proportions of W1, W2–3 and W4+ utterances. We argue that these phenomena show transitions corresponding to critical points in grammatical development, which could be indicative of the emergence of simple combinatorial and syntactic stages of language successively. Our results emphasize the relevance of time-serial data and of intra-individual variability in the study of developmental transitions in general.
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from Developmental Science
Deviation of real speech from grammatical ideals due to disfluency and other speech errors presents potentially serious problems for the language learner. While infants may initially benefit from attending primarily or solely to infant-directed speech, which contains few grammatical errors, older infants may listen more to adult-directed speech. In a first experiment, Post-verbal infants preferred fluent speech to disfluent speech, while Pre-verbal infants showed no preference. In a second experiment, Post-verbal infants discriminated disfluent and fluent speech even when lexical information was removed, showing that they make use of prosodic properties of the speech stream to detect disfluency. Because disfluencies are highly correlated with grammatical errors, this sensitivity provides infants with a means of filtering ungrammaticality from their input.
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from MedGadget.com
Medtronic's Meniett Low-Pressure Pulse Generation system is slowly gaining acceptance in the fight against Meniere's disease. What's Meniere's? Why, it's the idiopathic disorder of hearing loss, dizziness and vertigo. What's Menniett? It's the number two therapy, according to a survey of ENT docs:
Dietary modification was recommended as first-line therapy by 99 percent of the survey respondents, including moderate to strict salt restriction, decreased caffeine intake and avoidance of alcohol. A diuretic was also recommended by 96 percent of respondents. When asked what they would offer if initial treatment failed, respondents chose the Meniett® device first and most frequently over therapies such as intratympanic corticosteroids, endolymphatic sac mastoid shunt, intratympanic gentamicin perfusion and endolymphatic sac vein decompression.
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from Journal of Child Psychology and Psychiatry
Background: The Social Communication Questionnaire (SCQ), formerly the Autism Screening Questionnaire (ASQ), is based on a well-validated parent interview, the Autism Diagnostic Interview (ADI). It has shown promise as a screening measure for autism spectrum disorders (ASDs) in a research-referred older sample, though recent studies with younger children reported lower sensitivities when using the suggested cutoff of =15 to differentiate ASDs from children with nonspectrum disorders (NS).
Methods: Diagnostic discrimination of the SCQ was evaluated alone and in combination with the ADOS (Autism Diagnostic Observation Schedule) in a clinical and research-referred sample of 590 children and adolescents (2 to 16 years), with best estimate consensus diagnoses of autism, pervasive developmental disorder, not otherwise specified (PDD-NOS) and non-ASD disorders. The SCQ was completed before the evaluation in most cases. Performance of the SCQ was also compared with the Autism Diagnostic Interview – Revised (ADI-R).
Results: Absolute scores and sensitivity in the younger children and specificity for all groups were lower than reported in the original study. Using receiver operating curves (ROC) to examine the area under the curve (AUC), the SCQ was more similar to the ADI-R total score in differentiating ASD from NS disorders in the older (8–10, >11) than younger age groups (<5, 5–7). Lowering the cutoff score in the 2 younger groups improved sensitivity, with specificity remaining relatively low in all groups. Using the SCQ in combination with the ADOS resulted in improved specificity. Diagnostic discrimination was best using the ADI-R and ADOS in combination.
Conclusions: Those interested in using the SCQ should consider adjusting cutoff scores according to age and purpose, and using it in combination with another measure. Sensitivity or specificity may be prioritized for research or screening depending on goals.
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from Journal of Child Psychology and Psychiatry
Aims: To examine prevalence and correlates of psychopathology in deaf adolescents using a multi-method multi-informant approach.
Methods: Data for the study came from checklist assessments by parents (Child Behavior Checklist (CBCL)) and teachers (Teacher's Report Form (TRF)) of 70 deaf adolescents aged 13 to 21 years, from semi-structured clinical interviews of the adolescents (Semi-structured Clinical Interview for Children and Adolescents (SCICA)), and from expert ratings of dossier data.
Results: The percentages of Total Problems scores in the borderline clinical range in this population as found with the CBCL, TRF and SCICA are 28%, 32% and 49–63% respectively. Expert dossier ratings identified psychiatric caseness in 49% and DSM-classifications in 46% of the adolescents (primary classifications: emotional disorder 27%, behavioral disorder 11%, other disorder 7%). Cross-informant agreement between single ratings and expert dossier ratings was better than agreement between single ratings. Logistic regression analyses revealed that low IQ, a signing mode of communication and a history of three or more physical disorders were associated with psychiatric caseness.
Conclusions: Findings suggest a high prevalence of psychopathology in the population studied and argue for a special focus on the early detection of significant emotional and behavioral problems as well as a multi-informant approach to the assessment of disorder in deaf children and adolescents. The correlational findings support the view that it is not deafness per se that contributes to psychiatric problems.
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from Developmental Science
It has been proposed that specific language impairment (SLI) is the consequence of low-level abnormalities in auditory perception. However, studies of long-latency auditory ERPs in children with SLI have generated inconsistent findings. A possible reason for this inconsistency is the heterogeneity of SLI. The intraclass correlation (ICC) has been proposed as a useful statistic for evaluating heterogeneity because it allows one to compare an individual's auditory ERP with the grand average waveform from a typically developing reference group. We used this method to reanalyse auditory ERPs from a sample previously described by Uwer, Albrecht and von Suchodoletz (2002). In a subset of children with receptive SLI, there was less correspondence (i.e. lower ICC) with the normative waveform (based on the control grand average) than for typically developing children. This poorer correspondence was seen in responses to both tone and speech stimuli for the period 100–228 ms post stimulus onset. The effect was lateralized and seen at right- but not left-sided electrodes.
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from Infant Behavior and Development
Objective
To determine the effects of maternal smoking on fetal spontaneous behavior and auditory processing.
Methods
38 fetuses of smoking (n = 18) and non-smoking (n = 20) mothers, stratified by gestational age (<37, =37 weeks GA), were examined at least 1 h following smoking. Observations included spontaneous fetal heart rate (FHR; 20 min) and body movements (20 min) followed by a 2 min audiotape of the mother reading a story while FHR and body movements were recorded.
Results
There were no differences in spontaneous behaviors; full-term fetuses showed a FHR acceleration and body movement during the mother's voice. A FHR response following voice offset was limited to fetuses less than 37 weeks GA of non-smoking mothers.
Conclusion
Fetuses less than 37 weeks GA of mothers who smoke throughout pregnancy have a delayed onset of response to the maternal voice, a subtle difference which may have implications for later language development for prematurely born infants which needs further investigation.
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from Infant Behavior and Development
This study examined the nature and correlates of the behavioral characteristics of a nationally representative sample of 1612 toddlers 18–31 months of age entering Part C early intervention services in the U.S. Factor analysis of 15 items describing child behavior collected as part of an extensive telephone interview of parents yielded four dimensions of behavior: difficult behaviors, lack of persistence, distractible, and withdrawn. Demographic and personal characteristics of the child and family were found to be related to the four behavioral dimensions. Parent reports of behavior of toddlers with fair or poor health or those with communication difficulties were less positive for all behavioral dimensions, suggesting the development of toddler behavioral characteristics is influencing or being influenced by other facets of development.
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from Advances in Child Development and Behavior
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from Advances in Child Development and Behavior
The accumulated evidence that we reviewed suggests that children make use of regularities in the language--be it phonological, orthographic, and morphological--to read and spell words. Given that languages vary in the clarity with which oral language is represented in writing, one should expect the relative roles of phonological, orthographic, and morphological processing to vary accordingly. In this chapter, we focused on the relative contribution of morphological analysis and awareness to reading and spelling. We found that the morphological information in complex words can facilitate reading and spelling and that knowledge about the morphemic structure of a language can assist a child in reading, spelling, and deriving the meaning of multimorphemic words. The accumulated evidence also demonstrates that morphological awareness contributes to individual differences in reading and spelling that cannot be entirely subsumed to orthographic and phonological processing. Intervention studies on morphological knowledge (i.e., analysis and awareness), however, have not yielded the strong effects that one would have expected. We suspect that more successful intervention studies on how morphological knowledge can enhance literacy warrant a more thorough understanding of the complex interplay between morphological knowledge and a number of different variables such as oral vocabulary, phonological and orthographic awareness, and reading exposure. Given the demonstrated facilitative effects that morphological information can have on reading and spelling along with the particular difficulties that multimorphemic words can pose, researchers argue that systematic and sequential instruction of morphology is needed during the elementary years of schooling. Morphological rules, however, are currently not taught or taught partially to elementary school children. Perhaps, as Carlisle suggests, this is partly due to the fact that educators are more familiar with concepts of phonemes and phoneme awareness than with concepts of morphemes and morphemic awareness. This may change in time as we cumulate stronger scientific evidence on the valuable role of morphological knowledge in reading and spelling.
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from the European Archives of Oto-Rhino-Laryngology
Abstract Perineurioma is a rare, benign tumour of the perineurium, which develops mostly on the nerves of the extremities. The neoplasm related to a genetic mutation on the 22nd chromosome, is a rarity on the vagal nerve branches. Authors report the case of a 15-year-old female with an immunhistochemically verified (focal EMA positive, vimentin, CD56 positive) perineurioma originating from the left recurrent laryngeal nerve. After the removal of the tumour together with the involved 2-cm-long part of the nerve, vocal fold palsy developed with aphonia (left vocal fold was in intermedian position). The treatment had to be chosen carefully as the larynx was still in growth. In our case there was no possibility of spontaneous regeneration, thus we chose lipoaugmentation of the left vocal fold, which does not affect the laryngeal framework, so causes the least harm to the larynx. Following surgery the patient’s voice reached the normal range (before lipoaugmentation perception (0–100): G40 B80 R40 Acoustics: Ji 1.1%, Shi 10.8% Harmonicity: 13.9 dB maximum phonation time (MPT) 5 s after augmentation, Perception: G10 B10 R20, Acoustics: Ji 0.3 %, Shi 2.6%, Harmonicity: 21.2 dB MPT 22 s). This result was permanent, as the regularly performed objective voice evaluations confirmed during the 2-year follow-up.
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from Revista Brasileira de Otorrinolaringologia
One of the main factors that make tinnitus treatment so difficult is the subjectivity of measuring methods and therapeutic monitoring. DATABASE: Our aim, in this study, is to make a critical analysis of tinnitus measuring methods. CONCLUSION: There is no consensus about tinnitus measuring methods, causing criticism in the methodology used in many papers. In Brazil, the simplest methods are the most used.
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from Revista Brasileira de Otorrinolaringologia
The middle latency response (MLR) to an acoustic stimulus occurs between 10 and 80 ms. The waveform is characterized by a series of peaks and troughs labeled N0, P0, Na, Pa, Nb and Pb. Certain acoustic stimuli may excite specific cochlear areas in contrast with clicks, that activate the cochlea between 1000 and 4000 Hz. The logon stimulus activates segmentar areas of the cochlea and has advantages over clicks when assessing low frequency areas of the cochlea (below 1 kHz). AIM: The aim of this paper was to study the MLR electrophysiologic response when activated by logon stimuli at 500, 1000 and 2000 Hz. Method- a prospective and descriptive study. 14 female volunteers had normal otology and conventional audiology results. The stimulus was monoaural and ipsilateral (Cz/A1-2). RESULTS: the NaPa complex was readily identified compared to other complexes and was present in 100% of the tests done at 2000 Hz, and in 96.4% of the tests done at 500 and 1000 Hz. CONCLUSION: the logon stimulus at 500, 1000 and 2000 Hz elicits MLRs; the NaPa complex was the most frequent event and the 2000 Hz frequency elicited more responses than other frequencies.
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from Revista Brasileira de Otorrinolaringologia
Tympanoplasty is done to eradicate ear pathology and to restore the conductive hearing mechanism (eardrum and ossicles). Some patients, however, do not tolerate tinnitus and question physicians about the results of surgery when tinnitus persists. AIM: to evaluate the progression of tinnitus in patients with conductive hearing loss after tympanoplasty. STUDY DESIGN: a prospective cohort study. Material and Methods: 23 consecutive patients with tinnitus due to chronic otitis media underwent tympanoplasty. The patients underwent a medical and audiological protocol for tinnitus before and after tympanoplasty. RESULTS: 82.6% of patients had improvement or elimination of tinnitus after tympanoplasty The mean score of postoperative intolerance to tinnitus (1.91 for 30 and 180 days) was significantly different from preoperative scores (5.26). As to hearing loss, patients improved medically 30 and 180 days after surgery (3.65 and 2.91) compared to the preoperative condition (6.56). Audiometry revealed improvement at all frequencies from 0.25 to 6KHz, except at 8KHz. The air-bone gap was closed or was within 10dB in 14 cases (61%). An intact tympanic membrane was achieved in 78% of the cases. CONCLUSION: Aside from the classical improvement of hearing loss, tympanoplasty also offers good control of tinnitus.
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from Revista Brasileira de Otorrinolaringologia
Hearing aids may be a option to improve tinnitus and hearing loss. AIM: to evaluate tinnitus after one month use of BTE hearing aids with open molds and pressure vent molds in patients with symmetric sensorineural hearing loss. METHODS: 50 patients seen at our Tinnitus Clinic who presented bilateral tinnitus and hearing loss underwent a randomized blind crossover clinical trial: 26 first used BTE hearing aids with open molds, and the remaining 24 first used pressure vent molds. After 30 days using the first mold and a wash-out period, the type of earmold was changed and was applied for another 30-day-period. Tinnitus evaluation was done qualitatively (improved, unchanged and worsened) and quantitatively (variation on a numeric scale from 0 to 10). RESULTS: 82% of the cases reported improvement of tinnitus with at least one type of earmold; there was no significant difference in the reduction of discomfort due to tinnitus in the quantitative and qualitative evaluations. Although similar tinnitus control was obtained with both methods, 66% of the patients preferred the open mold. CONCLUSION: In a short-term evaluation improvement of tinnitus by the use of hearing aids does not depend on earmold ventilation.
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from Revista Brasileira de Otorrinolaringologia
Ménière;s disease is a frequent vestibular disease that occurs predominantly in the fourth decade of life. Diagnosis is mostly medical and is based on findings of vertigo, sensorineural hearing loss, tinnitus and aural fullness. AIM: To study the clinical findings of Ménière;s disease: age, duration of vertigo, tinnitus, hearing loss and aural fullness, and unilateral or bilateral involvement. METHOD: a retrospective study included 39 patients with a diagnosis of Ménière;s disease confirmed by electrocochleography, who were seen at a neuro-otology referral centre. Patients underwent a clinical examination, audiometry and bilateral transtympanic electrocochleography. Patients were separated into 2 groups: bilateral Ménière;s disease and unilateral Ménière;s disease. RESULTS: The mean age was 42.9 years; 72.5% were female. Fluctuation of hearing loss occurred in 54.5% of cases, and 65.7% had frequent attacks of vertigo. Bilateral disease was observed in 33.3%. The onset of the disease was earlier in the bilateral group (33.7 years) compared to the unilateral group (p= 0.0013). Duration of disease, tinnitus, hearing loss and aural fullness were similar between groups. CONCLUSION: Patients with bilateral Ménière;s disease had symptoms earlier than patients with unilateral disease. There was no difference between the groups in duration of disease and associated symptoms.
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from Revista Brasileira de Otorrinolaringologia
Tinnitus is a common symptom, defined as a sound perception in absence of a sound stimulus. AIM: Evaluate if Trazodone, an antidepressant drug, which modulates serotonin at central neuronal pathways, is effective in controlling tinnitus. STUDY DESIGN : Prospective, double blind, randomized, placebo-controlled. Materials and Methods: Study performed with patients presenting tinnitus. 85 patients were analyzed between February and June of 2005. 43 received trazodone and 42 placebo, for 60 days. The clinical criteria of analysis were tinnitus intensity, discomfort and life quality impact by tinnitus, using an analogue scale varying between 0 and 10, scored by patients before and after drug or placebo use. RESULTS: There was a significant improvement in intensity, discomfort and life quality in both groups after treatment; however, there was no significant difference between the drug and placebo groups. Patients with age equal or over 60 years presented better results after treatment. CONCLUSION: Trazodone was not efficient in controlling tinnitus in the patients evaluated under the doses utilized.
