Folia Phoniatrica et Logopaedica最新文献

Background: Links between the mastery of complex syntax and more general cognitive abilities (e.g., working memory [WM] and attention) are widely reported for both typically developing children and children with atypical language development, such as developmental language disorder (DLD). These observations have resulted in debates about whether the locus of breakdown in populations with known syntactic impairment is situated in a specific language system or a more general cognitive system. Recently, a hybrid model of language acquisition, the parallel combination approach (PCA), in which both domain-specific and domain-general processes contribute to language development, was put forward.

Summary: Our review, which is the first to examine the validity of the PCA, compares a body of our own work investigating the language-cognition interface in various populations: children with specific learning difficulties, attention deficit hyperactivity disorder (ADHD), and DLD. We report findings from two cross-sectional studies (studies 1 and 2), one priming study (study 3), and two training studies (studies 4 and 5). The results confirm a close link between WM, attention, and syntax, in line with domain-general approaches to language impairment. However, certain findings within this review also reveal that impaired general skills can be found alongside intact syntax, providing support for domain-specific approaches. While these results may initially appear contradictory, we argue that they are perfectly in line with the predictions made by the PCA.

Key messages: Study 1 confirms that clinicians should assess syntax in children with specific learning difficulties to avoid the missed diagnosis of comorbid DLD. Studies 2 and 3 offer perspectives on the differential diagnosis of ADHD and DLD and highlight the advantages of using probe tests and dynamic assessment when evaluating children with suspected syntactic impairment. Studies 4 and 5 describe a novel, empirically validated WM training program that has been shown to lead to syntactic improvements in clinical markers of DLD. Finally, the PCA is also clinically relevant as it underscores that children with the same diagnostic label can present dissimilar cognitive profiles with different sources of breakdown. Collectively, the various studies highlight the intricacy of the relationship between syntax and cognition, which cannot be easily described by traditional single-disciplinary frameworks.

Introduction: Augmentative and alternative communication (AAC) intervention research is rarely focused on school-age beginning communicators, despite the urgent need to ensure individuals in this population have access to the fundamental human right of communication.

Methods: Four school-age children with multiple disabilities who were primarily prelinguistic communicators participated in the current study. The study used a single-subject research design to explore the effects of two interaction approaches - a social routine approach and a directive approach - on prelinguistic communication, compared to independent play and to one another. This study then evaluated the added effects of high-tech AAC within the most effective interaction approach for each participant.

Results: All participants demonstrated prelinguistic communication indicating positive affect most frequently when interacting within a social routine. Furthermore, all participants increased linguistic communication while either maintaining or increasing prelinguistic communication when high-tech AAC was added to the social routine interaction.

Conclusions: Clinicians should consider building accessible, predictable, engaging, and age-respectful social routines into leisure contexts to promote prelinguistic communication from school-age beginning communicators. Clinicians should also provide access to linguistic communication through high-tech AAC while continuing to honor and promote prelinguistic communication.

Introduction: The aim of this study was to compare auditory brainstem response (ABR) findings of normal-hearing preschool children with different types of speech and language pathology.

Methods: This retrospective, non-randomized, cohort study was conducted at a tertiary speech and hearing rehabilitation institution according to STROBE guidelines. The study enrolled 123 preschool children diagnosed with speech language pathology and normal hearing. The participants included children with developmental language disorder, autism spectrum disorder, isolated articulation pathology, organic brain lesions, cognitive delay, and a group of very young children with clinically significant speech development delay. All patients underwent standard ABR procedures.

Results: The latencies were the longest in the group of children with organic lesion, followed by the group of children with autism spectrum disorder, then the group with developmental language disorder, and the young children group. In the group of children with articulation pathology and the cognitive delay group, the latencies were the shortest.

Conclusion: This study showed a connection between several groups of children with language pathology that includes comprehension problems and prolongation of ABR latencies.

Introduction: Voice disorders and burnout syndrome are common among teachers. This study aimed to explore the relationship among vocal problems, burnout syndrome, and some personal work factors.

Methods: This cross-sectional descriptive study enrolled 90 nonuniversity teachers who completed the Multidimensional Vocal Scale for Teachers (EVM-D) to evaluate vocal problems and an adapted Spanish version of the Maslach Burnout Inventory-Educators Survey (MBI-ES) to detect burnout syndrome.

