Folia Phoniatrica et Logopaedica最新文献

Introduction: Chronic rhinosinusitis (CRS) is a common disabling condition that affects 5-12% of the general population. The impact of CRS on voice has garnered interest due to the increasing number of individuals relying on their voice professionally. Previous studies have shown inconsistent results due to heterogeneous study groups and varying outcome measures. The objective of this study was to investigate the voice characteristics of a large homogenous group of patients with chronic rhinosinusitis and nasal polyposis (CRSwNP) and normal laryngeal examination.

Methods: Adult patients presenting to the rhinology clinic of a tertiary referral center between March 2023 and March 2024 with a diagnosis of CRSwNP and normal laryngeal examination were recruited. Subjects matched by age and gender and with no history of CRSwNP and normal laryngeal examination were recruited as controls. Primary voice outcome measures consisted of the Voice Handicap Index-10 (VHI-10) and acoustic/aerodynamic parameters including percent shimmer, percent jitter, noise-to-harmonic ratio, voice turbulence index, and maximum phonation time.

Results: A total of 58 patients were included and divided into a study group (n = 29 cases) and a control group (n = 29). There was a statistically significant difference in the mean VHI-10 score of the study group compared to the control group (8.14 ± 4.01 vs. 2.79 ± 2.73, p < 0.001). Moreover, there was a moderate to strong correlation between the VHI-10 score and the SNOT-22 score (r = 0.612; p < 0.001). There was no significant difference in any of the acoustic and aerodynamic parameters between the study group and control group (p > 0.05).

Conclusion: Patients with CRSwNP are more likely to have vocal symptoms that impact their quality of life in comparison to controls. Early recognition of these vocal symptoms should prompt early treatment to avoid any structural or functional voice disorders.

Introduction: Cry melody serves as a platform for the eventual development of expressive language. Complex melodic structures exist in the naturally occurring discomfort cries of healthy term infants as young as 2 months of age. To date, no study has analyzed the influence of distress on complexity of cry melody. The purpose of this study was to determine whether the distress cries produced across a group of infants contained a comparable amount of the complexity as previously reported for discomfort cries at that age.

Methods: A group of 11 healthy 2-month-old infants served as participants for the study. Distress cries were collected from each infant and were analyzed acoustically. The complex melodies occurring within the overall crying episode of each infant were determined.

Results: Findings indicated a low occurrence of complex melody in distress cries at the age of 2 months compared to past reports for same-aged infants producing non-distress spontaneous cries. Cries judged to be reflective of low distress were generally found to have a more complex melody.

Conclusion: Collectively, the present study supports the hypothesis that the complexity of cry melody is reduced in distress-elicited crying.

Introduction: The social stigma experienced by parents of children with speech and language impairments is a significant concern, since it can profoundly affect the welfare and assistance provided to both the parents and their children. This study aimed to investigate the emotions and perspectives of parents regarding their children's speech and language challenges, using a survey methodology.

Methods: This is a comparative and descriptive study that includes 376 participants who have a child diagnosed with a speech and language disorder. A survey designed to assess perceived stigma was implemented to accumulate data. A comparison was conducted using Kruskal-Wallis and correlation analysis.

Results: Parents with children with autism experienced the greatest level of perceived stigma, followed by parents of children with Down syndrome. Parents of children with speech sound disorders obtained the lowest scores in terms of perceived stigma. There were no significant differences observed in the education level of parents, therapy duration of their child, age, and perceived stigma scores.

Conclusion: Speech and language therapists must comprehend the stigma that families feel and encounter. To address this stigma, it is crucial to provide parents' options such as self-help groups or activities and resources that promote stigma awareness. Also, speech and language therapists who work with these populations should enhance their understanding of stigma.

Introduction: Inferential comprehension is a complex language skill fundamental for social competence and reading comprehension. Evidence from the literature demonstrates that this ability develops early in a child's life. Using a longitudinal design, this study aimed to describe the early developmental trajectory of oral inferential comprehension ability in young typically developing French-speaking children from 3;6 to 5;6 years of age.

Methods: A narrative-based oral inferential comprehension task was administered to a group of typically developing children (n = 79) at 3;6, 4;6, and 5;6 years old; as part of the Early Longitudinal Language and Neglect [ELLAN] study. A total of 19 inferential questions were classified into six types of causal inferences targeting the comprehension of story grammar elements.

Results: Inferential comprehension total scores showed significant improvement across all three time points, with the most significant increase between 3;6 and 4;6 years of age. At 3;6 years old, questions about the problem of the story, goal, and characters' internal responses were better answered compared to questions about the attempts to solve the problem, predictions, and the story's resolution. By 5;6 years of age, no ceiling effects were observed for any of the inference types, indicating ongoing development of inferential comprehension ability.

