Logopedics Phoniatrics Vocology最新文献

Objectives: The aim of the study was to evaluate voice and swallowing function before thyroid surgery and to explore the possible role of thyroid enlargement and laryngopharyngeal reflux (LPR).

Methods: We conducted a prospective study of patients who underwent hemi- or total thyroidectomy (n = 118) and compared the results with patients of laparoscopic cholecystectomy (n = 110). All subjects underwent videolaryngostroboscopy, filled in subjective evaluations of voice, swallowing and reflux complaints. Acoustic voice analysis (AVA), maximum phonation time (MPT) and perceptual voice evaluation were conducted.

Results: We found no difference in voice quality between study and control group, neither in subjective complaints nor in AVA or perceptual evaluation. We did find indicative signs of minor laryngeal changes in thyroid group. Swallowing Impairment Score (SIS) revealed worse swallowing function in thyroid patients (p = 0.0006). Comparison of Reflux Symptom Index (RSI) scores revealed that thyroid group patients have higher values compared to control group (p = 0.006). Nevertheless, Reflux Finding Score (RFS) showed identical scores in both groups (p = 0.220). In thyroid group there was a strong positive correlation between RSI and SIS (ρ = 0.641), but no correlation between RFS and SIS (ρ = -0.002). In addition, we found a weak positive correlation between thyroid weight and RFS (ρ = 0.379).

Conclusions: Changes in laryngeal area caused by thyroid disorders do not lead to subjective but indicate slight objective disturbances in voice quality. We detected a decline in swallowing quality within thyroid patients. Higher RSI scores and a positive correlation between RFS and thyroid weight, indicate a possible role of thyroid gland in LPR.

Purpose: The purpose of this study is to compare patient-reported voice handicap and auditory-perceptual measures of voice between healthy individuals and COVID-19 patients, as well as to investigate the effect of clinical factors on voice quality.

Methods: COVID-19 patients (n = 138) and 90 healthy controls were included in the study. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) was used to grade voice samples based on overall severity, roughness, breathiness, strain, pitch, and loudness. The Voice Handicap Index-10 was completed by all participants (VHI-10). Physical (pVHI), emotional (eVHI) and functional (fVHI) subscores were calculated. Clinical data were collected (disease stage, CT grade, neutrophil/lymphocyte ratio, CRP, and symptoms).

Results: A statistically significant difference between patient and control groups in VHI-10 and CAPE-V scores was detected (p < 0.001). Except eVHI, total score and all subscale scores were higher in patients with COVID-19 as the pVHI was the most affected (η² = 0.324) subscale. All scores of CAPE-V were significantly worse in patients with COVID-19 as highest impact of COVID-19 was on breathiness (η² = 0.518). Pre-existing pulmonary comorbidity_, dyspnoea and N/L was significantly associated with the VHI-10 overall score (β_pc = 4.27, β_dyspnoea = 5.69 and β_nl = 0.25). The overall severity of CAPE-V was significantly dependent on dyspnoea and pulmonary comorbidity (β_dyspnoea = 11.25, β_pc = 10.12). VHI ≥4 and CAPE-V overall severity ≥11 were good indicators of COVID-19 related dysphonia.

Conclusions: COVID-19 causes patient-reported voice handicap and deteriorates auditory-perceptual measures of voice. COVID-19 related voice impairment was mainly associated with the decreased respiratory capacity.

Aim: This study aims to show speech and language, sensory-motor, and emotional progress after one year of therapy according to the needs of and resources for a child with multiple disabilities and blindness due to retinopathy of prematurity (ROP).Methods: A 45-month-old boy was examined by a multidisciplinary team and assessed using the Sensory Profile 2, The Vineland Adaptive Behavior Scale II, The Communication Matrix, and The Scale for Evaluation of Psychophysiological Abilities of Children Aged 0-7. After a year of daily individually adopted speech and language therapy followed by supplementary therapeutics method, based on a multidisciplinary approach, the child was reassessed using the same battery of tests.Results: The obtained results might indicate the importance of factors such as a multidisciplinary approach, individualization, communication pathways, therapist's characteristics, and trust when working with children with multiple disabilities.Conclusion: Taking into account all the features of multiple disabilities during the treatment course, continuous monitoring, modification, and adaptation of applied therapy method proved successful in this case.