Results: Overall, 16% of teachers expressed symptoms compatible with burnout, and 60% of them were in the interval above the 75th percentile of the EVM-D, i.e., they had a high risk of vocal problems. An association between burnout and more vocal problems was established among teachers, particularly between the vocal symptoms and vocal abuse dimensions with the emotional exhaustion subscale of the MBI-ES. A history of anxiety/depression and fewer years of professional experience were associated with more vocal problems. The burnout group perceived more "loss of vocal power," "vocal fatigue," "vocal effort," and "hoarseness." Vocal abuse items received the highest scores of EVM-D. However, only "shouting" in the classroom was significantly different between the groups with and without burnout.

Conclusion: Emotional exhaustion of burnout syndrome, history of anxiety/depression, and a shorter professional experience were associated with vocal problems, which could limit the performance of teachers. Reducing classroom noise, establishing strategies to avoid shouting, or strengthening personal accomplishments in teachers could be useful in breaking the cycle of vocal problems and emotional exhaustion, particularly at the beginning of their professional experience.

Introduction: Adductor spasmodic dysphonia (ADSD) is characterized by involuntary laryngeal muscle spasms. Due to the lack of a quantitative evaluation method, most measurements have demonstrated difficulty in validity and reliability for diagnosing ADSD. This study aimed to establish a novel indicator for ADSD and determine its diagnostic effects.

Methods: We investigated 98 voice samples from 49 patients with ADSD and 49 healthy participants. A sustained vowel was recorded by a high-definition audio recorder. Voice samples underwent regular acoustic evaluation and a novel global dimension (GD) method. GD, Jitter, Shimmer, HNR, Frequency shift, and CPPS were measured for both groups.

Results: Statistical analysis revealed that the GD method effectively differentiated ADSD patients from healthy participants (p < 0.001, D'>0.8). Subsequent multiclass receiver operating characteristic analysis demonstrated that GD possessed the most significant classification accuracy (area under the curve = 0.988) compared with other acoustic parameters.

Conclusion: GD was an effective metric for objective differentiation between ADSD patients and healthy participants. This metric could assist clinicians in the diagnosis of ADSD patients.

Introduction: Online games provide a socializing environment for children aged 8-10 years, but there is a lack of information in the literature about whether children who stutter (CWS) access online gaming environments as frequently as their nonaffected peers and about their interaction habits. This study aimed to investigate the participation frequency of school-age CWS and children who do not stutter (CWNS) in online games, the speech characteristics during games, and whether they encountered bullying-like behaviors during games.

Methods: A total of 91 CWS (F/M = 18/73; age range = 8-13) and 116 CWNS (F/M = 60/56; age range 8-13) participated in this study. Children's participation habits in online, chat-based, multiplayer games were evaluated with web-based questionnaires. Differences between questionnaire responses were analyzed using the significance test for a difference in two proportions.

Results: There was no significant difference between the participation rates of CWS and CWNS in online games (z = 1.46; p = 0.14), their frequency (p > 0.05), and the time they spent in the game (p > 0.05). It was found that those who stutter preferred to use one-word expressions more than their peers who do not stutter (z = 2.03; p = 0.04), and those who stutter had higher rates of not encountering bullying-like behaviors in online games than those who do not stutter (z = 2.2; p = 0.03).

Discussion/conclusion: CWS and CWNS show similar participation habits in online, chat-based, multiplayer games with similar frequency and duration. Speech features that emerge in online games and whether these games play a role in providing CWS with a communication environment where the risk of bullying is reduced and fluency is increased may be the subject of future research.

Introduction: We examined the effects of four types of voicing on vocal tract movements by comparing the articulatory kinematics of whispered speech to habitual, loud, and soft conditions.

Methods: Participants included 10 males and 10 females with no history of communication disorders. They read six stimulus sentences in habitual, loud, soft, and whispered conditions. An electromagnetic articulograph tracked the tongue, jaw, and lip movements. Analysis focused on the words we do from a longer sentence. Vertical tongue/jaw and horizontal lip movements were measured during the production of the retracted and rounded front and back vowels in we do.

Results: Soft speech led to smaller and slower lip movements than in the habitual condition. Displacement increased for the tongue and jaw in loud and whispered speech compared to the habitual condition. Tongue and jaw velocity increased for loud but not for whispered speech compared to the habitual condition. Utterance duration increased for loud and whispered conditions.

Discussion: The increasing tongue and jaw displacement and velocity from soft to habitual to loud speech reported here is consistent with previous accounts. Whispering was less intense than soft speech, yet it involved larger tongue and jaw movements than habitual speech, possibly reflecting a speaker's focus on greater articulatory clarity when the acoustic signal is the weakest.