Conclusion: Such longitudinal data documenting a developmental sequence of early oral inferential comprehension supports the importance of initiating assessments and interventions of this complex skill from an early age, especially from 3;6 to 4;6 years old, a period marked by significant growth.

Introduction: COVID-19 sequelae may persist for years, particularly in individuals who experienced critical illness. This longitudinal study aimed to assess lung function, voice, and their correlation in post-COVID-19 syndrome (PCS) patients after intensive care discharge and evaluate the impact on general and voice-related quality of life (V-RQoL).

Methods: Among the 284 patients who survived hospitalization at the University Hospital, 48 met the inclusion and exclusion criteria and participated in the study. Evaluations were conducted at an average of 4 and 8 months post-discharge and included assessments of dyspnea (modified Medical Research Council [mMRC] scale), spirometry, inspiratory (MIP), and expiratory (MEP) muscle strength, the 6-minute walk test (6MWT), maximum phonation time (MPT), sound pressure level (SPL), overall degree of dysphonia, general quality of life (Short Form Health Survey [SF-36]), and V-RQoL.

Results: There was a reduction in mMRC, and an increase in MIP, MEP, 6MWT, MPT, and usual and minimum SPL. Women still exhibited reduced MPT, and both sexes had persistent dysphonia. A negative correlation was found between mMRC and MPT, and a positive correlation was found between 6MWT and MPT. Some SF-36 domains and the physical score of the V-RQoL for women remained reduced.

Conclusions: Eight months after COVID-19, there was an improvement in pulmonary function and MPT, but an increase in usual and minimum SPL and persistent dysphonia. These findings highlight the need for further research into persistent dysphonia as a significant aspect of PCS.

Introduction: Construct validity represents the degree to which a tool assesses the construct that it is proposed to determine. The present study aimed to evaluate the construct validity of the Arabic version of the Eating Assessment Tool (A-EAT-10) questionnaire to determine its informative value and justify its use in clinical practice and research.

Methods: A retrospective study was accomplished on 124 adult hospitalized COVID-19 patients with oropharyngeal dysphagia as evidenced by screening tools A-EAT-10 and Yale swallow protocol (YSP). Eighty of these 124 patients were evaluated by fiberoptic endoscopic evaluation of swallowing (FEES).

Results: The A-EAT-10 questionnaire shows high construct validity, evidenced by exploratory factor analysis and its significant positive correlation with the YSP and validated FEES scales.

Conclusion: A-EAT-10 verified its applicability in both research and clinical applications.

Introduction: Flexible endoscopic evaluation of swallowing (FEES) is a procedure used widely to assess pharyngeal residue, penetration, and aspiration in people with dysphagia. While the types of liquids and purees used during FEES are known to significantly affect swallowing outcomes during FEES, it is unknown if similar effects are observed with regular chewable foods. Therefore, the primary aim of this study was to assess the effects of food type on ratings of pharyngeal residue, penetration, and aspiration during FEES. As a secondary aim, we assessed the effects of food type on oral processing, as measured by the number of masticatory cycles.

Methods: Pharyngeal residue, penetration, and aspiration were assessed in consecutive outpatient dysphagic adults undergoing routine FEES. Patients were presented with four types of foods (one trial each in a randomized order): saltine cracker, graham cracker, shortbread cookie, and shortbread cookie with pudding. Foods were matched by volume. All data were blindly analyzed by pairs of independent raters using the Visual Analysis of Swallowing Efficiency and Safety (VASES). Multilevel statistical models were used to examine the effects of food type on oropharyngeal residue, hypopharyngeal residue, Penetration-Aspiration Scale (PAS) scores, and number of masticatory cycles.

Results: A total of 193 food trials were analyzed across 50 FEES. Oropharyngeal residue was greatest with saltine crackers compared to all other food types. Hypopharyngeal residue was greater for shortbread cookies compared to saltine crackers and for shortbread cookies with pudding compared to saltine crackers and graham crackers. Shortbread cookies with pudding required fewer masticatory cycles compared to all other food types.

Conclusion: This study identified significant differences in oropharyngeal residue, hypopharyngeal residue, and oral processing but not penetration or aspiration, across food types in this group of outpatient dysphagic adults. These data suggest that clinicians and researchers should consider standardizing the type of regular chewable foods used during FEES. Future research should examine the generalizability of findings in people with more severe swallow impairments and in more specific patient populations.

Introduction: The objective of the study was to analyze complex auditory skills (music abilities and emotional speech perception) in children with cochlear implant (CI) compared to normal-hearing controls.