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from Revista Brasileira de Otorrinolaringologia
Glucose metabolism has a significant impact on inner ear physiology, and small changes may result in hearing and balance disorders. AIM: To investigate vestibulocochlear symptoms in patients with type I diabetes mellitus. STUDY DESIGN: a cross-sectional study of a contemporary group. MATERIAL AND METHOD: 30 patients referred from Clinical Hospital-UFPR to the Laboratory of Otoneurology-UTP between Mar/2004 to Feb/2005 were evaluated. The following procedures were carried out: a medical history, otological inspections, audiometry, acoustic impedance tests, and vestibular function tests. RESULTS: The prevalence of otoneurologic complaints was: headache (23.3%), vertigo (16.6%), and tinnitus (13.3%). The prevalence of associated complaints and habits was: caffeine abuse (20.0%), allergies (10.0%), and alcohol abuse (10.0%). The prevalence of normal auditory thresholds was 90.0%. Acoustic impedance showed no changes. The vestibular test showed changes in 60.0% of cases. Peripheral vestibular deficiency syndromes were also found. CONCLUSIONS: Significant vestibular system changes were found (60.0%) compared to the auditory system (10.0%). Audiometry revealed mostly normal results. The vestibular test showed changes in the peripheral vestibular system and the peripheral vestibular deficiency syndrome.
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from the Italian Journal of Neurological Sciences
Abstract Alteration of the pharyngoesophageal musculature is a common finding in patients with myotonic dystrophy (MD), regardless of the presence of dysphagia. The aim of the present study was to determine whether a specific pattern of swallowing abnormalities could be identified in MD patients, and the possible correlation with the size of CTG repeats. Fifteen MD patients, 8 of whom were asymptomatic for dysphagia, underwent a videofluoroscopic study of swallowing. Alterations of the pharyngoesophageal phase of swallowing were detected in 12 of 15 patients, 6 without clinical evidence of dysphagia. Incomplete relaxation of the upper esophageal sphincter (UES) and esophageal hypotonia were the most common alterations. We found a significant correlation between the number of radiological alterations and the size of CTG repeats. A typical radiological pattern of swallowing has also been identified. The role of videofluoroscopy in evaluation of MD patients is briefly discussed.
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from Ivanhoe.com
“Relax.” “Calm down.” “Take it slow.” If you are one of the 3 million Americans who stutter, you’re probably tired of hearing those words. Now, experts say stuttering may not be a nervous condition after all. Many believe the brain may be to blame.
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from JARO -- Journal of the Association for Research in Otolaryngology
Abstract Although drug-induced and age-related hearing losses are frequent otologic problems affecting millions of people, their underlying mechanisms remain uncertain. The inner ear is exclusively endowed with a positive endocochlear potential (EP) that serves as the main driving force for the generation of receptor potential in hair cells to confer hearing. Deterioration of EP leads to hearing loss or deafness. The generation of EP relies on the activity of many ion transporters to establish active potassium (K+) cycling within the inner ear, including K+ channels, the Na–K–2Cl co-transporter (NKCC1), and the a1 and a2 isoforms of Na,K–ATPase. We show that heterozygous deletion of either NKCC1, a1-Na,K–ATPase, or a2–Na,K–ATPase independently results in progressive, age-dependent hearing loss with minimal alteration in cochlear morphology. Double heterozygote deletion of NKCC1 with a1–Na,K–ATPase also shows a progressive, though delayed, age-dependent hearing loss. Remarkably, double heterozygote deletion of NKCC1 with a2–Na,K–ATPase demonstrates a striking preservation of hearing threshold both initially and with age. Measurements of the EP confirm the anticipated drop in potential for genotypes that demonstrate age-dependent hearing loss. The EP generated by the NKCC1 + a2-Na,K–ATPase double heterozygote, however, is maintained at a level comparable to that of the control condition, suggesting a potential advantage in this combination of ion transporter modification. These observations provide insight into the detailed mechanisms of EP generation, and results of combination-knockout experiments may have important implications in the future treatment of drug-induced and age-related hearing losses.
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from Sci-Tech Today.com
It is called the "word spurt," that magical time when a toddler's vocabulary explodes, seemingly overnight.
New research offers a decidedly un-magical explanation: Babies start really jabbering after they have mastered enough easy words to tackle more of the harder ones. It is essentially a snowball effect.
That explanation, published in Friday's edition of the journal Science, is far simpler than scientists' assumptions that some special brain mechanisms must click to trigger the word boom.
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from Language and Cognitive Processes
Gestures that accompany speech are known to be tightly coupled with speech production. However little is known about the cognitive processes that underlie this link. Previous cross-linguistic research has provided preliminary evidence for online interaction between the two systems based on the systematic co-variation found between how different languages syntactically package Manner and Path information of a motion event and how gestures represent Manner and Path. Here we elaborate on this finding by testing whether speakers within the same language gesturally express Manner and Path differently according to their online choice of syntactic packaging of Manner and Path, or whether gestural expression is pre-determined by a habitual conceptual schema congruent with the linguistic typology. Typologically congruent and incongruent syntactic structures for expressing Manner and Path (i.e., in a single clause or multiple clauses) were elicited from English speakers. We found that gestural expressions were determined by the online choice of syntactic packaging rather than by a habitual conceptual schema. It is therefore concluded that speech and gesture production processes interface online at the conceptual planning phase. Implications of the findings for models of speech and gesture production are discussed.
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from Journal of Neuroscience
In several sensory systems, the conversion of the representation of stimuli from graded membrane potentials into stochastic spike trains is performed by ribbon synapses. In the mammalian auditory system, the spiking characteristics of the vast majority of primary afferent auditory-nerve (AN) fibers are determined primarily by a single ribbon synapse in a single inner hair cell (IHC), and thus provide a unique window into the operation of the synapse. Here, we examine the distributions of interspike intervals (ISIs) of cat AN fibers under conditions when the IHC membrane potential can be considered constant and the processes generating AN fiber activity can be considered stationary, namely in the absence of auditory stimulation. Such spontaneous activity is commonly thought to result from an excitatory Poisson point process modified by the refractory properties of the fiber, but here we show that this cannot be the case. Rather, the ISI distributions are one to two orders of magnitude better and very accurately described as a result of a homogeneous stochastic process of excitation (transmitter release events) in which the distribution of interevent times is a mixture of an exponential and a gamma distribution with shape factor 2, both with the same scale parameter. Whereas the scale parameter varies across fibers, the proportions of exponentially and gamma distributed intervals in the mixture, and the refractory properties, can be considered constant. This suggests that all of the ribbon synapses operate in a similar manner, possibly just at different rates. Our findings also constitute an essential step toward a better understanding of the spike-train representation of time-varying stimuli initiated at this synapse, and thus of the fundamentals of temporal coding in the auditory pathway.
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from Audiology & Neuro-Otology
Introduction: Constant histological changes in otosclerosis lead to progressive hearing loss which may end up in a profound hearing loss and then be treated by means of cochlear implants. These progressive changes could be followed by changes in cochlear implants fitting and speech discrimination results over the years. Objectives: The aim of the study is to correlate the progressive histological changes to the cochlear implant clinical outcomes (fitting and speech discrimination results). Also main complications (facial nerve stimulation and difficulties at insertion) and new complications will be discussed. Design: A 5-year prospective case-control study was performed in order to compare cochlear implant results in otosclerosis patients to those in a matched-pair control group. Materials and Methods: Fifteen otosclerosis patients were followed throughout the study. Preoperatively temporal bone high-resolution computed tomography, electrically evoked auditory brainstem responses and speech discrimination tests were performed in order to select the patients to be implanted. Results: Not only difficulties with electrode guide insertion were reported, but also difficulties with fitting over the years, due to increasing difficulties to spread the electrical stimuli, which provokes increasing thresholds, maximum comfort levels and charges needed to stimulate hearing cells in basal and medial turn electrodes (p < 0.05), which required deactivating some basal and medial turn electrodes in order to improve cochlear implant effectiveness. The results demonstrated no statistical differences in speech discrimination in otosclerosis patients compared to the control group (p > 0.05). Several complications were reported: facial nerve stimulation (7.14%) and sudden episodes of tinnitus and headaches (14.28%). Conclusions: Although progressive histological changes in otosclerosis lead to increasing thresholds, maximum comfort levels and charges needed to stimulate hearing cells, speech discrimination results support the cochlear implantation in otosclerosis.
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from the Indian Journal of Medical Sciences
Context : Stuttering has a life span incidence and it significantly impacts academic, social, emotional and vocational achievements of patients who stutter. Aims : The purpose of the present study was to examine phonological encoding in young children who stutter (CWS) during a nonword repetition task and to test the covert repair hypothesis (CRH) and phonological skills in Persian native children. Setting and Design : The study was conducted among 12 CWS and 12 children who do not stutter (CWNS) between the ages of 5.1 and 7.10 at the rehabilitation clinics in Tehran. Materials and Methods: A list of 40 bisyllabic and trisyllabic nonwords was used in a nonword repetition task to collect information about the following dependent variables: (a) reaction times (RTs), (b) the number of phonological errors (PEs) and (c) nonword length. Data Analysis: An independent sample T-test was performed to compare means of PEs and RTs between the two groups and a paired t-test for analysis of nonword length impacts. Results : Results indicated that the CWS had a slightly poor performance than CWNS but there was no significant difference between the groups. Also, the differences between bisyllabic and trisyllabic nonwords were significant for phonological errors but not for reaction times. Conclusion : In general, it is concluded that CWS might not have a gross problem in phonological retrieval of the novel phonological context even with increase in syllable length. Also, some predictions of CRH were not supported by this research. However, further research into this possibility may shed light on the emergence and characteristics of childhood stuttering.
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from Language and Cognitive Processes
Language production theories should explain how speakers generate an utterance's sound structure. One critical question is whether prosody and performance effects have different sources in the production system. It is argued that algorithms designed to predict phenomena such as pauses or intonational breaks are problematic because they tend to conflate prosody and planning. In addition, algorithms that have been proposed have not been evaluated systematically enough to allow their strengths and weaknesses to be assessed and compared, and to the extent that the algorithms have been evaluated, it is clear that they are only moderately successful at predicting the dependent measures of interest. Experimental work suggests that prosodic effects are based on prosodic constituency to the left of a potential boundary, and hesitations are due to planning of syntactic and semantic constituents to the right. Thus, any adequate algorithm must distinguish between prosody and performance, prosodic and syntactic-semantic constituency, and planning and execution effects.
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from the Journal of the Acoustical Society of America
The role of transient speech components on speech intelligibility was investigated. Speech was decomposed into two components—quasi-steady-state (QSS) and transient—using a set of time-varying filters whose center frequencies and bandwidths were controlled to identify the strongest formant components in speech. The relative energy and intelligibility of the QSS and transient components were compared to original speech. Most of the speech energy was in the QSS component, but this component had low intelligibility. The transient component had much lower energy but was almost as intelligible as the original speech, suggesting that the transient component included speech elements important to speech perception. A modified version of speech was produced by amplifying the transient component and recombining it with the original speech. The intelligibility of the modified speech in background noise was compared to that of the original speech, using a psychoacoustic procedure based on the modified rhyme protocol. Word recognition rates for the modified speech were significantly higher at low signal-to-noise ratios (SNRs), with minimal effect on intelligibility at higher SNRs. These results suggest that amplification of transient information may improve the intelligibility of speech in noise and that this improvement is more effective in severe noise conditions. ©2007 Acoustical Society of America
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from the Journal of the Acoustical Society of America
The ability of normally hearing and hearing-impaired subjects to use temporal fine structure information in complex tones was measured. Subjects were required to discriminate a harmonic complex tone from a tone in which all components were shifted upwards by the same amount in Hz, in a three-alternative, forced-choice task. The tones either contained five equal-amplitude components (non-shaped stimuli) or contained many components, but were passed through a fixed bandpass filter to reduce excitation pattern changes (shaped stimuli). Components were centered at nominal harmonic numbers (N) 7, 11, and 18. For the shaped stimuli, hearing-impaired subjects performed much more poorly than normally hearing subjects, with most of the former scoring no better than chance when N=11 or 18, suggesting that they could not access the temporal fine structure information. Performance for the hearing-impaired subjects was significantly improved for the non-shaped stimuli, presumably because they could benefit from spectral cues. It is proposed that normal-hearing subjects can use temporal fine structure information provided the spacing between fine structure peaks is not too small relative to the envelope period, but subjects with moderate cochlear hearing loss make little use of temporal fine structure information for unresolved components. ©2007 Acoustical Society of America
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from the Journal of the Acoustical Society of America
The present study had two main purposes. One was to examine if listeners perceive gradually increasing durations of a voiceless fricative categorically (“fluent” versus “stuttered”) or continuously (gradient perception from fluent to stuttered). The second purpose was to investigate whether there are gender differences in how listeners perceive various duration of sounds as “prolongations.” Forty-four listeners were instructed to rate the duration of the // in the word “shape” produced by a normally fluent speaker. The target word was embedded in the middle of an experimental phrase and the initial // sound was digitally manipulated to create a range of fluent to stuttered sounds. This was accomplished by creating 20 ms stepwise increments for sounds ranging from 120 to 500 ms in duration. Listeners were instructed to give a rating of 1 for a fluent word and a rating of 100 for a stuttered word. The results showed listeners perceived the range of sounds continuously. Also, there was a significant gender difference in that males rated fluent sounds higher than females but female listeners rated stuttered sounds higher than males. The implications of these results are discussed. ©2007 Acoustical Society of America
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from the Journal of the Acoustical Society of America
These experiments examined how high presentation levels influence speech recognition for high- and low-frequency stimuli in noise. Normally hearing (NH) and hearing-impaired (HI) listeners were tested. In Experiment 1, high- and low-frequency bandwidths yielding 70%-correct word recognition in quiet were determined at levels associated with broadband speech at 75 dB SPL. In Experiment 2, broadband and band-limited sentences (based on passbands measured in Experiment 1) were presented at this level in speech-shaped noise filtered to the same frequency bandwidths as targets. Noise levels were adjusted to produce ~30%-correct word recognition. Frequency bandwidths and signal-to-noise ratios supporting criterion performance in Experiment 2 were tested at 75, 87.5, and 100 dB SPL in Experiment 3. Performance tended to decrease as levels increased. For NH listeners, this “rollover” effect was greater for high-frequency and broadband materials than for low-frequency stimuli. For HI listeners, the 75- to 87.5-dB increase improved signal audibility for high-frequency stimuli and rollover was not observed. However, the 87.5- to 100-dB increase produced qualitatively similar results for both groups: scores decreased most for high-frequency stimuli and least for low-frequency materials. Predictions of speech intelligibility by quantitative methods such as the Speech Intelligibility Index may be improved if rollover effects are modeled as frequency dependent. ©2007 Acoustical Society of America
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from the Journal of the Acoustical Society of America
The idea that listeners are able to “glimpse” the target speech in the presence of competing noise has been supported by many studies, and is based on the assumption that listeners are able to glimpse pieces of the target speech occurring at different times and somehow patch them together to hear out the target speech. The factors influencing glimpsing in noise are not well understood and are examined in the present study. Specifically, the effects of the frequency location, spectral width, and duration of the glimpses are examined. Stimuli were constructed using an ideal time-frequency (T-F) masking technique that ensures that the target is stronger than the masker in certain T-F regions of the mixture, thereby rendering certain regions easier to glimpse than others. Sentences were synthesized using this technique with glimpse information placed in several frequency regions while varying the glimpse window duration and total duration of glimpsing. Results indicated that the frequency location and total duration of the glimpses had a significant effect on speech recognition, with the highest performance obtained when the listeners were able to glimpse information in the F1/F2 frequency region (0–3 kHz) for at least 60% of the utterance. ©2007 Acoustical Society of America
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from the Journal of the Acoustical Society of America
