Journal of Communication Disorders最新文献

Audiometric calibration, which includes the calibration of different audiometer transducers and the measurements of ambient noise levels, is historically carried out using Class 1 sound level meters. As technologies advance, many mobile applications (apps) have been developed to measure sound levels. These apps can provide alternative methods for audiometric calibration in places where sound level meters are not available, such as field testing environments, low-to-mid-income countries, and humanitarian settings. These apps, however, cannot be used for audiometric calibration without first evaluating their performance, which depends on multiple factors including the external components (if any), the operating system and the hardware of the electronic devices. The evaluation of the apps is actually the evaluation of the app and associated factors (i.e., the app systems). This paper discusses methods to assess several key functions of apps implemented in either Android or iOS operation system for audiometric calibration: 1) checking the measurement accuracy at all testing frequencies, 2) deriving and using correction factors, 3) determining the self-noise levels, and 4) evaluating the linear/measurement range. As audiometric calibration usually uses octave or 1/3 octave bands to measure sound pressure levels of tones and narrowband noises with relatively steady temporal characteristics, the accuracy of an app can be evaluated by comparing the levels measured by the app and a Class 1 sound level meter at each frequency. The level difference between the app and the Class 1 sound level meter at each frequency can then be used to calculate correction factors that can be added to subsequent levels measured by the app to improve its accuracy. In addition, methods to determine the self-noise level and the linearity range of apps are discussed. Sample measurement scenarios and alternative methods are provided to illustrate the evaluation process to determine whether an app is suitable for measuring ambient noise levels and for calibrating different audiometric transducers.

This paper describes the changes in communication skills, knowledge and confidence in Speech Language Therapy (SLT) students in conversations with People With Aphasia (PWA) after Training Con-tAct, a Dutch Communication Partner Training.

Methods

On a voluntary basis, nine SLT students (2^nd yr) completed Training Con-tAct, in which People With Aphasia (PWA) were involved as co-workers. A mixed method design with pre- and post-measures was used to analyze the students’ communication skills, knowledge and confidence. A quantitative video analysis was used to measure changes in students’ communication skills. Besides, a self-report questionnaire was used to measure the changes in students’ knowledge and confidence regarding their communication with PWA. To evaluate the perspectives of the students on Training Con-tAct, additionally a focus group interview was held.

Results

Regarding students’ communication skills the outcomes revealed a significantly higher score on the ‘supporting’ competence in students who took part in Training Con-tAct. The mean scores for the ‘acknowledging’ and ‘checking information’ competences did not improve significantly. The outcomes of the questionnaire showed students gained more knowledge and confidence regarding communication with PWA. The focus group interview provided insights into: motivation for participating in Communication Partner Training, content and structure of the training, feedback in CPT, and learning experiences.

Conclusion

The present study suggests that SLT students may benefit from Training Con-tAct as the training leads to better skills, more knowledge about aphasia and more confidence in communicating with PWA. Training Con-tAct could be a valuable addition to the curricula of all healthcare disciplines, and eventually support interprofessional collaboration, resulting in improved access to health care, which is important for communication vulnerable people. Further research with a larger sample size and a control group is required.

The COVID-19 pandemic disproportionately affected the health and well-being of marginalized communities, and it brought greater awareness to disparities in health care access and utilization. Addressing these disparities is difficult because of their multidimensional nature. Predisposing factors (demographic information, social structure, and beliefs), enabling factors (family and community) and illness levels (perceived and evaluated illness) are thought to jointly contribute to such disparities. Research has demonstrated that disparities in access and utilization of speech-language pathology and laryngology services are the result of racial and ethnic differences, geographic factors, sex, gender, educational background, income level and insurance status. For example, persons from diverse racial and ethnic backgrounds have been found to be less likely to attend or adhere to voice rehabilitation, and they are more likely to delay health care due to language barriers, longer wait times, a lack of transportation and difficulties contacting their physician. The purpose of this paper is to summarize existing research on telehealth, discuss how telehealth offers the potential to eliminate some disparities in the access and utilization of voice care, review its limitations, and encourage continued research in this area. A clinical perspective from a large volume laryngology clinic in a major city in northeastern United States highlights the use of telehealth in the provision of voice care by a laryngologist and speech-language pathologist during and after the COVID19 pandemic.

Purpose

The variable and intermittent nature of stuttering makes it difficult to consistently elicit a sufficient number of stuttered trials for longitudinal experimental research. This study tests the efficacy of using non-word pairs that phonetically mimic English words with no associated meaning, to reliably elicit balanced numbers of stuttering and fluent trials over multiple sessions. The study also evaluated the effect of non-word length on stuttering frequency, the consistency of stuttering frequency across sessions, and potential carry-over effects of increased stuttering frequency in the experimental task to conversational and reading speech after the task.

Methods

Twelve adults who stutter completed multiple sessions (mean of 4.8 sessions) where they were video-recorded during pre-task reading and conversation, followed by an experimental task where they read 400 non-word pairs randomized for each session, and then a post-task reading and conversation sample.

