Folia Phoniatrica et Logopaedica最新文献

Introduction: The purpose of the current study was to evaluate speech intelligibility and speech rate in individuals with Parkinson's disease using altered auditory feedback (AAF) in comparison to age-matched healthy controls. Based on prior research, it is hypothesized that the use of AAF will improve participants' speech intelligibility.

Methods: Five individuals with Parkinson's disease (clinical group) and five age-matched healthy controls aged 50 years and above participated in this pre-/post-group experiment. All participants completed reading and monologue tasks with and without AAF. The AAF delayed the participants' auditory feedback by 150 ms and altered it by 1/20 octave. Thirty-two naïve listeners listened to the recorded participants' speech samples (with and without AAF) randomly and rated the participants' speech intelligibility.

Results: Results of the mixed model ANOVA revealed that participants in the control group had significantly higher speech intelligibility scores than the participants in the clinical group. Post hoc tests indicated that only participants in the clinical group were more intelligible with AAF than without AAF. Participants in the clinical group had better speech intelligibility when reading the passage than speaking the monologue. With regards to speech rate, participants spoke more slowly with AAF than without. Finally, there was a negative correlation between speech rate and speech intelligibility.

Discussion: The current findings support our hypothesis that AAF improves speech intelligibility in people with Parkinson's disease, though not in healthy controls. Future research should evaluate the long-term effect of AAF use on speech intelligibility in people with Parkinson's disease.

Introduction: This study aimed to develop, validate, and analyze the reliability of the Korean version of the Voice Handicap Index-Throat (VHI-Tk).

Methods: This prospective study included 103 patients in the case group with voice problems (18 with functional dysphonia, 44 with mass in the larynx, 18 with neurological voice disorder, 23 with throat problems) and 27 in the control group without voice problems. All participants completed these questionnaires at their initial visit: the Korean version of the Voice Handicap Index (K-VHI), VHI-Tk, and the Korean version of the Voice Symptom Scale (K-VoiSS). Case group patients in the case group recompleted the VHI-Tk questionnaire to assess test-retest reliability. Finally, a one-way analysis of variance was implemented to assess differences in VHI-Tk scores among the four diagnosis types in the case group.

Results: The VHI-Tk scores in the case group were significantly higher than in the control group. The VHI-Tk was significantly correlated with the subscales of K-VHI and K-VoiSS. The VHI-Tk has significant test-retest reliability, and its internal consistency is good to excellent (Cronbach's alpha correlation coefficient range: 0.895-0.901). There was significant difference in the mean VHI-Tk scores according to the four diagnosis types (throat problems group > neurological voice disorder group).

Conclusion: We validated the VHI-T questionnaire to measure self-perceived voice and throat problems among Koreans. A large sample size and various diagnosis types are required in future studies to fully validate the VHI-T for use in multiple cultures.

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.

Introduction: Examination of oral movements is often part of an assessment undertaken by a speech and language therapist (SLT). Until now, there have been no specific instruments or tests with reference values for typically developing children in Dutch that exclusively evaluate non-speech oral movements in young children. Therefore, a non-speech oral motor observation list was designed to attempt to bridge this gap: the Non-Speech Oral Movement Assessment for Children (NOMAC). The aim of this study was to evaluate the psychometric properties of the NOMAC in terms of inter-rater reliability and its' construct validity. In addition, we aimed to collect reference values for non-speech oral movements in children.

Methods: Data from typically developing Dutch children aged 2-8 years were collected. Inter-rater reliability was studied by estimating the intra-class correlation coefficient (ICC). Construct validity was investigated by assessing the effect of age group and gender on the mean execution score per item (general linear model). To present normative data, the percentage of the children performing a normal oral motor execution was calculated.

Results: The study includes a total of 318 children, divided into 9 age groups. The inter-rater reliability shows a moderate to excellent ICC for most items. A significant effect of the factor age group on almost all items was seen, confirming robust construct validity. Normative data are presented with the percentage of the children performing a normal oral movement execution.

Conclusion: Non-speech oral movements can be assessed with the NOMAC in children between 2 and 8 years old and can be compared with values obtained from a normative group. It should be used as part of a clinical feeding and speech assessment. Despite the fact that current insights indicate that oral motor training has no value for improving mastication, swallowing, and speech, it is important to know the status of non-speech oral motor capabilities. With this assessment, a complete profile of the child's oral motor abilities can be achieved, supportive of clinical decision making in SLT.