Noise and distortion reduce speech intelligibility and quality in audio devices such as hearing aids. This study investigates the perception and prediction of sound quality by both normal-hearing and hearing-impaired subjects for conditions of noise and distortion related to those found in hearing aids. Stimuli were sentences subjected to three kinds of distortion (additive noise, peak clipping, and center clipping), with eight levels of degradation for each distortion type. The subjects performed paired comparisons for all possible pairs of 24 conditions. A one-dimensional coherence-based metric was used to analyze the quality judgments. This metric was an extension of a speech intelligibility metric presented in Kates and Arehart (2005) [J. Acoust. Soc. Am. 117, 2224–2237] and is based on dividing the speech signal into three amplitude regions, computing the coherence for each region, and then combining the three coherence values across frequency in a calculation based on the speech intelligibility index. The one-dimensional metric accurately predicted the quality judgments of normal-hearing listeners and listeners with mild-to-moderate hearing loss, although some systematic errors were present. A multidimensional analysis indicates that several dimensions are needed to describe the factors used by subjects to judge the effects of the three distortion types. ©2007 Acoustical Society of America
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from the Journal of the Acoustical Society of America
Speech perception in the presence of another competing voice is one of the most challenging tasks for cochlear implant users. Several studies have shown that (1) the fundamental frequency (F0) is a useful cue for segregating competing speech sounds and (2) the F0 is better represented by the temporal fine structure than by the temporal envelope. However, current cochlear implant speech processing algorithms emphasize temporal envelope information and discard the temporal fine structure. In this study, speech recognition was measured as a function of the F0 separation of the target and competing sentence in normal-hearing and cochlear implant listeners. For the normal-hearing listeners, the combined sentences were processed through either a standard implant simulation or a new algorithm which additionally extracts a slowed-down version of the temporal fine structure (called Frequency-Amplitude-Modulation-Encoding). The results showed no benefit of increasing F0 separation for the cochlear implant or simulation groups. In contrast, the new algorithm resulted in gradual improvements with increasing F0 separation, similar to that found with unprocessed sentences. These results emphasize the importance of temporal fine structure for speech perception and demonstrate a potential remedy for difficulty in the perceptual segregation of competing speech sounds. ©2007 Acoustical Society of America
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from the Journal of the Acoustical Society of America
Nonlinear sensory and neural processing mechanisms have been exploited to enhance spectral contrast for improvement of speech understanding in noise. The “companding” algorithm employs both two-tone suppression and adaptive gain mechanisms to achieve spectral enhancement. This study implemented a 50-channel companding strategy and evaluated its efficiency as a front-end noise suppression technique in cochlear implants. The key parameters were identified and evaluated to optimize the companding performance. Both normal-hearing (NH) listeners and cochlear-implant (CI) users performed phoneme and sentence recognition tests in quiet and in steady-state speech-shaped noise. Data from the NH listeners showed that for noise conditions, the implemented strategy improved vowel perception but not consonant and sentence perception. However, the CI users showed significant improvements in both phoneme and sentence perception in noise. Maximum average improvement for vowel recognition was 21.3 percentage points (p<0.05) at 0 dB signal-to-noise ratio (SNR), followed by 17.7 percentage points (p<0.05) at 5 dB SNR for sentence recognition and 12.1 percentage points (p<0.05) at 5 dB SNR for consonant recognition. While the observed results could be attributed to the enhanced spectral contrast, it is likely that the corresponding temporal changes caused by companding also played a significant role and should be addressed by future studies. ©2007 Acoustical Society of America
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from the Journal of the Acoustical Society of America
Cross-language perception studies report influences of speech style and consonantal context on perceived similarity and discrimination of non-native vowels by inexperienced and experienced listeners. Detailed acoustic comparisons of distributions of vowels produced by native speakers of North German (NG), Parisian French (PF) and New York English (AE) in citation (di)syllables and in sentences (surrounded by labial and alveolar stops) are reported here. Results of within- and cross-language discriminant analyses reveal striking dissimilarities across languages in the spectral/temporal variation of coarticulated vowels. As expected, vocalic duration was most important in differentiating NG vowels; it did not contribute to PF vowel classification. Spectrally, NG long vowels showed little coarticulatory change, but back/low short vowels were fronted/raised in alveolar context. PF vowels showed greater coarticulatory effects overall; back and front rounded vowels were fronted, low and mid-low vowels were raised in both sentence contexts. AE mid to high back vowels were extremely fronted in alveolar contexts, with little change in mid-low and low long vowels. Cross-language discriminant analyses revealed varying patterns of spectral (dis)similarity across speech styles and consonantal contexts that could, in part, account for AE listeners' perception of German and French front rounded vowels, and “similar” mid-high to mid-low vowels. ©2007 Acoustical Society of America
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from the Journal of the Acoustical Society of America
The mechanical properties of the vocal fold lamina propria, including the vocal fold cover and the vocal ligament, play an important role in regulating the fundamental frequency of human phonation. This study examines the equilibrium hyperelastic tensile deformation behavior of cover and ligament specimens isolated from excised human larynges. Ogden's hyperelastic model is used to characterize the tensile stress-stretch behaviors at equilibrium. Several statistically significant differences in the mechanical response differentiating cover and ligament, as well as gender are found. Fundamental frequencies are predicted from a string model and a beam model, both accounting for the cover and the ligament. The beam model predicts nonzero F0 for the unstretched state of the vocal fold. It is demonstrated that bending stiffness significantly contributes to the predicted F0, with the ligament contributing to a higher F0, especially in females. Despite the availability of only a small data set, the model predicts an age dependence of F0 in males in agreement with experimental findings. Accounting for two mechanisms of fundamental frequency regulation—vocal fold posturing (stretching) and extended clamping—brings predicted F0 close to the lower bound of the human phonatory range. Advantages and limitations of the current model are discussed. ©2007 Acoustical Society of America
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from Journal of Learning Disabilities
Teenagers with nonverbal learning disabilities (NLD) have difficulty with fine-motor coordination, which may relate to the novelty of the task or the lack of "self-talk" to mediate action. In this study, we required two teenagers with NLD and two control group teenagers to touch the thumb of each hand firmly and accurately to the fingertips of the same hand, in an order specified by verbal or tactile instruction. Brain activity patterns (measured using functional magnetic resonance imaging) suggest that unlike control participants, the NLD participants used internalized speech to facilitate the novel task only when instructions were verbal. NLD participants also showed activity in a more widely distributed network of neural structures. These findings provide preliminary evidence for remediation strategies that encourage internal speech.
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from Journal of Learning Disabilities
In this study, we aimed to ascertain whether it is possible to create reading contexts that eliminate the impact of word recognition on reading comprehension and permit pupils with reading disabilities (RD) to attain a level of comprehension similar to that of their peers without RD. Specifically, the study compared a traditional reading situation with one of reading with aids (joint reading). In both situations, pupils' comprehension level was assessed by means of a summary and a series of inferential questions, and we controlled the effect on comprehension of word recognition, previous knowledge, rhetorical competence, and working memory. The results showed that the aids provided during reading do not eliminate the effect of word recognition, but they do permit readers with RD to attain a comprehension level similar to that of their peers.
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from Dyslexia
This study focused on the relationship between school performance and performance on a dichotic listening (DL) task in dyslexic children. Dyslexia is associated with impaired phonological processing, related to functions in the left temporal lobe. DL is a frequently used task to assess functions of the left temporal lobe. Due to the predominance of the contralateral neuronal pathways, a right ear advantage in the DL task reflects the superior processing capacity for the right ear stimulus in the left hemisphere (Kimura, 1963). Previous studies using DL in dyslexia are, however, inconclusive, and may reflect degree of severity of dyslexia. The aim of the present study was therefore to investigate lateralized processing in two sub-groups of dyslexia, differing in symptom severity.
Two groups of dyslexic 12-year-old children and an age-matched control group were tested with a consonant-vowel DL task. The two dyslexia groups differed in severity through how they responded to training efforts being made in their schools, while otherwise being matched for age, IQ and diagnosis.
The D1 (respondent group) group showed a DL performance pattern similar to the control group, i.e. a right ear advantage, while the D2 (non-respondent) group failed to show a right ear advantage on the DL task.
The performance on the DL task by the two dyslexia groups may provide better insight as to the degree of reading and writing impairment in dyslexia. Cracking the code and acquiring automatized literacy skills may seem harder for the D2 group children compared to the D1 children. Also, the present study points to the use of DL as a valid assessment tool in clinical work to improve differential diagnoses, particularly in relation to measures of school performance. Copyright © 2007 John Wiley & Sons, Ltd.
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from Cerebral Cortex
Recent studies, conducted almost exclusively in primates, have shown that several cortical areas usually associated with modality-specific sensory processing are subject to influences from other senses. Here we demonstrate using single-unit recordings and estimates of mutual information that visual stimuli can influence the activity of units in the auditory cortex of anesthetized ferrets. In many cases, these units were also acoustically responsive and frequently transmitted more information in their spike discharge patterns in response to paired visual–auditory stimulation than when either modality was presented by itself. For each stimulus, this information was conveyed by a combination of spike count and spike timing. Even in primary auditory areas (primary auditory cortex [A1] and anterior auditory field [AAF]), 15% of recorded units were found to have nonauditory input. This proportion increased in the higher level fields that lie ventral to A1/AAF and was highest in the anterior ventral field, where nearly 50% of the units were found to be responsive to visual stimuli only and a further quarter to both visual and auditory stimuli. Within each field, the pure-tone response properties of neurons sensitive to visual stimuli did not differ in any systematic way from those of visually unresponsive neurons. Neural tracer injections revealed direct inputs from visual cortex into auditory cortex, indicating a potential source of origin for the visual responses. Primary visual cortex projects sparsely to A1, whereas higher visual areas innervate auditory areas in a field-specific manner. These data indicate that multisensory convergence and integration are features common to all auditory cortical areas but are especially prevalent in higher areas.
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from Cerebral Cortex
A hallmark of categorical perception is better discrimination of stimulus tokens from 2 different categories compared with token pairs that are equally dissimilar but drawn from the same category. This effect is well studied in speech perception and represents an important characteristic of how the phonetic form of speech is processed. We investigated the brain mechanisms of categorical perception of stop consonants using functional magnetic resonance imaging and a passive short-interval habituation trial design (Zevin and McCandliss 2005). The paradigm takes advantage of neural adaptation effects to identify specific regions sensitive to an oddball stimulus presented in the context of a repeated item. These effects were compared for changes in stimulus characteristics that result in either a between-category (phonetic and acoustic) or a within-category (acoustic only) stimulus shift. Significantly greater activation for between-category than within-category stimuli was observed in left superior sulcus and middle temporal gyrus as well as in inferior parietal cortex. In contrast, only a subcortical region specifically responded to within-category changes. The data suggest that these habituation effects are due to the unattended detection of a phonetic stimulus feature.
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from Medical News Today.com
A 30-year scientific debate over how specialized cells in the inner ear amplify sound in mammals appears to have been settled more in favor of bouncing cell bodies rather than vibrating, hair-like cilia, according to investigators at St. Jude Children's Research Hospital.
The finding could explain why dogs, cats, humans and other mammals have such sensitive hearing and the ability to discriminate among frequencies. The work also highlights the importance of basic hearing research in studies into the causes of deafness. A report on this work appears in the advanced online issue of Proceedings of the National Academy of Science.
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from International Journal of Audiology
The main purpose of this study is to examine the applicability of an adaptive and interactive optimization strategy to fine-tune three hearing-aid algorithms simultaneously: dynamic compression, temporal signal enhancement, and noise reduction. The optimal combination of these three algorithms was determined by a multidirectional pattern search with an adaptive step size. Additionally, we applied a round-robin procedure to validate the results of the optimization procedure. For both procedures the listeners were asked to compare two consecutive, differently processed sentences in continuous and fluctuating background noises on speech intelligibility. Ten hearing-impaired and four normal-hearing subjects participated. The reliability and consistency of the multidirectional pattern search was low, especially for the fluctuating noise condition. The results of the round-robin procedure did not correspond closely with the pattern search results. These findings suggest that the current implementation of a multidirectional optimization procedure has not yet proven to be applicable for the necessary individual fine tuning of complex signal processing strategies, when the objective is to maximize speech intelligibility.
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from International Journal of Audiology
Recent recommendations to record cochlear microphonic (CM) activity in auditory brainstem response (ABR) waveforms are being driven by reports of 'especially prominent' (Starr et al, 2001, p. 92) CM activity in ABR waveforms that were absent or grossly abnormal. This paper adds to these recommendations by providing the first description of especially prominent CM activity in ABR waveforms that were present and not grossly abnormal. The implications of this description are discussed via a review of the possible non-pathophysiological and pathophysiological causes of especially prominent CM activity in auditory evoked potentials.
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from Psychology News.it
Which of the human brain's biological and computational structures make language possible? What can the recent advances in computer processing of human language tell us about the nature of language and the process by which children learn it? Is there a precise, mathematical science of human language and, if so, what is it?
With the support of a five-year $3.2 million Integrative Graduate Education and Research Traineeship grant from the National Science Foundation, doctoral students in the Department of Cognitive Science at Johns Hopkins are being trained to tackle these and other mysteries of language from a multidisciplinary perspective.
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from EurekAlert.org
Recently named a Pew Scholar in the Biomedical Sciences, Bart Krekelberg, assistant professor in the Center for Molecular and Behavioral Neuroscience (CMBN) at Rutgers University in Newark, seeks to provide a map of the neural activity involved in visual processing during eye movements. Such knowledge could provide a better understanding of the visual perception dysfunctions involved in dyslexia, and the hallucinations experienced by those who suffer from schizophrenia.
As one of 20 U.S. Pew Scholars selected for the 2007 awards, Krekelberg has received a $250,000 grant from the Pew Charitable Trusts to fund his work in vision and eye movements. The highly selective program supports researchers in studying unexplored areas so they can generate the knowledge that may lead to new medical treatments and save lives. Krekelberg is the only researcher in New Jersey named a 2007 Pew Scholar in the Biomedical Sciences. Working at the neural systems and network levels, Krekelberg and his research team plan to pinpoint those areas of the brain involved in visual perception and eye movements and how they work in unison. Traditionally, such research has focused on the function of specific cells in individual areas of the brain, but not on the connections between cellular function and global neural networks, says Krekelberg. The failure to integrate the two, he says, “reminds one of the 10 blindfolded wise men trying to identify an elephant by touching its different parts.”
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from International Journal of Audiology
Results from a large study of adults who completed a randomized crossover study of listening and communication enhancement (LACETM) training were analysed to observe trends. The objective of this study was to determine predictors for greatest improvement following this four-week adaptive auditory training and aural rehabilitation program. Subjects with the poorest scores on the baseline tests, particularly those with the greatest degree of hearing loss, poorest scores on measures of degraded and competing speech, and those with the highest hearing handicap scores, were more likely to have greater improvement overall. However, there was considerable variability among the subjects, and some subjects' positive subjective reports belie smaller overall measured gains. Information collected from both the testing and the counseling of the patient should be taken into consideration when determining whether to proceed with LACE™ training.
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from International Journal of Audiology
The test-retest reliability of DPOAEs was investigated in 24 children (43 ears) with normal hearing at five F2 frequencies (2530, 3561, 5014, 7029, and 10 028 Hz). Two DPOAE recordings were performed on the same subjects in the same location using the same equipment. The second recordings were made 13 to 15 days after the first recording. The DPOAE level recorded in the subjects ranged between -13.10 and 20.20 dB for all the five frequencies. The variation in DPOAE level was greater at 10 028 Hz than at other frequencies. The mean difference between the test and retest recordings was 0.52±2.87, -1.57±4.62, 0.01±3.38, -0.55±2.85, and -0.56±5.57dB at 2530, 3561, 5014, 7029, and 10 028 Hz, respectively. The intra-correlation coefficients for DPOAE level at each of the five (F2) frequencies were 0.85, 0.68, 0.62, 0.89, and 0.64 respectively. Calculations of mean +2SD showed that retest recordings greater than 6.26, 7.67, 6.81, 5.15, and 10.58 dB SPL at 2530, 3561, 5014, 7029, and 10 028 Hz respectively could possibly be interpreted as a significant change in status of the ear.