Results

On average, across sessions and participants, non-word pairs consistently yielded a balanced distribution of fluent (60.7%) and stuttered (39.3%) trials over five sessions. Non-word length had a positive effect on stuttering frequency. No carryover effects from experimental to post-task conversation and reading were found.

Conclusions

Non-word pairs effectively and consistently elicited balanced proportions of stuttered and fluent trials. This approach can be used to gather longitudinal data to better understand the neurophysiological and behavioral correlates of stuttering.

Purpose

To evaluate adult remote performance in speech discrimination on the Temple Assessment of Language and Short-term Memory in Aphasia (TALSA), and to compare to remote performance in NU-6 word repetition and participant ratings of self-perceived hearing ability obtained via remote session.

Method

Sixty older adults completed TALSA speech discrimination of concrete, low frequency words and of non-words via telephone. Remote repetition of words controlled for sound frequency was assessed using the Northwestern University (NU-6) word lists administered in live voice and recorded voice conditions. Forty-six of the participants completed questionnaires about their hearing via Zoom videoconference.

Results

Mean performance in TALSA speech discrimination for words was similar to performance in NU-6 word repetition. Word repetition of NU-6 lists did not differ significantly for live voice versus recorded voice conditions. TALSA non-word speech discrimination was significantly worse than TALSA speech discrimination for words and was associated with age and self-reported hearing ability.

Conclusions

TALSA speech discrimination can be administered remotely to evaluate potential perceptual influences on auditory comprehension. In remote assessment, participants demonstrated the expected pattern of more accurate speech discrimination for word stimuli than for non-words. The non-word TALSA condition may be particularly useful for detecting speech perception impairment, both in face-to-face and telepractice sessions. Similar performance of participants in both live voice and recorded conditions of the NU-6 word lists suggests that recordings used in SLP receptive language or memory assessment, including the TALSA, need not be abandoned in favor of live voice to support audition during telepractice.

Introduction

Phonetic-phonological impairments have been described in dementia due to Alzheimer's disease (AD). However, whether the likely phonological-linguistic changes progress with the evolution of the disease or whether phonetic-motor manifestations occur in all three stages of AD (mild, moderate, and severe) has not yet been clarified. Thus, the aim of this study was to verify whether phonological-linguistic and phonetic-motor speech manifestations occur in the mild, moderate, and severe stages of AD.

Methods

Thirty participants in each stage of probable AD (mild, moderate, and severe) and 30 healthy older adults underwent cognitive, instrumental activities of daily living and phonetic-phonological assessments. Phonetic-phonological manifestations were classified into three types: likely phonetic-motor, likely phonological-linguistic, and manifestations that may occur in disorders of both phonetic and phonological origin.

Results

The manifestations analyzed in this study occurred rarely. The manifestations that may occur in disorders of both phonetic and phonological origin were the most common in all stages of the disease. The likely phonetic-motor manifestations emerged during the mild stage of the disease (distortions, prolonged intersegment duration, and vowel prolongations), while the likely phonological-linguistic manifestations were present mainly in the moderate (substitutions and attempts at the word level) and severe stages (substitutions, attempts at the word level, self-corrections, and anticipations). The occurrence of phonetic-phonological manifestations increased with disease progression.

Conclusions

The type of phonological and phonetic manifestations in the individuals with AD differed according to the dementia stage and were statistically more frequent as dementia worsened.

Introduction

This study investigated the level of satisfaction with life (SWL) in a group of cochlear implant (CI) users who had been prelingually deaf but were orally educated. They had received one or two CIs (as a child, adolescent, or adult) and were highly competent Polish speakers. This study looked at three factors that may affect SWL – psychosocial, deafness/hearing and communication related, and sociodemographic.

Methods

The participants were prelingually deaf CI users who had learned highly competent spoken Polish as their primary language. They had been educated in mainstream or integrated schools (not schools for the deaf), and had no other disability or severe illness. Measurements were done with 5 questionnaires: the Satisfaction With Life Scale (SWLS), the I–Others Questionnaire, the Patient Health Questionnaire (PHQ-9), the Deaf Identity Development Scale (DIDS), and the Nijmegen Cochlear Implant Questionnaire (NCIQ).

Results

The SWL level of the group was similar to that of the standard Polish population. SWL was positively related to positive self-perception, acceptance of oneself as a deaf person, and to perceiving the benefits of having a CI (as measured by three NCIQ domains: self-esteem, activity limitations, and social interactions). On the other hand, negative self-perception, marginal deaf identity, and depressive symptoms were negatively related to SWL. There was no relationship between SWL and knowledge of sign language. Lower depressive symptoms and greater hearing loss were both significant predictors of SWL, although those who used two CIs generally had a lower SWL.

Conclusions

Prelingually deaf CI users with low SWL require psychological support in many spheres, including working through problems of deaf identity, self-acceptance, and depression. Additional research should involve diverse DHH CI users, including those with limited spoken Polish competency or sign language skills, as well as members of the Polish Deaf community.

