Folia Phoniatrica et Logopaedica最新文献

Introduction: In aural rehabilitation, speech bananas are often used as a counseling tool to visually indicate one's auditory access to speech sounds. We constructed a Chinese-based speech banana to provide Chinese-speaking users with a more appropriate distribution of Chinese speech sounds on an audiogram.

Method: The location of each phoneme was defined by its frequency and intensity. To evaluate the clinical validity of the proposed speech banana, 15 Chinese-speaking hearing aid users were recruited; the predictability of the present speech banana was examined in terms of sensitivity and specificity based on their aided sound-field narrow-band noise thresholds and speech recognition thresholds.

Results: The data revealed high specificity rates of 94.2% below 8,000 Hz and high sensitivity of 96.8% above 8,000 Hz. Specificity measures the percentage of perceptible sounds correctly identified as such by the Chinese speech banana (CSB); sensitivity measures the percentage of imperceptible sounds that are correctly identified as such by the CSB.

Discussion/conclusion: The CSB represents a potentially valid counseling tool to identify phonemes that have poor perceptual quality and indicate auditory access gaps.

Background: Hearing loss is a neglected global health priority affecting 1.5 billion persons. Global access to hearing care is severely limited with management options, like hearing aids, inaccessible to most. The cost and centralised nature of traditional service-delivery approaches in hearing care have undermined equitable access alongside poor awareness.

Summary: Recent innovations in digital and mHealth hearing technologies used by health workers through task shifting are enabling novel community-based services across the continuum of care. This narrative review explores technology-enabled hearing care in communities. We provide examples focused on our work over the past decade to explore more equitable hearing care across primary, secondary, and tertiary levels of prevention.

Key messages: Hearing health innovations have the potential to increase access to care, improve the quality of life for those affected by hearing loss, and reduce global costs associated with untreated hearing loss. More equitable hearing care is a global health priority that requires scalable service-delivery models enabled by innovative technologies within communities and integrated into public health initiatives including hearing health promotion.

Introduction: Dysphonic voice is present in patients with unilateral vocal fold paralysis (UVFP). The aim of this study was to present outcomes following rehabilitation of patients with UVFP, performed according to a voice therapy protocol.

Methods: This prospective study comprised 27 women with UVFP who underwent pre- and post-voice therapy assessment. The mean age of patients was 53.19 ± 10.06 years. The protocol included the following: (1) multidimensional assessment of voice quality before treatment; (2) digital laryngeal manipulation voice therapy; (3) voice therapy evaluation which implied repeated multidimensional assessment of voice.

Results: The results showed improvement in voice quality following voice therapy with regard to the parameters of the objective voice analysis (maximum fundamental frequency of voice, minimum intensity of voice, jitter, shimmer, harmonics-to-noise ratio, and signal-to-noise ratio, p ˂ 0.05), maximum phonation time, subjective analysis of voice, as well as self-assessment of voice quality on all the subscales and overall score (p ˂ 0.001).

Conclusion: Implementing a protocol provides clear guidelines at each stage of the treatment. Voice therapy performed using digital laryngeal manipulation improves the majority of the acoustic and perceptual characteristics of the voice.

Introduction: The fundamental frequency contour (melody) of cry and non-cry utterances becomes more complex with age. However, there is a lack of longitudinal analyses of melody development during the first year of life.

Objective: The aim of the study was to longitudinally analyze melody development in typical vocalization types across the first 12 months of life. The aim was twofold: (1) to answer the question whether melody becomes more complex in all vocalization types with age and (2) to characterize complex patterns in more detail.

Methods: Repeatedly recorded vocalizations (n = 10,988) of 10 healthy infants (6 female) over their first year of life were analyzed using frequency spectrograms and fundamental frequency (f0) analyses (PRAAT). Melody complexity analysis was performed using specific in-lab software (CDAP, pw-project) in a final subset of 9,237 utterances that contained noise-free, undisturbed contours. Generalized mixed linear models were used to analyze age and vocalization type effects on melody complexity.

Results: The vocalization repertoire showed a higher proportion of complex melodies from the second month onward. The age effect was significant, but no difference was found in melody complexity between cry and non-cry vocalizations across the first 6 months. From month 7-12, there was a further significant increase in complex structures only in canonical babbling not in marginal babbling. Melody segmentations by laryngeal constrictions prevailed among complex shapes.

Conclusion: The study demonstrated the regularity of melody development in different vocalization types throughout the first year of life. In terms of prosodic features of infant sounds, melody contour is of primary importance, and further studies are required that also include infants at risk for language development.

Introduction: The Pediatric Eating Assessment Tool (PediEAT) is a parent-report tool to assess feeding problems in children aged 6 months to 7 years. This study aimed to translate and adapt the PediEAT to Persian and determine its psychometric properties.

Methods: The PediEAT was translated and culturally adapted the following guidelines for health-related instruments. Face and content validity was assessed using an expert panel. This study also aimed to evaluate psychometric properties using a sample of 160 children without feeding problems and 43 children with diagnosed feeding problems. Known-groups validation was used to compare PediEAT scores between children with and without feeding problems. In criterion validity, pediatricians' opinions were used as a criterion. To calculate internal consistency, Cronbach's alpha was used. After 2 weeks, temporal stability was assessed with 40 parents who repeated the PediEAT.