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from International Journal of Audiology
Sudden hearing loss is a very rare complication of interferon-alpha treatment. At this time, hearing loss in patients treated with pegylated interferon and ribavirin has only been described in two reports. We present a case of a 27-year-old patient who was diagnosed with Turner syndrome, treated for hepatitis C with pegylated interferon and ribavirin, and suffered from hearing loss during the 10th week of treatment. Audiometric examination revealed a bilateral sensorineural hearing loss (SNHL). Auditory brainstem response (ABR) measures confirmed the diagnosis. We decided to comply with the patient's request to continue therapy, which only led to slight further deterioration of the patient's hearing ability. However, 18 months after the end of therapy a follow-up audiometric examination disclosed a bilateral SNHL.
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from International Journal of Audiology
The aim of the study is to understand the implications of disclosing the results of connexin26 (Cx26) gene testing to the concerned family with hearing impaired individuals. The department of biotechnology is funding a multicentric multidisciplinary team from Jawaharlal Nehru Center for Advanced Scientific Research (Bangalore), AYJNIHH (Mumbai), PGIBMS (Chennai), and MAMC (New Delhi) to profile mutations of deafness genes in India. Under this program, blood samples were taken from various centers and were sent to JNCASR for genetic analysis (screening for Cx26 mutations). This case study is an attempt to bring out issues encountered when disclosing the implications of genetic diagnosis to the concerned family.
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from News-Medical.net
Hearing and balance experts at Johns Hopkins report successful testing in animals of an electrical device that partly restores a damaged or impaired sense of balance.
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from News-Medical.net
For many people, hearing loss is part of aging. Hearing loss affects approximately one-third of people over age 65. Among people age 75 and older, 40 percent to 50 percent experience hearing loss.
The August issue of Mayo Clinic Health Letter covers what changes occur with age-related hearing loss and when it's time to visit a doctor to discuss ways to improve communication.
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from Movement Disorders
Parkinson's disease (PD) affects speech, including respiration, phonation, and articulation. We measured the blood oxygen level-dependent (BOLD) response to overt sentence reading in: (1) 9 treated female patients with mild to moderate PD (age; mean 66.0 ± 11.6 years, mean levodopa equivalent 583.3 ± 397.9 mg) and (2) 8 age-matched healthy female controls (age; mean 62.2 years ± 12.3). Speech was recorded in the scanner to assess which brain regions underlie variations in the initiation and paralinguistic aspects (e.g., pitch, loudness, and rate) of speech production in the two groups. There were no differences in paralinguistic aspects of speech except for speech loudness; it was lower in PD patients compared with that in controls, when age was used as a covariate. In both groups, we observed increases in the BOLD response (reading-baseline) in brain regions involved in speech production and perception. In PD patients, as compared with controls, we found significantly higher BOLD signal in the right primary orofacial sensorimotor cortex and more robust correlations between the measured speech parameters and the BOLD response to reading, particularly, in the left primary orofacial sensorimotor cortex. These results might reflect compensatory mechanisms and/or treatment effects that take place in mild to moderately ill PD patients with quality of speech yet comparable with that of age-matched controls. © 2007 Movement Disorder Society
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from the Journal of Speech, Language, and Hearing Research
Purpose: The authors examined the benefits of younger cochlear implantation, longer cochlear implant use, and greater pre-implant aided hearing to spoken language at 3.5 and 4.5 years of age.
Method: Language samples were obtained at ages 3.5 and 4.5 years from 76 children who received an implant by their 3rd birthday. Hierarchical linear modeling was used to identify characteristics associated with spoken language outcomes at the 2 test ages. The Preschool Language Scale (I. L. Zimmerman, V. G. Steiner, & R. E. Pond, 1992) was used to compare the participants' skills with those of hearing age-mates at age 4.5 years.
Results: Expected language scores increased with younger age at implant and lower pre-implant thresholds, even when compared at the same duration of implant use. Expected Preschool Language Scale scores of the children who received the implant at the youngest ages reached those of hearing age-mates by 4.5 years, but those children implanted after 24 months of age did not catch up with hearing peers.
Conclusion: Children who received a cochlear implant before a substantial delay in spoken language developed (i.e., between 12 and 16 months) were more likely to achieve age-appropriate spoken language. These results favor cochlear implantation before 24 months of age, especially for children with aided pure-tone average thresholds greater than 65 dB prior to surgery.
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from the Journal of Speech, Language, and Hearing Research
Purpose: Dry-air challenges increase the osmolarity of fluid lining the luminal surface of the proximal airway. The homeostasis of surface fluid is thought to be essential for voice production and laryngeal defense. Therefore, the authors hypothesized that viable vocal fold epithelium would generate a water flux to reduce an osmotic challenge (150 mOsm mannitol) on the lumen. Bidirectional transepithelial water fluxes were measured in vocal folds exposed to physiologically realistic luminal osmotic perturbations in vitro.
Method: Thirty-six native ovine vocal folds were exposed to either luminal hyperosmotic or isosmotic perturbations. Vocal fold viability and water fluxes toward the lumen and into the mucosa were measured at prechallenge baseline and for 30 min after challenge.
Results: Vocal fold electrophysiological viability was maintained for the duration of osmotic perturbation. Luminal osmotic exposure increased luminally directed transepithelial water fluxes in 60% of vocal folds. This increase was electrically silent, of short duration, and would not negate the osmotic gradient.
Conclusion: Ovine vocal fold epithelia detect osmotic perturbations to the luminal surface in vitro. This ability to detect and respond to changes in surface composition may be important in homeostatic regulation of vocal fold surface fluid during osmotic perturbations in respiration and phonation.
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from the Journal of Speech, Language, and Hearing Research
Purpose: Some researchers (F. R. Vellutino, F. M. Scanlon, & M. S. Tanzman, 1994) have argued that the different domains comprising language (e.g., phonology, semantics, and grammar) may influence reading development in a differential manner and at different developmental periods. The purpose of this study was to examine proposed causal relationships among different linguistic subsystems and different measures of reading achievement in a group of children with reading disabilities.
Methods: Participants were 279 students in 2nd to 3rd grade who met research criteria for reading disability. Of those students, 108 were girls and 171 were boys. In terms of heritage, 135 were African and 144 were Caucasian. Measures assessing pre-reading skills, word identification, reading comprehension, and general oral language skills were administered.
Results: Structural equation modeling analyses indicated receptive and expressive vocabulary knowledge was independently related to pre-reading skills. Additionally, expressive vocabulary knowledge and listening comprehension skills were found to be independently related to word identification abilities.
Conclusion: Results are consistent with previous research indicating that oral language skills are related to reading achievement (e.g., A. Olofsson & J. Niedersoe, 1999; H. S. Scarborough, 1990). Results from this study suggest that receptive and expressive vocabulary knowledge influence pre-reading skills in differential ways. Further, results suggest that expressive vocabulary knowledge and listening comprehension skills facilitate word identification skills.
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from the Journal of Speech, Language, and Hearing Research
Purpose: To develop a reliable and valid questionnaire of bilingual language status with predictable relationships between self-reported and behavioral measures.
Method: In Study 1, the internal validity of the Language Experience and Proficiency Questionnaire (LEAP-Q) was established on the basis of self-reported data from 52 multilingual adult participants. In Study 2, criterion-based validity was established on the basis of standardized language tests and self-reported measures from 50 adult Spanish–English bilinguals. Reliability and validity of the questionnaire were established on healthy adults whose literacy levels were equivalent to that of someone with a high school education or higher.
Results: Factor analyses revealed consistent factors across both studies and suggested that the LEAP-Q was internally valid. Multiple regression and correlation analyses established criterion-based validity and suggested that self-reports were reliable indicators of language performance. Self-reported reading proficiency was a more accurate predictor of first-language performance, and self-reported speaking proficiency was a more accurate predictor of second-language performance. Although global measures of self-reported proficiency were generally predictive of language ability, deriving a precise estimate of performance on a particular task required that specific aspects of language history be taken into account.
Conclusion: The LEAP-Q is a valid, reliable, and efficient tool for assessing the language profiles of multilingual, neurologically intact adult populations in research settings.
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from the Journal of Speech, Language, and Hearing Research
Purpose: To compare the effects of speech presentation level on acceptance of noise in listeners with normal and impaired hearing.
Method: Participants were listeners with normal (n = 24) and impaired (n = 46) hearing who were matched for conventional acceptable noise level (ANL). ANL was then measured at 8 fixed speech presentation levels (40, 45, 50, 55, 60, 65, 70, and 75 dB HL) to determine if global ANL (i.e., ANL averaged across speech presentation levels) or ANL growth (i.e., the slope of the ANL function) varied between groups.
Results: The effects of speech presentation level on acceptance of noise were evaluated using global ANLs and ANL growth. Results showed global ANL and ANL growth were not significantly different for listeners with normal and impaired hearing, and neither ANL measure was related to pure-tone average for listeners with impaired hearing. Additionally, conventional ANLs were significantly correlated with both global ANLs and ANL growth for all listeners.
Conclusion: These results indicate that the effects of speech presentation level on acceptance of noise are not related to hearing sensitivity. These results further indicate that a listener's conventional ANL was related to his or her global ANL and ANL growth.
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from the Journal of Speech, Language, and Hearing Research
Purpose: To evaluate the discriminant accuracy of a grammatical measure for the identification of language impairment (LI) in Latino English-speaking children. Specifically, the study examined the diagnostic accuracy of the Test of English Morphosyntax (E-MST; Peña, Gutiérrez-Clellen, Iglesias, Goldstein, & Bedore (n.d.) to determine (a) whether use and exposure to Spanish had an effect on the performance of bilingual children compared with monolingual Latino children and (b) whether dialectal differences within Latino English speakers might result in performance differences and a greater incidence of misclassifications for children from Caribbean English backgrounds.
Method: One hundred and eleven children (i.e., 59 children with typical language development and 52 children with LI) were sampled from the Southwest and Northeast regions of the U.S. Southwestern children were of Mexican origin. Children from the Northeast were from Puerto Rican or Dominican backgrounds. Linear discriminant analyses evaluating group classifications on the basis of the E-MST were performed on exploratory and confirmatory data sets across 3 groups: Southwestern English-only proficient (SW EP) children, Southwestern English-dominant bilingual (SW EDB) children, and Northeastern (NE) children.
Results: Results of the exploratory discriminant analyses indicated good sensitivity for the SW EP children. The discriminant functions derived from the exploratory analysis were able to predict group membership in confirmatory discriminant analyses with fair sensitivity and good specificity for the SW EDB children and with fair sensitivity but poor specificity for the NE children. Children who were English-dominant bilingual were not more likely to be misclassified compared with their English-only proficient peers. However, nonmainstream English dialect differences appeared to affect classification accuracy and resulted in a greater number of misclassifications for the NE children with typical language development.
Conclusion: The measure seems to be suitable for identifying LI in SW children who are exposed to Spanish and/or who are English-dominant bilingual. Additional assessment tools will be needed to rule out the disorder in children who are exposed to African American or Caribbean English dialects.
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from the Journal of Speech, Language, and Hearing Research
Purpose: In this study, the authors investigated speech rhythm acquisition by bilingual Spanish–English-speaking children, comparing their performance with functionally monolingual peers in both languages and to monolingual and bilingual adults.
Method: Participants included younger children (3;9 [years;months] to 4;5.15[years;months.days]), older children (4;6.18 to 5;2), and adults (over 18 years). Twenty-six sentences were elicited and analyzed using the normalized vocalic and intervocalic Pairwise Variability Indices (PVIs) that express the level of variability in successive duration measurements, on the basis of E. Grabe and E. L. Low (2002).
Results: Younger bilingual children displayed distinct speech rhythm patterns for their target languages, and they deviated from their monolingual English-speaking peers. Older bilingual children also separated speech rhythm by language, and differences between older bilingual children and their monolingual peers speaking English were also found. Younger and older bilingual children differed on the vocalic PVI, but not the intervocalic PVI, providing partial support for age differences. Bilingual adults showed separation of their languages and performed similarly to their monolingual peers.
Conclusion: Bilingual children show distinct speech rhythm patterns for their target languages but with some early equal timing bias that diminishes over time, on the basis of the vocalic measurements. Overall, the vocalic PVI is more robust than the intervocalic PVI, but further research is necessary.
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from the Journal of Speech, Language, and Hearing Research
Purpose: This study simultaneously examined predictors of phonological awareness within the framework of 2 theories: the phonological distinctness hypothesis and the lexical restructuring model. Additionally, age as a moderator of the relations between predictor variables and phonological awareness was examined.
Method: This cross-sectional quantitative study included a total of 700 participants between 2 and 5 years of age. Participants were identified as being from homes of lower or higher socioeconomic status (SES) based on preschool funding source, and they completed 2 measures of vocabulary, 8 measures of phonological awareness, and 2 measures of speech sound accuracy.
Results: Results indicate that SES, age, speech sound accuracy, and vocabulary each contributed unique variance to the prediction of phonological awareness. Age amplified the relations between speech sound accuracy and phonological awareness and between SES and phonological awareness but not between vocabulary and phonological awareness.
Conclusion: The current study provides further support for both the phonological distinctness hypothesis and the lexical restructuring model. Additionally, this study provides novel information regarding the role that age plays in the prediction models. Specifically, the effects of SES and speech sound accuracy on phonological awareness were amplified by age.
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from the Journal of Speech, Language, and Hearing Research
Purpose: This study aimed to identify the nature and extent of receptive and expressive prosodic deficits in children with high-functioning autism (HFA).
Method: Thirty-one children with HFA, 72 typically developing controls matched on verbal mental age, and 33 adults with normal speech completed the prosody assessment procedure, Profiling Elements of Prosodic Systems in Children.
Results: Children with HFA performed significantly less well than controls on 11 of 12 prosody tasks (p < .005). Receptive prosodic skills showed a strong correlation (p < .01) with verbal mental age in both groups, and to a lesser extent with expressive prosodic skills. Receptive prosodic scores also correlated with expressive prosody scores, particularly in grammatical prosodic functions. Prosodic development in the HFA group appeared to be delayed in many aspects of prosody and deviant in some. Adults showed near-ceiling scores in all tasks.
Conclusions: The study demonstrates that receptive and expressive prosodic skills are closely associated in HFA. Receptive prosodic skills would be an appropriate focus for clinical intervention, and further investigation of prosody and the relationship between prosody and social skills is warranted.
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from the Journal of Speech, Language, and Hearing Research
Purpose: Children with specific language impairment (SLI) lag behind children with typical language (TL) in their grammatical development, despite equivalent early exposure to recasts in conversation (M. E. Fey, T. E. Krulik, D. F. Loeb, & K. Proctor-Williams, 1999) and the ability to learn from recasts in intervention as quickly as do children with TL (K. E. Nelson, S. Camarata, J. Welsh, L. Butovsky, & M. Camarata, 1996). This experiment tested whether this apparent paradox could be attributed to variations in the density of recasts in conversation versus intervention.
Method: Thirteen children (7–8 years of age) with SLI and 13 language-similar children (5–6 years of age) with TL were exposed to 3 recast densities of novel irregular past tense verbs (none, conversation-like, intervention-like) over 5 sessions. Outcomes were based on spontaneous conversational productions and a post-test probe.
Results: As predicted, at conversation-like densities, children with TL more accurately produced the target verbs they heard in recasts than in nonrecast models (d = 0.58), children with SLI showed no differences, and children with TL produced the verbs more accurately than did children with SLI (d = 0.54). Contrary to expectations, at higher intervention-like recast densities, the SLI group did not improve their accuracy, and the TL group performances were significantly poorer (d = 0.47).
Conclusion: At conversational levels, recasts facilitated greater verb learning than models alone but only in the TL group. Increasing recast density to the modest levels in this brief intervention experiment did not benefit children with SLI and led to poorer learning for children with TL. To optimize learning, efficiency of recast distribution as well as rate must be considered.
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from the Journal of Speech, Language, and Hearing Research
Purpose: The association between language delay and behavior problems in toddlers was examined in 2 studies, 1 conducted in a developmental clinic in New Jersey (Study 1; N = 83) and the other conducted in a developmental clinic in New York (Study 2; N = 103).
Method: In both clinics, parents of 18- to 35-month-olds completed the Language Development Survey (LDS) and the Child Behavior Checklist/1.5-5 (CBCL). In Study 2, the Preschool Language Scale–Fourth Edition (PLS-4) was also administered. Neurodevelopmental delay (ND) and pervasive developmental disorder (PDD) symptoms were also assessed in both studies but were done so using different measures.