Purpose

Language Mixing (LM) occurs among neurotypical bilinguals as well as among bilingual persons with aphasia (BiPWAs). The current study aimed to investigate whether LM in BiPWAs stems from a linguistic impairment, an impairment in cognitive control, or both.

Method

Twenty Russian-Hebrew-speaking BiPWAs were split into two groups based on aphasia severity (Severe/Moderate vs. Mild). Frequencies and patterns of LM in narrative production by BiPWAs in L1-Russian and in L2-Hebrew were analyzed. To investigate the underlying mechanisms of LM, all participants completed linguistic background questionnaires, the Bilingual Aphasia Test (BAT) in both languages, and a battery of 10 cognitive tests.

Results

The results indicated an effect of aphasia severity and an effect of language. Higher LM frequency was observed in BiPWAs with severe/moderate aphasia symptoms as compared to BiPWAs with mild symptoms. In both groups, higher LM frequency was observed in L2-Hebrew narratives, the weaker post-stroke language for most participants in the sample. The results also showed qualitative LM differences in L1-Russsian and L2-Hebrew contexts. In L1-Russian narratives, BiPWAs mainly switched to L2-Hebrew nouns, while in L2-Hebrew narratives, they mainly inserted L1-Russian discourse markers and function words.

Conclusions

Linguistic factors such as pre- and post-stroke self-rated language proficiency and level of language impairment due to aphasia were found to predict LM frequency in L1-Russian and in L2-Hebrew. Cognitive abilities did not predict LM frequency. Based on our findings, we suggest that LM behavior in BiPWAs might be primarily related to language skills in L1 and L2, rather than to cognitive control impairments.

Introduction

Individuals living with aphasia (IWA) are more likely than stroke survivors without aphasia to experience depression, anxiety, stress, and social isolation due to communication difficulties, social and life barriers, and neurobiological changes (Hilari, 2011). Researchers in the U.K., Australia, and elsewhere have surveyed speech-language pathologists (SLPs) to ascertain their training and confidence in addressing the psychosocial well-being of IWA (Northcott et al., 2017; Sekhon et al., 2015). To date, no similar survey has been performed in the U.S. The aim of this study was to survey the perspectives of U.S. SLPs on addressing the psychosocial well-being of IWA.

Methods

The survey questions were drawn from Northcott et al. (2017), with adjustments for a U.S. audience and additional questions. We conducted a Qualtrics survey which remained open from November 2021 through May 2022 and collected 101 responses. Responses to the closed questions were analyzed using descriptive statistics and open-ended responses were analyzed with qualitative content analysis.

Results

Some of the most significant findings of this survey include the low levels of confidence in addressing psychological health, lack of training among SLPs, and rarity of successful collaboration with mental health professionals. In comparison to surveys conducted in other countries, many overarching themes were similar, but there was some variation in specific responses and patterns. Categories emerging from the open-ended responses included the need for more trained mental health professionals, improved collaboration, and emphasis on the importance of the topic.

Conclusions

This research highlights the necessity of increased training, as well as improved interprofessional collaboration between SLPs and mental health professionals. Limitations of the study include the potential bias of respondents, as well as the number and scope of the questions and responses. Future studies can employ interviews, trial models for collaboration, and partner with IWA to explore their experiences with psychosocial health support and services.

Introduction

Significant attention has been given to the role of brain function and disruption in determining performance on naming tasks among individuals with aphasia. However, scholarly pursuit of a neurological explanation has overlooked the fundamental cornerstone of individual health—the underlying social, economic, and environmental factors that shape how they live, work, and age, also known as the social determinants of health (SDOH). This study examines the correlation between naming performance and these underlying factors.

Methods

Individual level data from the 2010 Moss Aphasia Psycholinguistic Project Database (MAPPD) was matched with the 2009–2011 Medical Expenditure Panel Survey (MEPS) using a propensity score algorithm based on functional, health, and demographic characteristics. Multilevel, generalized, nonlinear regression models were applied to the resulting data set to assess the correlation between the Boston Naming Test (BNT) percentile score and age, income, sex, race, household size, marital status, aphasia type, and region of residence. Poisson regression models with bootstrapped standard errors were used to estimate these relationships

Results

Discrete dependent variable estimation with non-normal prior specification included individual level (age, marital status, years of education), socioeconomic (family income), health (aphasia type), household (family size), and environmental (region of residence) characteristics. Regression results indicated that, relative to individuals with Wernicke's, individuals with Anomic (0.74, SE = 0.0008) and Conduction (0.42, SE = 0.0009) aphasia performed better on the BNT. While age at the time of testing was not significantly correlated, higher income level (0.15, SE = 0.0003) and larger family size (0.002, SE = 0.002) was associated with higher BNT score percentiles. Finally, Black persons with aphasia (PWA) (-0.0124, SE = 0.0007) had lower average score percentiles when other factors were held constant.

Conclusions

The findings reported here suggest higher income and larger family size are associated with better outcomes. As expected, aphasia type was significantly associated with naming outcomes. However, poorer performance by Black PWA and individuals with low income suggests that SDOH can play a critical role (positive and negative) in naming impairment in some populations with aphasia.