Introduction: Feeding is an interactive process between a child and a caregiver, and its early and chronic problems can affect the stress and quality of life of parents. Since the health and support of caregivers can affect the child's disability and performance, it is important to consider the impact of feeding and swallowing disorders on caregivers. Hence, the present study aimed to translate and investigate the validity and reliability of the Feeding/Swallowing Impact Survey (FS-IS) in Persian.

Methods: This methodological study consisted of two phases: translating the test to Persian (P-FS-IS) and evaluating psychometric properties including face and content validity (through experts' opinions and cognitive interviews), construct validity (by known-group validity and exploratory factor analysis), and reliability of the questionnaire (by internal consistency and test-retest reliability). The present study was performed on 97 Iranian mothers of children with cerebral palsy aged 2-18 years with swallowing impairments.

Results: Exploratory factor analysis rendered two factors with a cumulative variance of 59.71%. When evaluating known-group validity, the questionnaire scores were significantly different across the groups with different severity of the disorder (F(2, 94) = 57.1, p ≤ 0.001). P-FS-IS had a high internal consistency with Cronbach's alpha of 0.95, and there was an appropriate intra-class correlation coefficient of 0.97 for the total questionnaire.

Conclusion: P-FS-IS has good validity and reliability and is a suitable questionnaire for assessing the impact of pediatric feeding and swallowing disorders on Persian language mothers. This scale can be used in research and clinical settings to evaluate and determine therapeutic goals.

Introduction: The Multilingual-Multicultural Affairs Committee of the International Association of Communication Disorders (IALP) conducted a survey of diagnostic criteria for developmental language disorder (DLD) in multilingual children to discover how clinicians apply terminology and diagnostic criteria to multilingual children in different parts of the world.

Methods: An international web survey was used to survey 354 participants from 44 countries about their assessment practices, and clinical opinions about assessing multilingual children for DLD.

Results: The findings show that most clinicians felt confident in assessing multilingual children, and they applied the DLD terminology and inclusionary criteria to multilingual children with difficulty learning language. Clinicians used different procedures to assess heritage and societal languages. Barriers to access to services included a lack of knowledge by parents and referral sources about services available and typical multilingual development, with additional reasons differing by geographical region.

Discussion: Speech pathologists across the globe have many similarities in the way that they assess multilingual children. Differences may be attributed to clinical experience, professional education, the clinician's role, the system they work in, and the clinician's own language skills. This paper advances knowledge of current clinical practices, which can be used to evaluate frameworks in international and national contexts, with implications for policy and practice to improve access to clinical services.

Introduction: Auditory-perceptual assessments of cough are commonly used by speech-language pathologists working with people with swallowing disorders with emerging evidence beginning to demonstrate their validity; however, their reliability among novice clinicians is unknown. Therefore, the primary aim of this study was to characterize the reliability of auditory-perceptual assessments of cough among a group of novice clinicians. As a secondary aim, we assessed the effects of a standardized training protocol on the reliability of auditory-perceptual assessments of cough.

Methods: Twelve novice clinicians blindly rated ten auditory-perceptual cough descriptors for 120 cough audio clips. Standardized training was then completed by the group of clinicians. The same cough audio clips were then re-randomized and blindly rated. Reliability was analyzed pre- and post-training within each clinician (intra-rater), between each unique pair of raters (dyad-level inter-rater), and for the entire group of raters (group-level inter-rater) using intraclass correlation coefficients and Cohen's Kappa.

Results: Pre-training reliability was greatest for measures of strength, effectiveness, and normality and lowest when judging the type of expiratory maneuver (cough, throat clear, huff, other). The measures that improved the most with training were ratings of perceived crispness, amount of voicing, and type of expiratory maneuver. Intra-rater reliability coefficients ranged from 0.580 to 0.903 pre-training and 0.756-0.904 post-training. Dyad-level inter-rater reliability coefficients ranged from 0.295 to 0.745 pre-training and 0.450-0.804 post-training. Group-level inter-rater reliability coefficients ranged from 0.454 to 0.919 pre-training and 0.558-0.948 post-training.

Conclusion: Reliability of auditory-perceptual assessments varied across perceptual cough descriptors, but all appeared within the range of what has been historically reported for auditory-perceptual assessments of voice and visual-perceptual assessments of swallowing and cough airflow. Reliability improved for most cough descriptors following 30-60 min of standardized training. Future research is needed to examine the validity of auditory-perceptual assessments of cough by assessing the relationship between perceptual cough descriptors and instrumental measures of cough effectiveness to better understand the role of perceptual assessments in clinical practice.