Results: In Study 1, LDS Vocabulary score and CBCL Total Problems, Internalizing, and Withdrawn scores were significantly correlated. However, when children with ND and/or suspected PDD were excluded, only the correlation between LDS Vocabulary and Withdrawn remained significant. In Study 2, only the correlation between LDS Vocabulary and Withdrawn approached significance. Children delayed in language on the PLS-4 had higher CBCL scores than typically developing toddlers only on the CBCL Withdrawn syndrome.
Conclusion: Significant associations between language delays and behavior problems were not found in 2 samples of 18- to 35-month-olds when children with ND and PDD were excluded, except that toddlers with language delays appeared to show elevated social withdrawal relative to typically developing toddlers.
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from the Journal of Speech, Language, and Hearing Research
Purpose: The movement of the jaw during speech and chewing has frequently been studied by tracking surface landmarks on the chin. However, the extent to which chin motions accurately represent those of the underlying mandible remains in question. In this investigation, the movements of a pellet attached to the incisor of the mandible were compared with those of pellets attached to different regions of the chin.
Method: Ten healthy talkers served as participants. Three speaking contexts were recorded from each participant: word, sentence, and paragraph. Chin position errors were estimated by computing the standard distance between the mandibular incisor pellet and the chin pellets.
Results: Relative to the underlying mandible, chin pellets moved with an average absolute and relative error of 0.81 mm and 7.30%, respectively. The movements of chin and mandibular pellets were tightly coupled in time.
Conclusion: The chin tracking errors observed in this investigation are considered acceptable for descriptive studies of oromotor behavior, particularly in situations where mandibular placements are not practical (e.g., young children or edentulous adults). The observed amount of error, however, may not be tolerable for fine-grained analyses of mandibular biomechanics. Several guidelines are provided for minimizing error associated with tracking surface landmarks on the chin.
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from the Journal of Speech, Language, and Hearing Research
Purpose: To assess the effects of short- and long-term changes in auditory feedback on vowel and sibilant contrasts and to evaluate hypotheses arising from a model of speech motor planning.
Method: The perception and production of vowel and sibilant contrasts were measured in 8 postlingually deafened adults prior to activation of their cochlear implant speech processors, 1 month postactivation, and 1 year postactivation. Measures were taken postactivation both with and without auditory feedback. Contrast measures were also made for a group of speakers with reportedly normal hearing speaking with masked and unmasked auditory feedback.
Results: Vowel and sibilant contrasts, measured in the absence of auditory feedback after 1 month of prosthesis use, were diminished compared with their values measured before prosthesis. Contrasts measured in the absence of auditory feedback after 1 year's experience with the prosthesis were increased compared with their values after 1 month's experience. In both time samples, contrasts were enhanced when auditory feedback was restored.
Conclusion: The provision of prosthetic hearing to postlingually deafened adults impaired their phonemic contrasts at first, as their auditory feedback had novel characteristics. Once auditory feedback became recalibrated with prosthesis use, it could, in turn, revise feedforward commands that control the contrasts in its absence.
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from the Journal of Speech, Language, and Hearing Research
Purpose: To evaluate the effects of intensive voice treatment targeting vocal loudness (the Lee Silverman Voice Treatment [LSVT]) on vowel articulation in dysarthric individuals with idiopathic Parkinson's disease (PD).
Method: A group of individuals with PD receiving LSVT (n = 14) was compared to a group of individuals with PD not receiving LSVT (n = 15) and a group of age-matched healthy individuals (n = 14) on the variables vocal sound pressure level (VocSPL); various measures of the first (F1) and second (F2) formants of the vowels /i/, /u/, and /a/; vowel triangle area; and perceptual vowel ratings. The vowels were extracted from the words key, stew, and Bobby embedded in phrases. Perceptual vowel rating was performed by trained raters using a visual analog scale.
Results: Only VocSPL, F2 of the vowel /u/ (F2u), and the ratio F2i/F2u significantly differed between patients and healthy individuals pretreatment. These variables, along with perceptual vowel ratings, significantly changed (improved) in the group receiving LSVT only.
Conclusion: These results, along with previous findings, add further support to the generalized therapeutic impact of intensive voice treatment on orofacial functions (speech, swallowing, facial expression) and respiratory and laryngeal functions in individuals with PD.
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from the Journal of Speech, Language, and Hearing Research
Purpose: Where the auditory saltation illusion has been used as a measure of auditory temporal processing (ATP) in dyslexia, conflicting results have been apparent (cf. R. Hari & P. Kiesilä, 1996; M. Kronbichler, F. Hutzler, & H. Wimmer, 2002). This study sought to re-examine these findings by investigating whether dyslexia is characterized by poor saltation task performance and whether saltation thresholds are related to reading and phonological processing within groups of either dyslexic or competent readers.
Method: Nineteen dyslexic and 20 competently reading adults (18–64 years of age) participated. Participants completed 2 runs of a 2-alternative forced-choice saltation task, along with standard measures of reading and phonological processing.
Results: Although overall poorer saltation thresholds were apparent in the dyslexic group, the threshold distributions overlapped considerably, with thresholds alone unable to predict group membership at a level significantly greater than chance. Neither strong nor significant correlations were observed among saltation thresholds, reading, and phonological processing skills within either group.
Conclusion: The results of this study do not support suggestions of impaired ATP in dyslexia or associations among ATP, reading, and phonological processing. However, it is proposed that increased within- and between-subject variability in auditory thresholds might be a more valuable marker of dyslexia than the thresholds themselves. Implications of this observation for dyslexia research are discussed.
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from the Journal of Speech, Language, and Hearing Research
Purpose: The authors assessed whether (a) a full-insertion cochlear implant would provide a higher level of speech understanding than bilateral low-frequency acoustic hearing, (b) contralateral acoustic hearing would add to the speech understanding provided by the implant, and (c) the level of performance achieved with electric stimulation plus contralateral acoustic hearing would be similar to performance reported in the literature for patients with a partial insertion cochlear implant.
Method: Monosyllabic word recognition as well as sentence recognition in quiet and at +10 and +5 dB was assessed. Before implantation, scores were obtained in monaural and binaural conditions. Following implantation, scores were obtained in electric-only and electric-plus-contralateral acoustic conditions.
Results: Postoperatively, all individuals achieved higher scores in the electric-only test conditions than they did in the best pre-implant test conditions. All individuals benefited from the addition of low-frequency information to the electric hearing.
Conclusion: A full-insertion cochlear implant provides better speech understanding than bilateral, low-frequency residual hearing. The combination of an implant and contralateral acoustic hearing yields comparable performance to that of patients with a partially inserted implant and bilateral, low-frequency acoustic hearing. These data suggest that a full-insertion cochlear implant is a viable treatment option for patients with low-frequency residual hearing.
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from the Journal of Speech, Language, and Hearing Research
Purpose: To assess the Computerized Revised Token Test (CRTT) performance of individuals with normal hearing under several intensity conditions and under several spectral and temporal perturbation conditions.
Method: Sixty normal-hearing listeners were randomly assigned to 1 of 3 groups. Group 1 provided performance-intensity information about CRTT performance using uncompressed acoustic stimuli. Groups 2 and 3 completed the CRTT using temporally and spectrally compressed and expanded stimuli. CRTT performance functions were plotted for each group.
Results: Group 1 required minimal audibility to perform maximally on this task. As expected, Groups 2 and 3 showed significant differences across subtests, regardless of distortion condition. Mean differences in performance between successive conditions for Group 2 increased beyond 40% time compressed. There was 1 significant difference for the time-expanded condition. There were no differences across frequency compressed and expanded conditions.
Conclusion: Young listeners require limited signal gain on the CRTT to achieve maximum performance. Time and frequency compression and expansion results were consistent with previous findings with varying types of speech stimuli. The results have implications for administration and interpretation of the CRTT administered to persons from other populations and will help in the development of a normative database for the CRTT.
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from the Journal of Speech, Language, and Hearing Research
Purpose: To compare speech intelligibility in the presence of a 10-Hz square-wave noise masker in younger and older listeners and to relate performance to recovery from forward masking.
Method: The signal-to-noise ratio required to achieve 50% sentence identification in the presence of a 10-Hz square-wave noise masker was obtained for each of the 8 younger/older listener pairs. Listeners were matched according to their quiet thresholds for frequencies from 600 to 4800 Hz in octave steps. Forward masking was also measured in 2 younger/older threshold-matched groups for signal delays of 2–40 ms.
Results: Older listeners typically required a significantly higher signal-to-noise ratio than younger listeners to achieve 50% correct sentence recognition. This effect may be understood in terms of increased forward-masked thresholds throughout the range of signal delays corresponding to the silent intervals in the modulated noise (e.g., <50 ms).
Conclusions: Significant differences were observed between older and younger listeners on measures of both speech intelligibility in a modulated background and forward masking over a range of signal delays (0–40 ms). Age-related susceptibility to forward masking at relatively short delays may reflect a deficit in processing at a fairly central level (e.g., broader temporal windows or less efficient processing).
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from the Journal of Speech, Language, and Hearing Research
Purpose: The purpose of this study was to examine in listeners with normal hearing and listeners with sensorineural hearing loss the within- and between-group differences obtained with 4 commonly available speech-in-noise protocols.
Method: Recognition performances by 24 listeners with normal hearing and 72 listeners with sensorineural hearing loss were compared for 4 speech-in-noise protocols that varied with respect to the amount of contextual cues conveyed in the target signal. The protocols studied included the Bamford-Kowal-Bench Speech-in-Noise Test (BKB-SIN; Etymtic Research, 2005; J. Bench, A. Kowal, & J. Bamford, 1979; P. Niquette et al., 2003), the Quick Speech-in-Noise Test (QuickSIN; M. C. Killion, P. A. Niquette, G. I. Gudmundsen, L. J. Revit, & S. Banerjee, 2004), and the Words-in-Noise test (WIN; R. H. Wilson, 2003; R. H. Wilson & C. A. Burks, 2005), each of which used multitalker babble and a modified method of constants, as well as the Hearing in Noise Test (HINT; M. Nilsson, S. Soli, & J. Sullivan, 1994), which used speech-spectrum noise and an adaptive psychophysical procedure.
Results: The 50% points for the listeners with normal hearing were in the 1- to 4-dB signal-to-babble ratio (S/B) range and for the listeners with hearing loss in the 5- to 14-dB S/B range. Separation between groups was least with the BKB-SIN and HINT (4–6 dB) and most with the QuickSIN and WIN (8–10 dB).
Conclusion: The QuickSIN and WIN materials are more sensitive measures of recognition performance in background noise than are the BKB-SIN and HINT materials.
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from the Journal of Speech, Language, and Hearing Research
Purpose: Interpreting the rapidly changing speech skills of young children recovering from neurological injury is difficult because developmental expectations are generally available only at relatively lengthy intervals (e.g., 6 or 12 months). In this research note, the authors describe the process of generating a Percentage of Consonants Correct–Revised (PCC-R; L. D. Shriberg, D. Austin, B. A. Lewis, J. L. McSweeny, & D. L. Wilson, 1997a) performance curve and illustrate some of its applications for assessing change in performance over time.
Method: The authors compiled mean PCC-R scores from 16 samples of typically developing children (18–172 months) and used curve fitting to test more than 11,000 statistical models of monthly growth in PCC-R. They selected a parsimonious and developmentally plausible model with R2 = .9839 (p < .0005) and used it to generate the PCC-R, standard deviation, and standard error expected at each monthly age.
Results: The PCC-R performance curve distinguished among 65 children (37–57 months of age) diagnosed independently with normal or disordered speech with a high degree of success. More important, the PCC-R performance curve can be used to identify the points at which children (18–172 months) recovering from neurological injury achieve normal-range consonant production.
Conclusion: The curve-fitting approach holds promise as a means of interpreting temporal variations in speech production at a finer grain than existing normative data currently allow.
from Laryngoscope
"Objective: To examine aspects of round window (RW) anatomy that are relevant to its use as a portal for atraumatic insertion of cochlear implant electrodes.
Study Design: Anatomic study using human cadaveric temporal bones.
Methods: A series of 30 temporal bones was dissected to permit microscopic study of the RW region.
Results: The bony overhangs of the RW niche limit visibility of the RW membrane during surgery. Measurements of RW membrane area visible through a facial recess opening before and after drilling the overhangs in 15 temporal bones showed that RW membrane visibility is typically increased by a factor of 1.5 to 3 times after drilling and by as much as 13 times when the opening of the RW niche is relatively small. Observations from within the scala tympani in 15 cochlear dissections showed substantial variability in size of the RW opening available for electrode insertion. Area measurements of the portion of the RW covered by the vertical segment of the RW membrane ranged from 0.8 to 1.75 mm2 in these specimens. In addition, irregularities in contour of the RW margin may make insertion challenging, which may necessitate drilling the anterior-inferior margin of the RW. Drilling in this region should be approached with care because of the close proximity of the cochlear aqueduct opening.
Conclusion: RW insertion can be performed in a manner that is potentially less traumatic than the standard cochleostomy insertion. It may therefore be advantageous in cases in which hearing preservation is the goal."
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from the British Journal of Special Education
"The systematic assessment of the social and affective outcomes of inclusion has been lagging behind the assessment of academic outcomes. This is particularly problematic in view of research evidence supporting concerns about peer rejection and bullying. In this article, Norah Frederickson and Elizabeth Simmonds, of University College London, and Lynda Evans and Chris Soulsby, from Foxwood Special School, report their evaluation of the social and affective outcomes of a special- mainstream school inclusion initiative that places particular emphasis on peer preparation. Measures completed by pupils were used to assess peer group inclusion, social behaviour, bullying and feelings of belonging at school. Results showed that pupils who had transferred from special to mainstream schools experienced positive social outcomes and none experienced peer group rejection. However, results were less positive for mainstream pupils with special educational needs and the authors discuss possibilities for development. Trends in peer reports of bullying suggest that there is no room for complacency and that ongoing monitoring is required."
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from Human Genetics
"Abstract Type 1 Usher syndrome (USH1) is a recessively inherited condition, characterized by profound prelingual deafness, vestibular areflexia, and prepubertal onset of retinitis pigmentosa (RP). While the auditory component of USH1 can be treated by cochlear implants, to date there is no effective treatment for RP. USH1 can be caused by mutations in each of at least six genes. While truncating mutations of these genes cause USH1, some missense mutations of the same genes cause nonsyndromic deafness. These observations suggest that partial or low level activity of the encoded proteins may be sufficient for normal retinal function, although not for normal hearing. In individuals with USH1 due to nonsense mutations, interventions enabling partial translation of a full-length functional protein may delay the onset and/or progression of RP. One such possible therapeutic approach is suppression of nonsense mutations by small molecules such as aminoglycosides. We decided to test this approach as a potential therapy for RP in USH1 patients due to nonsense mutations. We initially focused on nonsense mutations of the PCDH15 gene, underlying USH1F. Here, we show suppression of several PCDH15 nonsense mutations, both in vitro and ex vivo. Suppression was achieved both by commercial aminoglycosides and by NB30, a new aminoglycoside-derivative developed by us. NB30 has reduced cytotoxicity in comparison to commercial aminoglycosides, and thus may be more efficiently used for therapeutic purposes. The research described here has important implications for the development of targeted interventions that are effective for patients with USH1 caused by various nonsense mutations."