Methods: This was a prospective case-control study. A total of 30 controls and 28 children (7-14 years) with congenital severe-to-profound hearing loss (HL) with unilateral or bilateral CI underwent the pitch discrimination test (PDT), the songs identification test (SIT), and the melodies identification test (MIT) to measure music abilities; the speaker and gender discrimination and emotions identification auditory test (SDEIAT) to evaluate socioemotional speech perception.

Results: Controls had significantly higher PDT, MIT, and SDEIAT scores than CI recipients (p < 0.05). Patients with asymmetrical HL and bimodal stimulation (CI and hearing aid) had significantly better MIT scores than unilateral (p = 0.007) and bilateral CIs (p = 0.013). In the bilateral CI group, patients with a history of sequential implantation had significant lower scores in melodic recognition than simultaneous CI (p = 0.005). Pitch discrimination was not related to the age of patients or to music exposure time. An inverse relationship existed between musical abilities and age of cochlear implantation (Pearson's R = -0.62), with better results before 24 months (p = 0.039). Controls and CI users recognized the gender of the speakers equally; bimodal stimulation identified complex emotions significantly better than the other groups (p < 0.05). SDEIAT was statistically related to SIT (Pearson's R = 0.59), PDT (Pearson's R = 0.67), and age of implantation (Pearson's R = -0.54) with better result the lower the age of surgery.

Conclusion: The close relationship between emotional speech perception, music abilities, and pitch discrimination confirmed the importance to improve complex linguistic auditory tasks that are rarely examined in clinical practice but fundamental for social interactions in children affected by congenital HL.

Introduction: Intrinsic pitch or fundamental frequency (IF0) is an inherent property of vowels where close vowels are produced with a higher fundamental frequency than open vowels. Although well studied in adults, it remains underexplored in children. IF0 reflects combined biomechanical effects as well as a deliberate effort from speakers to produce distinct vowels and enhance vowel contrasts. Vowel errors and inconsistency in vowel production are well-known characteristics in Childhood Apraxia of Speech (CAS). We aimed to investigate if children with CAS exhibit IF0 and if present, how it compares with typically developing (TD) children.

Method: A total of 17 CAS children and 8 TD children were asked to repeat simple bisyllabic nonword utterances of the type [dəCV] six times. The stimuli contained a consonant, C (/b, d/), and a vowel V, which comprised the corner vowels of the Dutch vowel space (/a, i, u/). The target stimulus was produced in a carrier sentence (/he dəCV wɪːr/; "hey the CV again"). Mean pitch (F0) and formant (F1 to F3) values were extracted from the recorded speech samples around vowel midpoint and bark transformed prior to further analyses. Statistical analyses were carried out using linear mixed models for each outcome measure separately.

Results: The main finding of our study is that IF0 is present in children with CAS, showing a pattern that is generally similar to TD children. Additionally, we observed differences in vowel characteristics in children with CAS that are ambiguous; rather, we observed vowel-specific differences. Children with CAS produced /i/ less closed and /a/ with an exaggerated openness, whereas they produced /u/ more fronted compared to TD children. Also, children with CAS produced their vowels generally with a higher pitch and a longer duration compared to TD children. Pitch and duration were only correlated (negatively) in the vowel /a/ in both groups.

Conclusions: Where IF0 appears to be preserved in children with CAS, they do show differences in articulatory dimensions of vowel production compared to TD that are vowel specific. Clinicians should take these vowel-specific differences into account when choosing therapeutic targets.

Introduction: Minipuberty is a period in early infancy, in which the hypothalamic-pituitary-gonadal axis is activated, leading to a secretion of bioactive estradiol and testosterone. It is assumed to affect brain development and, as a result, vocal characteristics. While studies have found hormonal influences on fundamental frequency and articulatory characteristics in infants' crying and babbling, temporal characteristics have not been studied so far. The aim of this study was therefore, as a first step, to investigate the potential influence of sex hormones on the mean duration of babbling vocalizations.

Methods: Blood samples were taken from 16 infants at 4, 8, and 20 weeks and sex hormone concentrations were measured. The duration of individual infant vocalizations was analyzed from recordings of marginal babbling. A hierarchical, multiple regression approach was used to investigate associations between mean duration and bioactive hormone levels (estradiol [E2], testosterone [T]).

Results: While no estradiol effects were found, the mean duration of an infant's babbling at 20 weeks showed a significant negative association with the corresponding bioactive testosterone concentration in the same infant at the same age (p = 0.003).

Conclusion: The results bolster the assumption that it is not sex per se, which seem to determine prelinguistic development. A better understanding of minipubertal influences is essential both for our understanding of gender-specific brain physiological mechanisms and for the resulting language performance.