Introduction: Diabetes mellitus type 2 is a growing health concern that affects several systems in the body, among which is the phonatory apparatus. Voice may be affected in view of the high prevalence of myopathy and neuropathy in diseased subjects. The authors aimed to answer the following question: does type 2 diabetes have an effect on voice?

Methods: The systematic review included search terms such as "speech, voice, larynx, glucose, diabetes, and hyperglycemia." The search strategy yielded 221 articles, only five of which satisfied the inclusion criteria. Articles were considered for inclusion using the PRISMA method. Analysis included 321 patients with type 2 diabetes mellitus and 171 controls. All studies included were case-control studies except for one study which was an observational cohort. Six parameters were chosen as endpoints for the systematic review and meta-analysis: the presence/absence of voice complaints, fundamental frequency, jitter, shimmer, noise-to-harmonic ratio, and maximum phonation time.

Results: There was no significant difference in the prevalence of voice complaints (i.e., hoarseness) between diabetic patients and control groups. There was also no significant difference in any of the acoustic and aerodynamic measures between patients with type 2 diabetes and controls. These findings can be ascribed to the high resilience of the laryngeal muscles to the adverse effect of systemic diseases.

Conclusion: There is no consensus in the literature that the prevalence of voice symptoms in diabetic patients is significantly higher than that reported in healthy subjects.

Introduction: Hearing loss (HL) strongly impacts communication abilities and impairs social interactions. Moreover, it modifies the vocal parameters of affected patients. The effects of hearing rehabilitation through hearing aids (HA) on the vocal production of patients suffering from HL have not been thoroughly analyzed in the literature. The aim of this study was to use the ambulatory phonation monitor (APM), a portable vocal dosimeter, to evaluate the variations in the vocal production of a group of patients suffering from moderate-to-severe HL treated with HA and the relationship between such modifications and quality of life (QoL).

Materials and methods: Twenty-six patients suffering from a variable degree of HL and treated with HA have been enrolled. Each of them underwent an evaluation before and 4 months after rehabilitation with HA. The analysis of daily voice production was carried out with the APM, while subjective QoL data were collected through the Speech, Spatial, and Qualities questionnaire (SSQ) and the International Outcome Inventory for Hearing Aids (IOI-HA). The differences in phonatory measurements and subjective evaluations before and after HA rehabilitation were assessed using Wilcoxon signed rank test. The Spearman correlation test was used to analyze the correlation between phonatory measurements, auditory measurements, and SSQ scores.

Results: Significant differences in the APM parameters before and after HA rehabilitation were found. After 4 months of HA use, we recorded a significant increase in phonation time and percentage of phonation time and a significant decrease in average amplitude in dB SPL. We also found a significant increase in the SSQ scores after HA rehabilitation. Finally, we were able to detect low but significant correlations between phonatory measurements and SSQ results.

Conclusions: The APM proved to be a useful instrument in the evaluation of the benefits of HA and its measurements can be used as indicators of the participation in communication and social life of patients with HL, which are strongly related to QoL.

Introduction: This study examined the utility of multiple second formant (F2) slope metrics to capture differences in speech production for individuals with dysarthria and healthy controls as a function of speaking rate. In addition, the utility of F2 slope metrics for predicting severity of intelligibility impairment in dysarthria was examined.

Methods: Twenty three speakers with Parkinson's disease and mild to moderate hypokinetic dysarthria (HD), 9 speakers with various neurological diseases and mild to severe ataxic or ataxic-spastic dysarthria (AD), and 26 age-matched healthy control speakers (CON) participated in a sentence repetition task. Sentences were produced at habitual, fast, and slow speaking rate. A variety of metrics were derived from the rising F2 transition portion of the diphthong /ai/. To obtain measures of intelligibility for the two clinical speaker groups, 15 undergraduate SLP students participated in a transcription experiment.

Results: Significantly shallower slopes were found for the speakers with HD compared to control speakers. Steeper F2 slopes were associated with increased speaking rate for all groups. Higher variability in F2 slope metrics was found for the speakers with AD compared to the two other speaker groups. For both clinical speaker groups, there was a negative association between intelligibility and F2 slope variability metrics, indicating lower variability in speech production was associated with higher intelligibility.

Discussion: F2 slope metrics were sensitive to dysarthria presence, dysarthria type, and speaking rate. The current study provided evidence that the use of F2 slope variability measures has additional value to F2 slope averaged measures for predicting severity of intelligibility impairment in dysarthria.