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from the BWH Bulletin
"Kerry Thompson responds to each message on her Sidekick with the swift key strokes of a text-messaging pro. But Thompson, a finance specialist in Partners Research Management, doesn’t use any ordinary texting system. She is the creator of text4deaf.com, a Web site that makes communication easier between the deaf and hearing communities through computers and devices."
from Clinical Genetics
"An audioprofile displays phenotypic data from several audiograms on a single graph that share a common genotype. In this report, we describe the application of audioprofiling to a large family in which a genome-wide screen failed to identify a deafness locus. Analysis of audiograms by audioprofiling suggested that two persons with hearing impairment had a different deafness genotype. On this basis, we reassigned affectation status and identified a p.Cys1837Arg autosomal dominant mutation in a-tectorin segregating in all family members except two persons, who segregated autosomal recessive deafness caused by p.Val37Ile and p.Leu90Pro mutations in Connexin 26. One nuclear family in the extended pedigree segregates both dominant and recessive non-syndromic hearing loss."
from JARO -- Journal of the Association for Research in Otolaryngology
"Abstract Bilateral cochlear implantation is intended to provide the advantages of binaural hearing, including sound localization and better speech recognition in noise. In most modern implants, temporal information is carried by the envelope of pulsatile stimulation, and thresholds to interaural time differences (ITDs) are generally high compared to those obtained in normal hearing observers. One factor thought to influence ITD sensitivity is the overlap of neural populations stimulated on each side. The present study investigated the effects of acoustically stimulating bilaterally mismatched neural populations in two related paradigms: rabbit neural recordings and human psychophysical testing. The neural coding of interaural envelope timing information was measured in recordings from neurons in the inferior colliculus of the unanesthetized rabbit. Binaural beat stimuli with a 1-Hz difference in modulation frequency were presented at the best modulation frequency and intensity as the carrier frequencies at each ear were varied. Some neurons encoded envelope ITDs with carrier frequency mismatches as great as several octaves. The synchronization strength was typically nonmonotonically related to intensity. Psychophysical data showed that human listeners could also make use of binaural envelope cues for carrier mismatches of up to 2–3 octaves. Thus, the physiological and psychophysical data were broadly consistent, and suggest that bilateral cochlear implants should provide information sufficient to detect envelope ITDs even in the face of bilateral mismatch in the neural populations responding to stimulation. However, the strongly nonmonotonic synchronization to envelope ITDs suggests that the limited dynamic range with electrical stimulation may be an important consideration for ITD encoding."
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from Disability and Society
"Augmentative and alternative communication (AAC) holds the potential to enable people with severe oral communication impairments to participate more fully in society. However, despite the development of increasingly sophisticated communication aids, as well as recent UK policy initiatives aimed at improving access to them, some major obstacles stand in the way of the inclusory potential of AAC being realized to any significant degree. Drawing on findings of a research study that explored the experiences of people who use AAC, this paper looks at the various problems that people encounter in using communication aids. It identifies the lack of consistent, structured support as a key overarching issue. The author goes on to argue that for the potential of AAC to be realized attention needs to be given to the development of coordinated systems of support within the policy domains of education, health and social services."
from Cerebral Cortex
"Research on the contributions of the human nervous system to language processing and learning has generally been focused on the association regions of the brain without considering the possible contribution of primary and adjacent sensory areas. We report a study examining the relationship between the anatomy of Heschl's Gyrus (HG), which includes predominately primary auditory areas and is often found to be associated with nonlinguistic pitch processing and language learning. Unlike English, most languages of the world use pitch patterns to signal word meaning. In the present study, native English-speaking adult subjects learned to incorporate foreign pitch patterns in word identification. Subjects who were less successful in learning showed a smaller HG volume on the left (especially gray matter volume), but not on the right, relative to learners who were successful. These results suggest that HG, typically shown to be associated with the processing of acoustic cues in nonspeech processing, is also involved in speech learning. These results also suggest that primary auditory regions may be important for encoding basic acoustic cues during the course of spoken language learning."
from Cerebral Cortex
"The map of the human motor cortex has lacked a representation for the intrinsic musculature of the larynx ever since the electrical stimulation studies of Penfield. In addition, there has been no attempt to localize this area using neuroimaging techniques. Because of the central importance of laryngeal function to vocalization, we sought to localize an area controlling the intrinsic muscles of the larynx by using functional magnetic resonance imaging and to place this area in a somatotopic context. We had subjects perform a series of oral tasks designed to isolate elementary components of phonation and articulation, including vocalization of a vowel, lip movement, and tongue movement. In addition, and for the first time in a neuroimaging study, we had subjects perform "glottal stops," in other words forced closure of the glottis in the absence of vocalizing. The results demonstrated a larynx-specific area in the motor cortex that is activated comparably by vocal and nonvocal laryngeal tasks. Converging evidence suggests that this area is the principal vocal center of the human motor cortex. Finally, the location of this larynx area is strikingly different from that reported in the monkey. We discuss the implications of this observation for the evolution of vocal communication in humans."
from Topix.net
"“We don't have enough Hispanics graduating from high school to go to college”
Elosa Ruano Gonzlez reports that getting emergency medical care can be a problem for non-English speakers, but it's especially difficult for those who need long-term treatment, including mental health and ... via OELA Newsline"
from Brain
"Careful consideration of motor impairments, such as those documented in autism, can afford valuable insights into the neurological basis of developmental disorders. Motor signs are highly quantifiable and reproducible and can serve as markers for deficits in parallel systems important for socialization and communication. Correlations of motor signs with anatomic MRI (aMRI) measures therefore offer an important means of investigating brain abnormalities contributing to autism. Prior aMRI studies have revealed increased cerebral volume in young children with autism, particularly in ‘outer zone’ radiate white matter; however functional correlates of these findings have not been reported. In this study, we examined whether radiate white matter within the primary motor cortex would predict impaired motor performance in children with autism. Subjects included children ages 8–12 years: 20 with autism, 36 typically developing (TD) controls and 20 clinical controls with attention-deficit/hyperactivity disorder (ADHD). Regional tissue volumes were measured using an automated tissue classification algorithm followed by a semi-automated parcellation method. Motor performance was assessed using the Physical and Neurologic Examination of Subtle Signs (PANESS), with higher scores indicating poorer performance. Independent linear regression analyses revealed that for TD controls there was a significant negative correlation between total PANESS score and primary motor cortex white matter volume in both the right and left hemispheres, such that increased white matter volume predicted improved motor skill. In contrast, children with autism showed a robust positive correlation between total PANESS score and left hemisphere primary motor and premotor white matter volumes, such that increased white matter volume predicted poorer motor skill. No significant correlations were found for ADHD. Multivariate regression analyses revealed that the correlation between PANESS score and left motor cortex white matter volume in children with autism significantly differed from those in both ADHD and TD children. The correlation in ADHD did not significantly differ from that in TD children. The findings for the first time demonstrate an association between increasing radiate white matter volume and functional impairment in children with autism, in this case basic motor skill impairment. The observed association, which appears specific to autism, may be representative of global patterns of brain abnormality that not only contribute to motor dysfunction in autism, but also deficits in socialization and communication that define the disorder."
from Brain
"Post-mortem measures of Aß amyloid deposition correlate only weakly with cognitive dysfunction antemortem. We tested the hypothesis that functional reorganization forms a critical intermediary step between Aß amyloid-associated brain injury and clinical disease expression. Fifteen patients with early-stage probable Alzheimer's disease (AD) and 16 cognitively intact controls participated in this combined functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) study. The fMRI design had two factors: task (associative-semantic versus visuoperceptual judgement) and input-modality (written words versus pictures). We measured Aß amyloid by means of Pittsburgh Compound B (11C-PIB). In the posterior third of the left superior temporal sulcus (STS), the fMRI response during the associative-semantic compared with the visuoperceptual task was lower in AD than in controls, in particular for words. Response amplitude correlated inversely with PIB uptake in this region. Contralaterally, the functional pattern differed substantially: the fMRI response in the right posterior STS during the associative-semantic versus the visuoperceptual task was higher in AD than in controls. Accuracy on the Boston Naming test correlated positively with the degree to which AD patients were able to recruit the right STS (r = 0.84, Pcorrected = 0.014). PIB uptake did not correlate with naming accuracy. Functional reorganization of the language system in response to Aß amyloid-related brain injury exists in early-stage AD and determines the degree of anomia more than Aß amyloid load per se does."
from American Annals of the Deaf
"The use of function words in 135 essays written by deaf college underclassmen in developmental and credit-bearing English composition classes is described and compared with Standard English (SE) versions of the same essay. If student and SE versions were the same, this was considered mastery; if the student omitted a word, this was considered avoidance; and if the student added a word, this was considered overuse. The deaf students varied from SE more for function than for content words. They demonstrated low mastery of independent clause markers, demonstratives, third-person singular neuter pronouns, and modals related to possibility, but had relatively high mastery of the first-person singular, and some punctuation. These students strongly avoided some dependent clause markers, some demonstratives, the indefinite article, punctuation except for periods and commas, and the modal verbs may, might and should, but greatly overused other dependent clause markers, the second person and third-person neuter pronouns, quantifiers, the verb do, and the modals could and will. They were also more likely to produce run-ons than fragments."
from EurekAlert.org
"Reading specialists have often pitted phonics against holistic word recognition and whole language approaches in the war over how to teach children to read. However, a new study by researchers at New York University shows that the three reading processes do not conflict, but, rather, work together to determine speed. The findings appear in the Aug. 1 issue of PLoS ONE, a journal published by the Public Library of Science. The paper, “Parts, Wholes, and Context in Reading: A Triple Dissociation,” is available at http://www.plosone.org/doi/pone.0000680 beginning Aug. 1."
from Behavioral and Brain Functions
"Background
Several studies in the past have found that phonological processing is abnormal in children with dyslexia. Phonological processing depends on the phonological rules of the language learnt. Western languages do not have a good phoneme to grapheme correspondence while many of the Indian languages do have it. Also phonological rules of western languages are different from that of Indian languages. Thus it would be erroneous to generalize the results obtained on children speaking western languages to those speaking Indian languages. Hence the present study was aimed to investigate the auditory processing in children with dyslexia who spoke and studied Indian languages.
Methods
Standard group comparison design was used in the study. The study was conducted on fifteen children with dyslexia and fifteen normal children. Mismatch negativity was elicited for speech and tonal stimuli. Results obtained on the clinical group were compared with that of control group using mixed design ANOVA. Children in both the groups were native speakers of Kannada (a south Indian language).
Results
A subgroup of children showed abnormalities in the processing of speech and/or tonal stimuli. Speech elicited MMN showed greater abnormalities than that of tonal stimuli. Though higher for spectral contrasts, processing deficits were also shown for durational contrasts.
Conclusions
Inspite of having different phonological rules and good phoneme-grapheme correspondence in Indian languages, children with dyslexia do have deficits in processing both spectral and durational cues."
from European Journal of Neurology
"The superimposed clinical features of motor neuron disease (MND) and frontotemporal lobar degeneration (FTLD) comprise a rare neurological overlap syndrome that represents a diagnostic challenge to neurologists. Currently, FTLD-MND is considered a distinct entity and its clinicopathological basis has recently been reviewed. Our aim is to present a patient with MND and non-fluent rapidly progressive aphasia with clinical, imaging and histopathological correlation, as well as a brief review of the literature. We demonstrated the selective corticospinal tract (CST) and temporal lobe involvement using T1 spin-echo with an additional magnetization transfer contrast pulse on resonance (T1 SE/MTC) and FLAIR MR sequences in our patient, with further clinical and histopathological correlation. To the best of our knowledge, there is no description about the use of these particular MR sequences in the evaluation of FTLD-MND patients."
from Hearing Research
"Sensorineural hearing loss, which is often caused by degeneration of hair cells in the auditory epithelium, is permanent because lost hair cells are not replaced. Several conceptual approaches can be used to place new hair cells in the auditory epithelium. One possibility is to enhance proliferation of non-sensory cells that remain in the deaf ear and induce transdifferentiation of some of these cells into the hair cell phenotype. Several genes, including p27Kip1, have been shown to regulate proliferation and differentiation in the developing auditory epithelium. The role of p27Kip1 in the mature ear is not well characterized. We now show that p27Kip1 is present in the nuclei of non-sensory cells of the mature auditory epithelium. We determined that forced expression of Skp2 using a recombinant adenovirus vector, resulted in presence of BrdU-positive cells in the auditory epithelium. When SKP2 over-expression was combined with forced expression of Atoh1, ectopic hair cells were found in the auditory epithelium in greater numbers than were seen with Atoh1 alone. Skp2 over-expression alone did not result in ectopic hair cells. These findings suggest that the p27Kip1 protein remains in the mature auditory epithelium and therefore p27Kip1 can serve as a target for gene manipulation. The data also suggest that induced proliferation, by itself, does not generate new hair cells in the cochlea."
from Hearing Research
"Although it is generally accepted that endolymphatic hydrops is the cause of complaints in patients suffering from Menière’s disease, it has not been possible up to now to prove the presence of an endolymphatic hydrops in living humans. This study evaluated the psychophysical method introduced by Mrowinski et al. [Mrowinski D., Gerull G., Nubel K., Scholz G., 1995. Masking and pitch shift of tone bursts and clicks by low-frequency tones. Hear. Res. 85, 95–102; Mrowinski D., Scholz G., Krompass S., Nubel K., 1996. Diagnosis of endolymphatic hydrops by low-frequency masking. Audiol. Neurootol. 1, 125–134] to diagnose endolymphatic hydrops. These authors used low frequency biasing to differentiate between individuals with and individuals without Menière’s disease. In the present study no statistically significant differences in masking parameters could be found between a large number (n = 91) of ears with Menière’s disease and ears (n = 52) with comparable sensorineural hearing losses, but without symptoms of Menière’s disease. Our results support the idea that results deviating from normal in low frequency biasing measurements are not due to endolymphatic hydrops itself, but to other pathological changes of the inner ear. An explanation could be that with increasing hearing loss the gain of the cochlear amplifier decreases, leading to smaller modulation depths."
from Hearing Research
"Cochlear damages have been shown to induce changes in tonotopic maps in the central auditory system of animals; neurons deprived from peripheral inputs start to respond to stimuli with frequencies close to the cutoff frequency (Fc) or “edge” of the hearing loss, which then become over-represented at the neural level. Here, we review findings, which reveal a possible psychophysical correlate of such central over-representation in human listeners with sensorineural hearing loss. These findings concur to demonstrate a local improvement in difference limens for frequency (DLFs) at or near Fc. This effect has now been observed in several studies and subjects with varied audiometric characteristics, including high- and low-frequency, and symmetric and asymmetric hearing losses. The presence of cochlear dead region or a steeply sloping hearing loss appear as a necessary condition for its occurrence. The effect cannot be explained simply by more prominent loudness cues or spontaneous otoacoustic emissions (SOAEs) near the audiogram edge. Overall, the data are consistent with local changes in pitch discrimination performance near the hearing-loss cutoff frequency being a result of the neural over-representation of that frequency region in the central auditory system. Further work is needed to confirm this hypothesis, and investigate other possible perceptual correlates of injury-related cortical plasticity in both humans and animals."
from Medical News Today.com
"A 30-year scientific debate over how specialized cells in the inner ear amplify sound in mammals appears to have been settled more in favor of bouncing cell bodies rather than vibrating, hair-like cilia, according to investigators at St. Jude Children's Research Hospital.
The finding could explain why dogs, cats, humans and other mammals have such sensitive hearing and the ability to discriminate among frequencies. The work also highlights the importance of basic hearing research in studies into the causes of deafness. A report on this work appears in the advanced online issue of Proceedings of the National Academy of Science."
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from Laryngoscope
"Objectives/Hypothesis: The aim of this study was to evaluate the extent and quality of evidence reported on the outcomes of bilateral cochlear implantation and thereby to inform opinion about future patient management.
Study Design: Retrospective literature review.
Methods: A detailed search of the medical literature was performed using the Medline, Embase, and CINAHL databases starting from the date of their conception. The quality of evidence in each article was assessed according to the categories of evidence as defined by the Oxford Centre for Evidence-based Medicine, Levels of Evidence (May 2001).
Results: A total of 37 studies were included; 28 (76%) investigated adult participants only, 7 (19%) investigated child participants, and 2 (5%) contained both groups. Of the studies presented, 9 (24%) studies contained level 2b evidence, 2 (6%) level 3b, 16 (43%) level 4, and 10 (27%) level 5 evidence. No studies were identified as representing evidence level 1. Adult bilateral recipients demonstrated an increase in sentence recognition of 21% correct over their first implanted ear (P < .001) and mean bilateral localization errors of 24[degrees] against a monaural error of 67[degrees] (P < .005).