Introduction: The study aimed to investigate the mechanisms of impairment and recovery in graph naming functions among patients with aphasia due to cerebral infarction. Specifically, the study compared immediate effects of transcranial direct current stimulation (tDCS) treatment in patients at different stages postinfarction: the acute phase (AP) and the recovery period (RP).

Methods: Twenty-eight patients were selected, consisting of 16 in the AP and 12 in the RP, along with 18 healthy controls. Both patient groups underwent 2 weeks of tDCS treatment. Posttreatment changes in functional connectivity (FC) within language-related brain regions, as well as in graph naming abilities, were assessed in both patient groups.

Results: Both AP and RP groups exhibited significant improvements in graph naming ability following tDCS treatment. Compared to healthy controls, patients showed decreased FC in multiple brain regions of both hemispheres, particularly in the dominant hemisphere. Posttreatment assessments revealed significant increases in FC within the bilateral frontotemporal lobes for both AP and RP groups, and within the bilateral temporo-occipital regions for the AP group. Moreover, the RP group demonstrated decreased FC in the left temporal lobe posttreatment, which had shown increased FC pre-treatment.

Conclusions: This study suggests that tDCS can effectively enhance graph naming functions in patients with postinfarction aphasia. The therapeutic effects appear to be mediated by enhancing FC within bilateral frontotemporal lobes.

Introduction: Research on voice onset time (VOT) production of stops in children with CI versus NH has reported conflicting results. Effects of age and place of articulation on VOT have not been examined for children with CI. The purpose of this study was to examine VOT production by Greek-speaking children with CI in comparison to NH controls, with a focus on the effects of age, type of stimuli, and place of articulation.

Methods: Participants were 24 children with CI aged from 2;8 to 13;3 years and 24 age- and gender-matched children with NH. Words were elicited via a picture-naming task, and nonwords were elicited via a fast mapping procedure.

Results: For voiced stops, children with CI showed longer VOT than children with NH, whereas VOT for voiceless stops was similar to that of NH peers. Also, in both voiced and voiceless stops, the VOT differed as a function of age and place of articulation across groups. Differences as a function of stimulus type were only noted for voiced stops across groups.

Conclusions: For the voiced stop consonants, which demand more articulatory effort, VOT production in children with CI was longer than in children with NH. For the voiceless stop consonants, VOT production in children with CI is acquired at a young age.

Purpose: Considering the conceptual migration from vocal load and vocal loading to vocal demand and vocal demand response, this review of literature aimed to identify physiological explanations, reported measurements, and associated factors (vocal demands) reported in the literature when considering the phonatory response to a vocal demand.

Methods: A systematic review of literature, following the PRISMA Statement, was conducted using Web of Science, PubMed, Scopus, and ScienceDirect. Data were analyzed and presented in two parts. First, a bibliometric analysis, co-occurrence analysis, and content analysis were performed. Three criteria that got article inclusion were defined: (1) written in English, Spanish, and Portuguese; (2) published between 2009 and 2021; and (3) focused on vocal load and loading, vocal demand response, and voice assessment parameters. A total of 54 publications met the criteria and were included in this review. The second part included a conceptual framework based on the content analysis of three aspects of vocal demand response: (1) physiological explanations, (2) reported measurements, and (3) vocal demands.

Results and conclusion: As would be expected since vocal demand response is a relatively new term and not yet commonly used in literature when discussing way that the speakers respond to communicative scenarios, most of the studies reviewed (both historical and recent) still use the term of vocal load and vocal loading. Although there is a broad variety of literature discussing a wide range of vocal demands and voice parameters used to characterize the vocal demand response, results show that there is consistency across the studies. While vocal demand response is unique and intrinsic to the talker, associated factors that contribute to this response include both internal talker and external talker factors. Internal factors include muscle stiffness, viscosity in the phonatory system, vocal fold tissue damage, elevated sound pressure levels during occupational voice demands, extended periods of voice use, suboptimal body posture, difficulties in breathing technique, and sleep disturbances. Associated external factors include the working environment (noise, acoustics, temperature, humidity). In conclusion, although vocal demand response is intrinsic to the speaker, the speaker's response is affected by external vocal demands. However, due to the wide methods to evaluate vocal demand response, it has been difficult to establish its contribution to voice disorders in the general population and, specifically, among occupational voice users. This literature review identified commonly reported parameters and factors that may help clinicians and researchers define vocal demand response.