Folia Phoniatrica et Logopaedica最新文献

Introduction: Vowel production in dysarthria tends to be centralized, which is affected by many factors. This study examined the acoustic effects of speaker sex, tones, and speech samples (including sustained vowels, syllables, and sentences) and their interactions on vowel production in Mandarin speakers with poststroke spastic dysarthria.

Methods: Twenty-eight patients with poststroke spastic dysarthria (18 males, 10 females) and 21 healthy speakers (11 males, 10 females) with no significant difference in sex and age with dysarthria were recruited. They were asked to read sustained vowels /a, i, u/, 12 syllables, and 12 sentences containing three vowels in four tones (bā, bá, bǎ, bà, bī, bí, bǐ, bì, pū, pú, pǔ, pù). Multiple spectral and temporal acoustic metrics were analyzed.

Results: Results showed that regardless of the speech samples or tones, vowel production was more centralized in dysarthria than healthy controls, manifested as the decrease in F1 range, F2 range, vowel space area (VSA), and vowel articulation index (VAI). A similar performance was observed for male speakers compared to females, and vowel duration in males was shorter than females. F1 range, F2 range, VSA, VAI, and vowel duration were significantly different across speech samples and tones, decreasing in the order of vowel-syllable-sentence and T3-T2-T1-T4, respectively. Interactions of group, speaker sex, speech sample, and tone were more sensitive in VAI and vowel duration.

Conclusion: VAI and vowel duration were recommended as the prior metrics to the assessment of vowel production. Specific influencing factors (speaker sex, speech sample, and tone) of vowel production need to be considered by speech and language pathologists in the assessment and rehabilitation.

Introduction: Swallowing outcomes regarding lingual resistance training have been mixed due to variability in methods, leading to ambiguity concerning the utility of this intervention. The purpose of this study was to explore the effect of a lingual resistance training protocol on the swallowing function of an individual presenting with dysphagia and reduced tongue pressure following a supratentorial ischemic stroke.

Methods: A study involving a lingual resistance training protocol with videofluoroscopy to measure outcomes comparing different parameters to ASPEKT normative reference values at three timepoints: baseline (videofluoroscopic swallowing study [VFSS] A), following a 4-week lead-in period to control for spontaneous recovery (VFSS B), and at the 8-week endpoint of treatment (VFSS C). The study was interrupted due to the COVID-19 pandemic after 1 participant enrollment and is presented as a single case study.

Results: Isometric tongue pressures: Following the 4-week lead-in, a decline in maximum isometric anterior tongue pressure (MAIP) and regular effort saliva swallow pressures (RESS) was noted; however, there was no change in maximum posterior isometric tongue pressures (MPIP). Isometric tongue pressures improved post-treatment, with increases in MAIP, MPIP, and to a lesser degree RESS. Swallowing function: Impairments in swallowing safety continued between the baseline VFSS A (Penetration-Aspiration Scale score [PAS] = 8) and lead-in VFSS B (PAS = 5). Swallowing safety improved following the intervention, with PAS scores = 1 at the endpoint VFSS C. Pixel-based measures of swallowing efficiency revealed a reduced frequency of post-swallow total pharyngeal residue following the treatment. Improvements were found in two other swallowing parameters, laryngeal vestibule closure integrity and pharyngeal area at maximum pharyngeal constriction, at the endpoint VFSS.

Conclusion: These pilot data suggest improvements in some swallowing parameters as an outcome of intervention.

Introduction: Psychosocial aspects of stuttering may affect the quality of life of a person who stutters (PWS). Further, the social stigma and experiences of PWS may vary globally. The WHO-ICF guidelines recommend quality of life as an essential component in the assessment of individuals who stutter. However, the availability of linguistically and culturally appropriate tools is often a challenge. Thus, the current study adapted and validated the OASES-A for Kannada-speaking adults who stutter.

Method: The original English version of OASES-A was adapted to Kannada using a standard reverse translation process. The adapted version was administered on 51 Kannada-speaking adults with very mild to very severe stuttering. The data were analyzed for item characteristics, reliability, and validity assessment.

Results: The results revealed floor and ceiling effects for six and two items, respectively. The mean overall impact score indicated a moderate impact of stuttering. Further, the impact score for section II was relatively higher when compared to the data from other countries. The reliability and validity analyses showed good internal consistency and test-retest reliability for OASES-A-K.

Conclusion: The findings of the current research suggest that OASES-A-K is a sensitive and reliable tool to assess the impact of stuttering in Kannada-speaking PWS. The findings also highlight cross-cultural differences and the need for research in this direction.

Introduction: Inflammatory bowel diseases, which are among the most common chronic gastrointestinal diseases, can also affect the voice for different reasons. The aim of this study was to investigate acoustic, perceptual, and subjective voice evaluation parameters in inflammatory bowel diseases (IBD).

Methods: This prospective case-control study included a total of 80 participants: 28 patients with ulcerative colitis (UC), 22 patients with Crohn's disease (CD), and 30 healthy controls. Following the endoscopic examination, the fundamental frequency (F0), shimmer (dB), jitter (%), and harmonic/noise ratio (HNR) were measured. GRBAS (grade, roughness, breathiness, asthenia, strain) scale was used for perceptual evaluation, and Voice Handicap Index-10 (VHI-10) Turkish version was used for subjective assessment.