Conclusions: The available evidence indicates that bilateral cochlear implantation confers material benefits not achievable with unilateral implantation, specifically in terms of sound localization and understanding of speech in noise. Well-designed prospective studies of sufficient size are now needed to precisely quantify these benefits, to validate outcome measures, especially in children, and to define the criteria for intervention."
from Laryngoscope
"Objectives: The vast majority of cochlear implant recipients realize significant improvement in speech perception. However, there continue to be a small group that does not realize such a benefit. In an effort to identify possible predictors for this, we have compared pre- and postimplant audiologic data using Hearing In Noise Test (HINT), City University of New York (CUNY), or Central Institute for the Deaf (CID) scores for 445 consecutive English-speaking adult patients followed for a minimum of 1 year postimplantation in two distinct groups, poor versus excellent performers.
Study Design: Retrospective.
Methods: Poor performers were those who realized a worsening, no improvement, or an improvement of less than 10%. This group numbered 58 (13%). High performers consisted of a cadre of 194 (44%) patients who scored between 91 and 100% postimplantation. Demographic data relating to onset of deafness, education exposure, etiology, etc., were evaluated.
Results: Of the poor performers, 33 (57%) were pre-/perilingually deafened. Of these, 79% had not received any auditory/oral training in childhood. On the other hand, a total of 109 implant recipients were individuals who were pre-/perilingually deafened. Of these, 24 were in the excellent performer category. All were identified early and were recipients of a strong auditory/oral education. Of the high performers, 170 (88%) were deafened late. Other findings such as preoperative electronystagmography with caloric testing, hearing aid use, device type, and high-resolution computed tomography scan of the temporal bone will be discussed for both groups.
Conclusions: A high preimplant speech score, auditory verbal therapy, and postlingual deafness statistically correlate with higher postimplant speech scores 1 year after cochlear implantation. Device type, caloric response and hearing aid use preimplantation, age at surgery, and sex do not statistically correlate with either poor or excellent speech discrimination scores postcochlear implantation."
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from Pediatrics
"OBJECTIVE. The purpose of this study was to evaluate the factors that affect the health-related quality of life of preadolescent children with nonsyndromic oral clefts using the Pediatric Quality of Life Inventory instrument and to evaluate whether there were any differences related to the type of cleft or other factors.
METHODS. Data for this study were derived from telephone interviews with the parents of a statewide population of children who were in the Iowa Registry for Congenital and Inherited Disorders, were aged 2 to 12 years, had nonsyndromic oral clefts, and were born in Iowa between January 1, 1990, and December 31, 2000. Twenty-minute interviews were conducted with mothers of 104 children in the spring and summer of 2003; respondents then completed and mailed back Pediatric Quality of Life Inventory surveys 2 to 3 weeks after the interviews (69% participation rate).
RESULTS. After controlling for demographic characteristics, children with less severe speech problems had higher total Pediatric Quality of Life Inventory scores as well as higher physical and psychosocial health domain scores. Age and cleft type interacted, with younger children (aged 2–7 years) with a cleft lip or cleft lip and palate having higher health-related quality of life scores than children with an isolated cleft palate; however, this pattern was reversed for older children (aged 8–12 years).
CONCLUSIONS. Speech and aesthetic concerns seem to have been important factors affecting the health-related quality of life for children with oral clefts. These factors seem to be more important as children get closer to adolescence (ages 8–12 years) when acceptance by peers becomes more critical."
from American Journal of Medical Genetics Part B: Neuropsychiatric Genetics
"Unlike other complex diseases, the study of autism has been almost exclusively limited to Caucasian families. This study represents a first effort to examine clinical and phenotypic findings in individuals with autism from African American families. Drawing from an ongoing genetic study of autism we compared African American (N = 46, mean age = 118 months) and Caucasian (N = 298, mean age = 105 months) groups on autism symptoms and developmental language symptoms. The African American group showed greater delays in language but did not differ from the Caucasian group on core autism symptoms. These findings, while suggestive of a more severe phenotype, may reflect an ascertainment bias. Nonetheless, we believe that more studies of racial-ethnic groups should be conducted with several goals in mind including strengthening recruiting strategies to include more ethnic-racial groups and more thoughtful evaluation of phenotypic traits. Such considerations will aid greatly in the search for genetic variants in autism. © 2007 Wiley-Liss, Inc."
from Audiology & Neuro-Otology
"This study evaluates sociodemographic and clinical characteristics of patients reporting discrepant levels of tinnitus loudness and annoyance. 4958 subjects recruited from a national tinnitus association completed a comprehensive screening questionnaire including Klockhoff and Lindblom's loudness grading system and the psychometric Mini-TQ (Tinnitus Questionnaire). There was a moderate correlation of 0.45 between loudness and annoyance. Of the subjects reporting very loud tinnitus, about one third had only mild or moderate annoyance scores. They were not different from those with high annoyance regarding age, gender and tinnitus duration, but annoyance was increased when subjects had additional hearing loss (OR = 1.71), vertigo/dizziness (OR = 1.94) or hyperacusis (OR = 4.96). Another significant predictor was history of neurological disease (OR = 3.16). Subjects reported low annoyance despite high loudness more often if not feeling low/depressed and not considering themselves as victims of their noises. A specific psychological profile was found to characterize annoyed tinnitus sufferers. Permanent awareness of the noises, decreased ability to ignore them and concentration difficulties were reported frequently even when overall annoyance scores were comparatively low. It is concluded that the coexistence of tinnitus with hearing loss, vertigo/dizziness and hyperacusis as complicating otological conditions seems to be of clinical relevance for the prediction of high annoyance levels. Tinnitus loudness and annoyance are not necessarily congruent and should be assessed separately."
from Audiology & Neuro-Otology
"Age-related hearing impairment (ARHI) is the most common sensory impairment seen in the elderly. It is a complex disorder, with both environmental as well as genetic factors contributing to the impairment. The involvement of several environmental factors has been partially elucidated. A first step towards the identification of the genetic factors has been made, which will result in the identification of susceptibility genes, and will provide possible targets for the future treatment and/or prevention of ARHI. This paper aims to give a broad overview of the scientific findings related to ARHI, focusing mainly on environmental and genetic data in humans and in animal models. In addition, methods for the identification of contributing genetic factors as well as possible future therapeutic strategies are discussed."
from Audiology & Neuro-Otology
"We [Don et al.: Otol Neurotol 2005;26:711-722] previously demonstrated that patients diagnosed with an active case of Ménière's disease could be distinguished from non-Ménière's normal-hearing subjects by a special auditory brainstem response method involving clicks and ipsilateral high-pass masking pink noise. Specifically, auditory brainstem responses to clicks presented alone and clicks with masking noise high-pass filtered at 8, 4, 2, 1 and 0.5 kHz were recorded. It was shown that the level of masking noise sufficient to progressively mask the response to clicks in non-Ménière's normal-hearing subjects was insufficient to appropriately mask the responses in Ménière's disease subjects, resulting in an obvious undermasked component. A relative latency measure of wave V or the undermasked component in the response to clicks with 0.5 kHz high-pass masking noise and wave V in the response to clicks presented alone clearly distinguished these two groups on an individual level, thus making it a valuable clinical tool. However, determining the peak latency of wave V or the undermasked component can be difficult in some cases. In anticipation of this difficulty, we investigated and present in this paper several amplitude measures that may help in the evaluation of these cases. One amplitude measure, the 'complex amplitude ratio', appears to be a good alternative when the latency measure of the undermasked component is difficult to determine."
from Audiology & Neuro-Otology
"Recent studies investigating whether the primary auditory cortex (PAC) is involved in silent lipreading gave inconsistent results. We used positron emission tomography to identify which areas in the temporal lobe process visible speech, with a focus on the PAC. Subjects were tested on lipreading numbers and only the best lipreaders were included in the study (n = 18; 9 female, 9 male). Each subject was scanned while either watching a movie with a speaker silently articulating numbers (lipreading condition) or watching a static image of the same speaker (baseline condition). Subjects were instructed to repeat internally the number seen or the number '1'. Compared to the baseline condition, silent lipreading activated temporal areas in both hemispheres with the largest activation clusters in the left hemisphere. When the whole group was examined, no activation in the PAC was found. But when investigating the two sexes separately, the female group demonstrated activation of the left PAC. There was no significant activation in the right female PAC or in the left and right male PAC. Since both groups had similar performances in lipreading, differential activity in the PAC has no effect on lipreading scores. These results may explain previous inconsistent results where no differentiation for sex was made."
from Language Acquisition: A Journal of Developmental Linguistics
"This article considers the comprehension of tense-aspect markers remote past BIN and habitual be by 3- to 5-year-old developing African American English (AAE)-speaking children and their Southwest Louisiana Vernacular English (SwLVE)-speaking peers. Overall both groups of children associated BIN with the distant past; however, the AAE-speaking children were twice as likely to give a distant past response on the BIN went task. These results are discussed in terms of event realization, the Aspect Hypothesis, and feature agreement. We delineate a path that uses the lexical part of the Aspect Hypothesis, the role of semantics in defining the end state of a refined aspectual system, and an interface between syntax and semantics to explain subtle steps involving agreement in the acquisition process. The AAE-speaking children scored significantly higher on the habitual be tasks than the SwLVE-speaking children, whose scores were not significantly different from chance. The results suggest that the AAE-speaking children have developing native knowledge of habitual be and are beginning to associate it with eventualities that recur."
from Language Acquisition: A Journal of Developmental Linguistics
"This paper focuses on the temporal and modal meanings associated with root infinitives (RIs) and other non-finite clauses in several typologically diverse languages—English, Russian, Greek and Dutch. I discuss the role that event structure, aspect, and modality play in the interpretation of these clauses. The basic hypothesis is that in the absence of a tense specification, the temporal reference of non-finite clauses is determined by the event structure of the predicate, in particular by the property of event closure. General principles of aspectual interpretation, such as the Punctuality Constraint (Giorgi and Pianesi 1997) and the Default Anchoring Requirement (a special case of a broader requirement that all clauses be temporally interpreted) interact with the particular aspectual features of the target language to explain the cross-linguistic differences in the temporal interpretation (past/present/modal) non-finite clauses."
from Language Acquisition: A Journal of Developmental Linguistics
"In this article, we propose that the Root Infinitive (RI) phenomenon in child language is best viewed and explained as the interaction between morphological learning and syntactic development. We make the following specific suggestions: The optionality in RI reflects the presence of a grammar such as Chinese which does not manifest tense marking. The gradual elimination of the nontense-marking grammar is facilitated by the learning of the morphosyntactic system of the target language. Quantitative differences in the input data among morphosyntactic systems result in the cross-linguistic variation in the RI phenomenon. More broadly, we aim to demonstrate that quantitative aspects of language learning data and concrete mechanisms of the language learning process can play an important role in the generative approach to language acquisition. In Section 2, we give a brief overview of the RI literature along with some methodological remarks regarding the explanation of the phenomenon. In Section 3, we lay out our theory of morphosyntactic learning and the broader variational approach to language acquisition. Our empirical work focuses on the development of tense in Spanish, French, and English. In Section 4 we show through corpus study of child-directed speech that differences in the morphosyntactic systems of these three languages explain the brief RI stage in Spanish acquisition, the prolonged RI stage in English acquisition, as well the intermediate status of the RI stage in French. In Section 5, we discuss how our approach relates to various findings established in the previous literature on RI. Section 6 concludes with a general discussion of the proper role of the input data in theories of language acquisition."
from News-Medical.net
"Born with no ear canal on his left side, Tom had significant hearing impairment and went to Loyola University Medical Center, where Dr. Sam Marzo surgically implanted a bone-anchored cochlear stimulator that delivers sound to the inner ear by bone conduction. Marzo activated Tom's device at Loyola's Oakbrook Terrace Medical Center.
"It harnesses the ability of the skull bone to conduct sound vibrations," said Marzo, associate professor of otolaryngology, Loyola University Chicago Stritch School of Medicine, Maywood, Ill. "It will enable Tom to perceive sounds on both sides of his head, which is critical for his speech development."
from Hearing Research
"Reflection masked thresholds (RMTs) for the simple scenario of a test reflection masked by the direct sound (200 ms long broadband noise) were measured as a function of reflection delay for diotic and dichotic stimulus presentations. In order to discriminate between contributions to reflection masking from simultaneous versus forward masking, the simultaneous RMT was measured in addition to the traditional RMT. Simultaneous RM was realized by truncating the offset of the test reflection such that the test reflection and the direct sound had a common offset. By comparing the experimental results for the two RMTs, it is shown that forward masking effects only have a significant effect on reflection masking for delays above 7–10 ms. Moreover, binaural mechanisms were revealed which deteriorate auditory detection of test reflections for delays below 7–10 ms and enhance detection for larger delays. The monaural and binaural processes that may underlie reflection masking are discussed in terms of auditory-modelling concepts."
from EurekAlert.org
"Researchers have long known that at about 18 months children experience a vocabulary explosion, suddenly learning words at a much faster rate. They have theorized that complex mechanisms are behind the phenomenon. But new research by a University of Iowa professor suggests far simpler mechanisms may be at play: word repetition, variations in the difficulty of words and the fact that children are learning multiple words at once."
from BMC Neuroscience
"Background
Sensory input is crucial to the initiation and modulation of swallowing. From a clinical point of view, oropharyngeal sensory deficits have been shown to be an important cause of dysphagia and aspiration in stroke patients. In the present study we therefore investigated effects of functional oropharyngeal deafferentation on the cortical control of swallowing. We employed whole-head MEG to study cortical activity during self-paced volitional swallowing with and without topical oropharyngeal anesthesia in ten healthy subjects. A simple swallowing screening-test confirmed that anesthesia caused swallowing difficulties with decreased swallowing speed and reduced volume per swallow in all subjects investigated. Data were analyzed by means of synthetic aperture magnetometry (SAM) and the group analysis of the individual SAM data was performed using a permutation test.
Results
The analysis of normal swallowing revealed bilateral activation of the mid-lateral primary sensorimotor cortex. Oropharyngeal anesthesia led to a pronounced decrease of both sensory and motor activation.
Conclusions
Our results suggest that a short-term decrease in oropharyngeal sensory input impedes the cortical control of swallowing. Apart from diminished sensory activity, a reduced activation of the primary motor cortex was found. These findings facilitate our understanding of the pathophysiology of dysphagia."
from Medical News Today.com
"Damaged or diseased vocal cords can forever change and even silence the voices we love, from a family member's to a famous personality's."
from Biochemical and Biophysical Research Communications
"Mutations in mitochondrial DNA is one of the important causes of hearing loss. Here, we performed a mutational screening of tRNASer(UCN) gene in 1542 Chinese subjects with hearing loss. One subject and five subjects carried tRNASer(UCN) A7445C and G7444A mutations, respectively, while two subjects harbored both G7444A and 12S rRNA A1555G mutations. Clinical evaluation revealed the variable phenotype of bilateral hearing impairment including severity and audiometric configuration in these subjects. Six pedigrees carrying only G7444A or A7445C mutation exhibited extremely low penetrance of hearing loss, while two families carrying both G7444A and A1555G mutations displayed high penetrance of hearing loss. Of 94 matrilineal relatives in these families, eight subjects suffered from aminoglycoside-induced hearing loss, while seven hearing-impaired subjects did not have a history of exposure to aminoglycosides. Those suggest that G7444A and A7445C mutations themselves are insufficient to produce a clinical phenotype and aminoglycosides are the major modifier factors for the development of deafness in these Chinese families. The combination of A1555G and G7444A mutations increased deafness expression. These observations provide an additional evidence for the early diction and prevention of deafness at the high risk populations carrying these mitochondrial DNA mutations."
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from Intute: Health and Life Sciences
"The British Society of Audiology and British Academy of Audiology have published joint guidelines on the use of real measurement in the fitting of digital signal processing hearing aids (July 2007). The guidelines are aimed at clinical audiologists, who will have some prior knowledge and apply to both adults and children, covering setting up the equipment, calibration, measurement and fitting."
from American Journal of Speech-Language Pathology
"Purpose: This study examined assessment procedures used by speech-language pathologists (SLPs) when assessing children suspected of having speech sound disorders (SSD). This national survey also determined the information participants obtained from clients' speech samples, evaluation of non-native English speakers, and time spent on assessment.
Method: One thousand surveys were mailed to a randomly selected group of SLPs, self-identified as having worked with children with SSD. A total of 333 (33%) surveys were returned.