Purpose: In overtone singing a singer produces two pitches simultaneously, a low-pitched, continuous drone plus a melody played on the higher, flutelike and strongly enhanced overtones of the drone. The purpose of this study was to analyse underlying acoustical, phonatory and articulatory phenomena.Methods: The voice source was analyzed by inverse filtering the sound, the articulation from a dynamic MRI video of the vocal tract profile, and the lip opening from a frontal-view video recording. Vocal tract cross-distances were measured in the MR recording and converted to area functions, the formant frequencies of which computed.Results: Inverse filtering revealed that the overtone enhancement resulted from a close clustering of formants 2 and 3. The MRI material showed that for low enhanced overtone frequencies (F_E) the tongue tip was raised and strongly retracted, while for high F_E the tongue tip was less retracted but forming a longer constriction. Thus, the tongue configuration changed from an apical/anterior to a dorsal/posterior articulation. The formant frequencies derived from the area functions matched almost perfectly those used for the inverse filtering. Further, analyses of the area functions revealed that the second formant frequency was strongly dependent on the back cavity, and the third on the front cavity, which acted like a Helmholtz resonator, tuned by the tongue tip position and lip opening.Conclusions: This type of overtone singing can be fully explained by the well-established source-filter theory of voice production, as recently found by Bergevin et al. [1] for another type of overtone singing.

Purpose: While many examples of speech pathology intervention approaches for children with speech sound disorders (SSDs) exist in English and some other European languages, approaches with children in other languages are largely unknown. The aim was to determine current speech-language pathologists (SLPs) intervention practices with children with SSDs in the ME, and to then compare these with international practices.

Methods: Data were collected by online questionnaire using Qualtrics. One hundred and eighty-nine SLPs completed the survey. Participants were required to be Arabic first language speaking SLPs practicing in the ME (e.g. Kuwait, Saudi Arabia, UAE, and Egypt), working with children with SSDs.

Results: The respondents reported a frequent use of phonological awareness, traditional articulation therapy, auditory discrimination, minimal pairs, and whole language therapy approaches in the treatment of children with SSDs, like their counterparts in Australia, the USA, UK, and Portugal. Gaps between research recommendations for evidence-based practice and actual clinical practice are identified, and discussed.

Conclusions: Future research should investigate the efficacy of speech-therapy approaches to improve service delivery for Arabic-speaking children with SSDs in the ME.

Objective: Although speaking rate is central for many speech disorders, no consensus exists regarding the measurement of this feature. The purpose of this study was to examine the correlations between perceptual listener evaluations and various measures of speaking rate. Furthermore, the study investigated the relationship between speaking rate and articulation rate and how pauses in speech affect the perceived tempo.

Method: Nine healthy females were selected to produce stimuli representing three habitual speech tempi during semi-spontaneous speech: slow (n = 3), neutral (n = 3) and fast (n = 3). Speaking rate was analyzed both by manual calculation and through automatic detection by a script to the computer-based program Praat. Thirty untrained male and female listeners evaluated the recordings with regard to speech tempo on visual analogue scales from very slow to very fast.

Results: Large, significant correlations (Pearson's r) were found between all objective measures of speaking rate and perceptual listener evaluations. Words/minute showed the largest correlation (.91), followed by syllables/second (.89), while articulation rate (pauses excluded) as automatically measured by the script, showed the smallest correlation (.69). Possible explanations for the findings are discussed.

Conclusion: Untrained listeners' evaluation of speech tempo in normal subjects correlated strongly with objective measurements. The results both support the use of auditive-perceptual evaluation of tempo and the use of automatic script analysis for clinical use. Speaking rate (pauses included) showed better consistency with perceptual listener evaluations than articulation rate.

Objective: We aimed to study the association between self-reported voice disorders among teachers and indoor air quality in school buildings.