Results: Face and content validity showed that all tool items had CVI and kappa coefficients higher than 0.8. Known-group validity showed that the total and subscale scores significantly differed between children with and without feeding problems (p < 0.001). Criterion validity showed that criterion measurements correlated with questionnaire measurements. All four subscales and the total scale showed acceptable internal consistency reliability (Cronbach's alpha > 0.74). Test-retest reliability was acceptable (ICC = 0.987, p < 0.001).

Conclusions: The PediEAT-Persian version is a valid and reliable tool for assessing symptoms of problematic feeding in Persian children aged 6 months to 7 years.

Introduction: Recent studies conducted with bilingual populations have shown that bilingual children who do not stutter (CWNS) are often less fluent than their monolingual counterparts, which seems to affect the accuracy with which speech-language pathologists (SLPs) identify stuttering in bilinguals. That is, misdiagnosis appears frequently in bilingual children and is more likely to occur with bilingual CWNS (false positives) than with bilingual CWS (false negatives).

Methods: The goal of the current study was to gain insight in the extent of this misdiagnosis. Speech samples of 6 Lebanese bilingual CWNS and 2 CWS were rated by Lebanese SLPs in an audio-only and audiovisual presentation mode. SLPs had to identify each child as stuttering or not and subsequently rate on a 6-point scale the stuttering severity for each child. SLPs also provided background information by means of a questionnaire.

Results: The results showed that stuttering severity ratings (1) were on average significantly higher for CWS than for CWNS, (2) were for each CWS higher than for all but one of the CWNS, (3) varied significantly among the CWNS but not the CWS, (4) were not affected by the presentation mode, and (5) correlated positively with the percentage of stuttering-like disfluencies (SLD) and the mean number of iterations, but not with the percentage of other disfluencies (OD).

Conclusion: Misdiagnosed bilingual CWNS are perceived by the SLPs as having a mild stutter, primarily based on the frequency of their disfluencies, but can be occasionally rated at par with CWS. Further research differentiating the disfluent speech of bilingual children who do and do not stutter is needed to reach a more adequate diagnosis of stuttering.

Purpose: The goal of this study was to examine the efficacy of acceleration-based articulatory measures in characterizing the decline in speech motor control due to amyotrophic lateral sclerosis (ALS).

Method: Electromagnetic articulography was used to record tongue and lip movements during the production of 20 phrases. Data were collected from 50 individuals diagnosed with ALS. Articulatory kinematic variability was measured using the spatiotemporal index of both instantaneous acceleration and speed signals. Linear regression models were used to analyze the relationship between variability measures and intelligible speaking rate (a clinical measure of disease progression). A machine learning algorithm (support vector regression, SVR) was used to assess whether acceleration or speed features (e.g., mean, median, maximum) showed better performance at predicting speech severity in patients with ALS.

Results: As intelligible speaking rate declined, the variability of acceleration of tongue and lip movement patterns significantly increased (p < 0.001). The variability of speed and vertical displacement did not significantly predict speech performance measures. Additionally, based on R2 and root mean square error (RMSE) values, the SVR model was able to predict speech severity more accurately from acceleration features (R2 = 0.601, RMSE = 38.453) and displacement features (R2 = 0.218, RMSE = 52.700) than from speed features (R2 = 0.554, RMSE = 40.772).

Conclusion: Results from these models highlight differences in speech motor control in participants with ALS. The variability in acceleration of tongue and lip movements increases as speech performance declines, potentially reflecting physiological deviations due to the progression of ALS. Our findings suggest that acceleration is a more sensitive indicator of speech deterioration due to ALS than displacement and speed and may contribute to improved algorithm designs for monitoring disease progression from speech signals.

Introduction: Studies on personal narratives are rare in Turkey and there is no standard protocol for eliciting them. The aim of this small-scale study was to translate the Global TALES Protocol into Turkish, with cultural adaptations, and to present the results regarding its usability for two different age-groups of 7- and 10-year-old school children. We investigated narrative skills in terms of verbal productivity (number of utterances, total number of words), syntactic complexity (mean length of utterance), and semantic diversity (number of different words). In addition, group comparisons were made in terms of the participants' gender and age.

Methods: A total of 20 children, 10 from each age-group (7;0-7;11 and 10;0-10;11) participated in the study. All children were monolingual Turkish-speaking children with typical development. Participants were recruited through personal and/or social networks. All personal narratives were gathered via online connections (Zoom).

Results: Descriptive statistics were used to describe the children's performance, and the analysis of group differences was made separately according to age and gender. All children produced narratives in response to the six protocol prompts. In addition, the number of children who did not require the scripted follow-up prompts was higher than those needing a scripted follow-up prompt to produce a response. No statistically significant group differences were found in terms of gender and age on any of the measurements.

Conclusion: The results from this small-scale investigation showed that the translated version of the Global TALES Protocol was effective in eliciting personal narratives from Turkish-speaking children. We concluded that there is no need to change the directions or give additional guidance or prompts to the children. Future studies with larger samples are needed to confirm these findings.