Results: The assessment tasks most frequently used included administering a commercial test, estimating intelligibility, assessing stimulability, and conducting a hearing screening. The amount of time dedicated to assessment activities (e.g., administering formal tests, contacting parents) varied across participants and was significantly related to years of experience but not caseload size. Most participants reported using informal assessment procedures, or English-only standardized tests, when evaluating non-native English speakers.
Conclusions: Most participants provided assessments that met federal guidelines to qualify children for special education services; however, additional assessment may be needed to create comprehensive treatment plans for their clients. These results provide a unique perspective on the assessment of children suspected of having SSD and should be helpful to SLPs as they examine their own assessment practices."
from American Journal of Speech-Language Pathology
"Purpose: The script frameworks model (R. Schank, 1975) and causal network model (T. Trabasso & L. Sperry, 1985) were used to assess script-based story retellings of children with and without language impairments (LI). When retelling scripts and stories, children developing typically include (a) more obligatory than optional elements, with few temporal sequencing errors, and (b) story elements having several versus few causal connections to other story elements. The purpose of this study was to determine whether children with LI demonstrated a similar pattern of recall.
Method: A script-based story retell was collected from 22 children with LI and 22 age-matched peers (AM). Retells were analyzed for inclusion of obligatory and optional elements, elements with high and low causal connectivity, and temporal sequencing accuracy.
Results: Retells from both groups contained more obligatory elements and elements with high causal connectivity. However, groups differed on the specific elements included.
Conclusions: Children in the AM group appeared to utilize script and causal connectivity elements when retelling a script-based story. Children in the LI group appeared to focus more on script elements than causal connectivity. Their deficiencies may reflect difficulties with flexible application of scripts and accessing relevant knowledge, and/or generalized difficulties organizing information and extracting patterns."
from American Journal of Speech-Language Pathology
"Purpose: To document and describe in detail the occurrence of apraxia of speech (AOS) in a group of individuals with a diagnosis of motor neuron disease (MND).
Method: Seven individuals with MND and AOS were identified from among 80 patients with a variety of neurodegenerative diseases and AOS (J. R. Duffy, 2006). The history, presenting complaints, neurological findings, and speech-language findings were documented for each case.
Results: Spastic or mixed spastic-flaccid dysarthria was present in all 7 cases. The AOS was judged as worse than the dysarthria in 4 cases. Nonverbal oral apraxia was eventually present in all cases. Aphasia was present in 2 cases and equivocally present in another 2. Dementia was present in 1 case and equivocally present in 2.
Conclusions: AOS can occur in MND, typically also with dysarthria, but not invariably with aphasia or other cognitive deficits. Thus, a diagnosis of MND does not preclude the presence of AOS. More importantly, MND should be a diagnostic consideration when AOS is a prominent sign of degenerative disease."
from American Journal of Speech-Language Pathology
"Purpose: To examine the relationship between phonological processing skills prior to kindergarten entry and reading skills at the end of 1st grade, in children with speech sound disorders (SSD).
Method: The participants were 17 children with SSD and poor phonological processing skills (SSD-low PP), 16 children with SSD and good phonological processing skills (SSD-high PP), and 35 children with typical speech who were first assessed during their prekindergarten year using measures of phonological processing (i.e., speech perception, rime awareness, and onset awareness tests), speech production, receptive and expressive language, and phonological awareness skills. This assessment was repeated when the children were completing 1st grade. The Test of Word Reading Efficiency was also conducted at that time. First-grade sight word and nonword reading performance was compared across these groups.
Results: At the end of 1st grade, the SSD-low PP group achieved significantly lower nonword decoding scores than the SSD-high PP and typical speech groups. The 2 SSD groups demonstrated similarly good receptive language skills and similarly poor articulation skills at that time, however. No between-group differences in sight word reading were observed. All but 1 child (in the SSD-low PP group) obtained reading scores that were within normal limits.
Conclusion: Weaknesses in phonological processing were stable for the SSD-low PP subgroup over a 2-year period."
from American Journal of Speech-Language Pathology
"Purpose: This qualitative study explored mothers' perceptions of their children's communication disabilities, emergent literacy development, and speech-language therapy programs.
Method: Participants were 14 Mexican immigrant mothers and their children (age 17–47 months) who were receiving center-based services from an early childhood intervention program, located in a large urban city in the Midwestern United States. Mother interviews composed the primary source of data. A secondary source of data included children's therapy files and log notes. Following the analysis of interviews through the constant comparative method, grounded theory was generated.
Results: The majority of mothers perceived their children as exhibiting a communication delay. Causal attributions were diverse and generally medical in nature (i.e., ear infections, seizures) or due to familial factors (i.e., family history and heredity, lack of extended family). Overall, mothers seemed more focused on their children's speech intelligibility and/or expressive language in comparison to emergent literacy abilities.
Conclusions: To promote culturally responsive intervention, mothers recommended that professionals speak Spanish, provide information about the therapy process, and use existing techniques with Mexican immigrant families."
from American Journal of Speech-Language Pathology
"Purpose: To examine the influence of visual information on speech intelligibility for a group of speakers with dysarthria associated with Parkinson's disease.
Method: Eight speakers with Parkinson's disease and dysarthria were recorded while they read sentences. Speakers performed a concurrent manual task to facilitate typical speech production. Twenty listeners (10 experienced and 10 inexperienced) transcribed sentences while watching and listening to videotapes of the speakers (auditory-visual mode) and while only listening to the speakers (auditory-only mode).
Results: Significant main effects were found for both presentation mode and speaker. Auditory-visual scores were significantly higher than auditory-only scores for the 3 speakers with the lowest intelligibility scores. No significant difference was found between the 2 listener groups.
Conclusions: The findings suggest that clinicians should consider both auditory-visual and auditory-only intelligibility measures in speakers with Parkinson's disease to determine the most effective strategies aimed at evaluation and treatment of speech intelligibility decrements."
from American Journal of Speech-Language Pathology
"Purpose: To offer an existential framework for understanding some of the emotional and grieving issues that can accompany communication disorders.
Method: A narrative review of selected existential psychology literature is provided. I. Yalom's (1980, 1986) model is used as a foundation to explore the 4 existential issues of death, freedom/responsibility, loneliness, and meaninglessness. This model is then applied to communication disorders based on the work of D. Luterman (1984, 2001). These 4 existential issues are juxtaposed with K. Moses' (1989) model of the grief response, which includes denial, anxiety, fear, depression, anger, and guilt. Suggestions for responding within one's scope of practice are provided.
Conclusion: Combined, existential and grieving models can offer clinicians new insight into clients' loss resolution work. This inner work constitutes a spiritual journey that may parallel the journey through therapy and rehabilitation. The case is made that attending to these issues can enhance long-term outcomes of treatment."
from Topix.net
“The changes in the man's functional abilities were statistically linked to the use of DBS, and those changes have been remarkable and sustained.”
DOCTORS have used electrical impulses to help a brain-damaged man learn to talk and eat again, it emerged yesterday. via Scotsman.com"
from Evidence-Based Communication Assessment and Intervention
from American Journal of Speech-Language Pathology
"Purpose: To compare morphosyntactic skills of preschoolers in different subgroups of language impairment.
Method: Eighty-three children participated in this study. They represented 4 groups: (a) language impairment-only, (b) speech-language impairment with minimal or no final cluster reduction/consonant deletion, (c) speech-language impairment with frequent final cluster reduction/consonant deletion, and (d) a no-impairment control group. Group performance was compared for finite and nonfinite morpheme production and sentence structure.
Results: Children in the language impairment-only group had significantly higher performance than children in both speech-language impairment subgroups, even when errors that could be attributed to final consonant deletion/cluster reduction were taken into account. The language impairment-only and control groups' performance was similar for finite and nonfinite morpheme production, and both groups produced nonfinite plurals with significantly higher accuracy than finite third person singular forms. The language impairment-only group had significantly higher accuracy for both plural and third person singular relative to the group with speech-language impairment characterized by infrequent final cluster reduction/consonant deletion.
Conclusions: Children with speech-language impairment generally had poorer morphosyntactic skills than peers who had language deficits and age-appropriate speech skills. Final consonant and final cluster production skills alone did not account for group differences. Clinically, the findings suggest that it is important to assess carefully the speech skills, including final cluster production skills, of preschoolers who have language deficits and language skills of preschoolers who have speech sound disorders."
from Brain and Language
"Electrophysiological techniques were used to assess the generalizability of concreteness effects on word processing across word class (nouns and verbs) and different types of lexical ambiguity (syntactic only and combined syntactic/semantic). The results replicated prior work in showing an enhanced N400 response and a sustained frontal negativity to concrete as compared with abstract nouns. The effect of concreteness on the N400 generalized to all word class and ambiguity conditions, whereas the frontal effect was present for all word types except for the syntactically and semantically ambiguous items when these were used as verbs. The seemingly dissociable ERP effects of concreteness at frontal and central/posterior electrode sites revealed by these data suggest that concreteness may impact multiple aspects of neurocognitive processing."
from Brain and Language
"In a simple prime–target visual rhyming paradigm, pairs of words, nonwords, and single letters elicited similar event-related potential (ERP) rhyming effects in young adults. Within each condition, primes elicited contingent negative variation (CNV) while nonrhyming targets elicited more negative waveforms than rhyming targets within the 320–500 ms (N400/N450) time window. The target rhyming effect, apparently primarily an index of phonological processing, was similar across conditions but tended to be smaller in mean amplitude for letters. One of the first reports of such a letter rhyming effect in the ERP literature, these findings could be important developmentally because letter rhyme tasks simultaneously index the two best predictors of ease of learning to read: letter name knowledge and phonological awareness."
from Advances in Speech-Language Pathology
"English-speaking children with Specific Language Impairment (SLI) variably produce inflected and bare stem forms in obligatory past tense contexts. Researchers have not reached consensus as to whether the underlying deficit is morphosyntactic or morphophonological in nature. The Computational Grammatical Complexity (CGC) Hypothesis takes a different tack: it hypothesizes that for children with a particular form of SLI, Grammatical-SLI, the deficit is in representing linguistic structural complexity in at least three components of the computational grammatical system - syntax, morphology and phonology. Deficits in all these components are predicted to impact on regular past tense formation. The impact of syntactic and morphological complexity on G-SLI children's realization of tense has been tested previously. Here we complete the picture by considering phonological effects on their production of regular past tense inflection. Using a past tense elicitation task where we manipulate the phonological complexity of the inflected verb end, we show that, as predicted, verb-end phonological complexity impacts on suffixation: G-SLI children are less likely to suffix stems when the inflected form ends in a consonant cluster. Typically developing controls show no such effect. The results of this study highlight the need to consider the independent contributions of language components to impaired and normal performance."
from Advances in Speech-Language Pathology
"The purpose of this pre-experimental, retrospective study was to examine the effect of a phonological awareness intervention program on qualitative changes in the non-word spelling skills of children with spelling difficulties. Additionally, this pilot study set out to determine the reliability and effectiveness of a newly developed spelling analysis tool. This tool, the Feature Analysis of Non-word Spelling (FANS) was devised to qualitatively describe children's non-word spelling performance. Participants were 16 school-aged children, ranging in age from 8 years 6 months to 10 years 1 month, who were selected for this study on the basis of their below average non-word spelling ability prior to intervention. All children in the study had received phonological awareness training based on the University of Queensland Phonological Awareness for Literacy (UQPAL) program. Pre- and post-intervention non-word spelling responses of participants were analysed using the FANS. Results revealed a significant overall improvement in non-word spelling skills following phonological awareness training. Specifically, participants displayed significant improvements in their ability to represent vowels post intervention. The FANS was found to be a highly reliable qualitative measure of non-word spelling. Results highlight the merit of using a qualitative analysis of spelling to best elucidate the effectiveness of intervention or developmental change."
from Advances in Speech-Language Pathology
"Although several aspects of prosody have been studied in speakers with right hemisphere damage (RHD), rhythm remains largely uninvestigated. This study compares the rhythm of an Australian English speaker with right hemisphere damage (due to a stroke, but with no concomitant dysarthria) to that of a neurologically unimpaired individual. The speakers' rhythm is compared using the pairwise variability index (PVI) which allows for an acoustic characterization of rhythm by comparing the duration of successive vocalic and intervocalic intervals. A sample of speech from a structured interview between a speech and language therapist and each participant was analysed. Previous research has shown that speakers with RHD may have difficulties with intonation production, and therefore it was hypothesized that there may also be rhythmic disturbance. Results show that the neurologically normal control uses a similar rhythm to that reported for British English (there are no previous studies available for Australian English), whilst the speaker with RHD produces speech with a less strongly stress-timed rhythm. This finding was statistically significant for the intervocalic intervals measured (t(8) = 4.7, p < .01), and suggests that some aspects of prosody may be right lateralized for this speaker. The findings are discussed in relation to previous findings of dysprosody in RHD populations, and in relation to syllable-timed speech of people with other neurological conditions."
from Advances in Speech-Language Pathology
"Speech pathology is a growth industry, but how this impacts on recruitment in Australia has not been explored in the research literature. The aim of this study was to investigate characteristics of advertised speech pathology positions and the ease with which they were filled, particularly for less attractive positions based in non-metropolitan locations or involving work with people with developmental disability. Contact persons for positions advertised mostly in newspapers over a 36-week period were recruited. There were 108 positions advertised, with 89 contact people agreeing to participate in two telephone surveys, including one conducted approximately one month after application closing dates. Positions represented a range of employment sectors, with Grade 2 followed by Grade 1 positions most frequent. Most (75%) positions were filled, but for 55% at grades other than that advertised. There was no evidence that positions in non-metropolitan positions or those involving work with people with developmental disability were particularly difficult to fill, but they did attract relatively few applicants. The data did, however, point to a potential mismatch between successful applicants' level of experience and job requirements. Implications for support needs of isolated and inexperienced clinicians, and further research needs are discussed."
from Advances in Speech-Language Pathology
"Non-fluent agrammatic speech output, a typical feature of Broca's aphasia, involves marked difficulty using complex verb tenses. This experiment examined the interactional effect among canonical properties of verb inflections in the simple verbs produced by Spanish-speaking individuals with agrammatic speech, based on data derived from a larger corpus. Twelve monolingual Spanish-speaking individuals, six with agrammatic speech and six control speakers, participated in the study. A sentence repetition task was deemed useful for this experiment because it provided clues between overt expressive syntactic abilities and their possible internal grammatical processing. Responses for simple verbs were examined in variable pairings to explore the effect each variable interaction had on the enhancement of verb inflection repetition. Findings showed that participants with agrammatic speech favoured the repetition of structurally simple verb endings associated with early acquired and frequently employed verb forms. These results support the notion that complex inflectional markers may overload processing capabilities of agrammatic speakers for the production of inflectional affixes. Instead, simple verb forms are easier to produce because they involve an enhancing interaction of morphophonological canonical features. Both theoretical and clinical implications of the findings are discussed."
from the Journal of Neurosphysiology
"The complex anatomical structure of the central nucleus of the inferior colliculus (ICC), the principal auditory nucleus in the midbrain, may provide the basis for functional organization of auditory information. To investigate this organization, we used tetrodes to record from neighboring neurons in the ICC of anesthetized cats and study the similarity and difference among the responses of these neurons to pure tone stimuli using widely used physiological characterizations. Consistent with the tonotopic arrangement of neurons in the ICC and reports of a threshold map, we found a high degree of correlation in the best frequencies (BF) of neighboring neurons, which were mostly below 3-kHz in our sample, and the pure tone thresholds among neighboring neurons. However, width of frequency tuning, shapes of the frequency response areas, and temporal discharge patterns showed little or no correlation among neighboring neurons. Since the BF and threshold are measured at levels near the threshold and the characteristic frequency (CF), neighboring neurons may receive similar primary inputs tuned to their CF; however, at higher levels, additional inputs from other frequency channels may be recruited, introducing greater variability in the responses. There was also no correlation among neighboring neurons' sensitivity to interaural time differences (ITD) measured with binaural beats. However, the characteristic phases (CP) of neighboring neurons revealed a significant correlation. Since the CP is related to the neural mechanisms generating the ITD sensitivity, this result is consistent with segregation of inputs to the ICC from the lateral and medial superior olives."
