Logopedics Phoniatrics Vocology最新文献

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.

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.

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.

Purpose: To explore Swedish clinical practice regarding assessment of suspected Speech Sound Disorders (SSD) in children.

Methods: A web-based questionnaire, regarding assessment of SSD in children 4;6-6;11 (years; months), was distributed to Swedish speech-language pathologists (SLPs) through social media and online forums. The questions concerned the frequency and manner of assessment for seven assessment components, chosen based on a review of international recommendations for SSD assessment.

Results: A total of 131 SLPs responded to the questionnaire. The results show that Swedish SSD assessment practices vary with regards to the frequency and manner of assessment for many components. Speech output is frequently assessed while speech perception, phonological awareness and oral-motor function are assessed less frequently. A variety of manners of assessment, for example, standardised tests, non-standardised material, and informal assessment procedures, such as observation, are utilized by respondents.

Conclusions: Swedish SSD assessment practices are variable. The present paper reveals areas for development within SLP practice and education programmes, and provides a new perspective on present praxis with regards to the assessment of suspected SSD in Sweden.

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.

Aim: The risk for language disorder is high in children with all levels of hearing loss (HL). Early identification and intervention should be as important for children with mild HL as for those with more severe HL. Despite new-born hearing screening, a recent survey of speech language therapist services in southern Sweden indicates that children with mild and moderate HL are severely neglected when it comes to language assessment and language intervention. In this study we explore associations between Best Ear Hearing Level (BEHL), time factors and language skills in Swedish children with HL with hearing aids (HA).

Method: Participants were 19 children with mild HL (BEHL 23-39) and 22 children with moderate HL (BEHL 40-70) aged 5-15 years. Information on age at diagnosis and at HA fitting were collected. The children performed a nonword repetition and a sentence comprehension task.

Results: The time elapsed between diagnosis and fitting with HA was longer for the children with mild HL.Participants with mild HL received their HA significantly later than children with moderate HL. No association between BEHL and the two language measures was found, and language skills were not better in children with mild than moderate HL. 17% of participants performed below cut-off for language disorder on both language measures.

Conclusion: Given the risk for long-term academic and social consequences of even mild HL delayed HA intervention for children with HLleads to serious concerns by families, clinicians, and pedagogues.

Objective: Children with speech sound disorders (SSDs) have difficulties affecting different levels of speech production. For treatment to be beneficial, it is important to differentiate between Childhood Apraxia of Speech (CAS) - a motor speech disorder with deficits in speech praxis - and other SSDs (nonCAS-SSD). We have previously developed a motor speech examination Dynamisk motorisk talbedömning (DYMTA). We aimed to evaluate DYMTAs reliability and validity in a small-scale sample to estimate DYMTAs usability in diagnostic settings.

Methods: Speech, language, and oral motor abilities were assessed in 45 children between 40 and 106 months. Intra- and inter-rater reliability of DYMTA were analyzed. Further, DYMTAs ability to validly discriminate between children with CAS and nonCAS-SSD was assessed.

Results: The intra-rater reliability for the scores of DYMTA was strong, with ICCs ranging from 0.97 to 1.0. DYMTA total score had strong inter-rater reliability as evidenced both by the agreement estimates (DYMTA-A: 0.91 and DYMTA-B: 0.87) and the ICCs (0.97 and 0.96). Inter-rater reliability was also strong for the separate subscores on agreement estimates and for all subscores on ICCs, except for the Prosody subscores. DYMTA accurately discriminated between children with CAS and nonCAS-SSD in this small sample with an AUC of 0.92 for DYMTA-A and 0.94 for DYMTA-B.

Conclusions: With its focus on speech movements, DYMTA could serve as a valuable addition to other tests when assessing children's speech motor performance. This first examination suggests that DYMTA may be both a reliable and valid tool in the diagnostic process of SSD.

Introduction: SPEAK OUT! with The LOUD Crowd is a standardized speech therapy program typically consisting of 12 one-on-one treatments and ongoing weekly group maintenance sessions for patients with dysarthria due to Parkinson's disease (PD). It is based upon the hypothesis that increased attention to speech, which is a goal-directed motor activity, may compensate for the impairment in automatic sequential motor behaviors often demonstrated in patients with PD. We present results on the 1-year response to treatment.

Methods: Forty individuals with idiopathic PD received SPEAK OUT! delivered in 12 one-on-one 40-min treatment sessions 3 times per week for four consecutive weeks in addition to ongoing group maintenance sessions called The LOUD Crowd. Evaluations occurred 3 times at baseline, within one and six weeks after completion of the SPEAK OUT! sessions (N = 40) and 1-year later (N = 35). Assessments included mean speech intensity and intonation from reading and monolog, the voice quality acoustic measure called cepstral peak prominence (CPP), and scores on the voice-related quality of life questionnaire.

Results: The significant improvements achieved in all outcome measures from baseline to completion of SPEAK OUT! were maintained 1-year later. Participation throughout the year in regular group maintenance sessions (The LOUD Crowd) was positively correlated with level of improvement at 1 year for all measures except patient perception of voice.

Conclusions: These long-term data contribute evidence of the effectiveness of this speech therapy program for improving communication for individuals with PD and emphasize the importance of regular and ongoing group sessions to sustain therapeutic gains.