Methods: We performed a questionnaire study of 538 Finnish teachers working in 67 school buildings utilizing both perceived and technical evaluations; the agreement between these two assessments was also studied. The technical assessment was provided by technical experts.

Results: Teachers with voice disorders reported significantly more complaints from indoor air than those without voice disorders. The results also indicated a possible connection between the technical assessment and voice disorders. After adjustment for sex, stress and asthma, the prevalence of voice disorders was 47% higher in teachers working in renovated buildings compared to those working in the non-problem buildings (aRR1.47; CI 95% 1.11-1.95). The prevalence of voice disorders was 28% higher among teachers working in buildings with problems compared to those working in non-problem buildings (aRR 1.28; 95% CI 0.99-1.64).

Discussion: In our study, poor perceived indoor air was significantly associated with self-reported voice disorders in teachers and there was an agreement between the perceived and technical assessments. Our results also indicated a possible connection between the technical assessment and voice disorders. Our results imply the need for longitudinal research with technical assessment to study the effect of renovation on voice disorders.

Purpose: A narrative is a reliable tool for assessing the child's oral language. There are various narrative assessment tools. Most of them follow the Language Sample Analysis method such as Systematic Analysis of Language Transcripts (SALT) which is time-consuming and needs extensive training. The Narrative Assessment Protocol (NAP) offers a free and faster method of assessment to administer. The current study compared the NAP online and offline coding methods.Methods: Fifty-two kindergarteners (40-66 months old) were voice-recorded while generating a story. A transcriber coded the samples using both online and offline methods. Then, relative and absolute reliabilities were measured.Results: The results indicate a high correlation between the NAP offline and online scoring methods. Aside from a few items, both methods showed good correlations with each other.Conclusions: The NAP online coding method can be used as an alternative to an offline transcription to obtain a quick picture of a child's microstructure measures in narration.

Objective/hypothesis: The aim of the study was to measure the morphology of the epilaryngeal tube during sustained phonation as a function of loudness variation and to compare subjects of different genders.

Study design: This is a prospective study.

Methods: Five female and five male classically trained singers were recorded by magnetic resonance imaging with simultaneous audio recordings while sustaining phonation at three different loudness conditions. Three-dimensional subsections of the vocal tract were segmented on multi-image-based cross-sections. Different volume and area measures were determined and their relation to sound pressure level and loudness condition was analyzed.

Results: Male singers tended to narrow the epilaryngeal tube when increasing sound pressure level whereas female singers did not.

Conclusion: Strategies of vocal tract adjustments during loudness variation in classical singing appear to be gender specific.

Aim: The aim of this pilot study was to evaluate two new retelling tasks intended for clinical use in terms of language sample size, effects of picture support, and order of presentation.

Methods: Forty Swedish-speaking children in grades 4-6 participated in the study, 31 children with typical language development (TLD, mean age 11;1), and nine children with developmental language disorder (DLD, mean age 11;5). Two oral retells, one with and one without picture support, were analyzed with regards to productivity, syntactic complexity, basic Story Grammar (SG) units, and Internal Responses (IR).

Results: Results showed no systematic order effects in the TLD group, although this needs to be investigated further, and good inter-rater reliability. Both tasks elicited sufficiently large language samples, except from one participant with DLD whose samples were excluded from subsequent comparisons. When appropriate, data were analyzed with ANOVA (productivity, mean length of C-unit/MLCU), otherwise t-tests (TLD-group) or non-parametric tests (DLD-group) were used. As expected, retells from participants with DLD were shorter, with shorter MLCU and fewer SG units compared to the TLD group. There were also task effects: in the task with picture support, all participants had longer MLCU, and participants with TLD also showed a higher proportion of subordinate clauses, indicating that pictures may function as a support for syntactic complexity. The task without picture support, on the other hand, elicited more C-units indicated by a significant main effect, and more SG units, which was a significant effect in the TLD group.

Conclusions: >We conclude that both tasks might be useful for Swedish speech-language pathologists.