Results: The F0 value was within normal limits in both disease groups in male and female participants and in the control group. Jitter and shimmer values were statistically higher in the UC and CD groups than in the control group. HNR did not differ between CD and control; however, it was statistically lower in the UC group when compared to both the control and CD groups. The total GRBAS score did not differ between the UC and CD groups; however, it was greater in IBD patients compared to the control group. However, these differences were within normative parameters. Although total VHI-10 score did not differ between UC and CD groups, both had a higher voice handicap than the control group.

Conclusion: IBD might have an effect on the voice and voice quality. This disease group was discovered to have perceptual and subjective voice problems additionally.

Introduction: Although melodic intonation therapy (MIT) has proven effective in individuals with non-fluent aphasia in a variety of western languages, its application to Mandarin-speaking aphasic patients has not been thoroughly studied. The adaptation is complicated because Mandarin Chinese is a tone language with specific prosodic elements that differ from Indo-European languages. This study developed a Chinese-specific variant of MIT, i.e., tone-rhythmic therapy (TRT), and tested its efficacy in individuals with non-fluent aphasia.

Methods: Six non-fluent aphasic patients were recruited; all of them were admitted to the study over 6 months after stroke and had received a standard program of language therapy. In the current research, tone and rhythmic practice were incorporated into the training procedures, and the adaptation was then examined in patients. The TRT treatment lasted 6 weeks, with five 50-min sessions per week. The Boston Diagnostic Aphasia Examination (BDAE) and the Functional Assessment of Communication Skills for Adults (FACS) tests were used to measure the change in the speech and language skills of patients.

Results: The results showed that the patients had increased BDAE and FACS scores after intervention, and the treatment effect lasted for 6 months.

Discussion: The modified MIT proved effective for Mandarin-speaking patients with non-fluent aphasia with lasting effects. Further studies evaluating its efficacy are needed for other types of aphasia and other tone languages.

Purpose: The constitution of social circles around patients treated for cancer of the upper aerodigestive tract (UADT) has a major influence on factors that affect quality of life (QOL) but is poorly assessed, mainly due to a lack of tools. The objective of this study is to develop a questionnaire that assesses the constitution of social circles in a population treated for UADT cancer and to analyze the construct (structural and clinical validity) and criterion validity.

Methods: The Evaluation of the Constitution of Social Circles (ECSC) questionnaire was developed in French by a committee of experts. Structural validity was analyzed using inter-item correlations. The scores of a group of patients treated for UADT cancer were compared with those of a group of healthy subjects (clinical validity). For criterion validity, the ECSC scores were compared to those from various questionnaires that assess social functioning (QFS), psychological status (HAD), perceived speech impairment (PHI), and QOL (EORTC QLQ-H&N35) in patients.

Results: Structural validity shows low to moderate inter-item correlations which is consistent with the construction of the questionnaire not assessing underlying concepts. Clinical validity was satisfactory regarding the frequency of contact (p = 0.01), satisfaction with the frequency of contact in the private circle (p = 0.03), and the size of the social circles of family and friends (p ≤ 0.01). Criterion validity was adequate with moderate correlations between the ECSC scores and the QFS sub-scores of interest (rs > 0.56, p < 0.05). Anxiety (HAD) had a low correlation (|rs| = 0.46, p < 0.05) with satisfaction with exchanges and the frequency of contact with family. Satisfaction with exchanges with the private circle was moderately correlated with the EORTC QLQ-H&N35 score (rs = 0.56, p = 0.01) and showed a negative trend on the PHI (rs < -0.39, p ≥ 0.05).

Conclusion: While the test-retest reliability is yet to be evaluated and the sample size should be increased, this preliminary study shows that the ECSC is a valid tool for assessing the constitution of social circles in patients treated for UADT cancer. It highlights the links between social circles and their functional impact on communication and QOL.

Introduction: The Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) is a 35-item patient-reported questionnaire developed to address the communication needs of patients with laryngectomies. The aim was to translate, cross-culturally adapt, and validate the Croatian version.

Methods: The SECEL was translated from English by two independent translators and back-translated by a native speaker, after which it was approved by an expert committee. The Croatian version of the Self-Evaluation of Communication Experiences after Laryngectomy questionnaire (SECEL:HR) was filled in by 50 laryngectomised patients who had completed their oncological treatment a year prior to inclusion in the study. Patients also filled in the Voice Handicap Index (VHI) and the Short Form Health Survey (SF-36) on the same day. All patients completed the SECEL:HR twice, the second time being 2 weeks after the initial test. Maximum phonation time and diadochokinesis of articulation organs were used for objective assessment.

Results: Among the Croatian patients, the questionnaire was well-accepted and demonstrated good test-retest reliability and internal consistency for two out of three subscales. The correlations between VHI, SF-36, and SECEL:HR were moderate to strong. There were no significant differences between patients who are using oesophageal speech, tracheoesophageal speech, or the electrolarynx based on the SECEL:HR.

Conclusion: Preliminary findings of the research indicate that the Croatian version of the SECEL has sufficient psychometric qualities, high reliability, and good internal consistency, with a Cronbach's alpha of 0.89 for the total score. The Croatian version of SECEL can be recommended as a reliable and clinically valid measure for the assessment of substitution voices in Croatian-speaking patients.

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.