Journal of Speech Language and Hearing Research最新文献

Purpose: The aims of this exploratory study were (a) to assess common terms used to describe cochlear implant (CI) sound quality by patients fit with conventional CIs and (b) to compare those descriptors to previously obtained acoustic matches to CI sound quality created by single-sided deaf (SSD) patients for their normal-hearing ear.

Method: CI patients fit with Advanced Bionics (AB; n = 89), Cochlear Corporation (n = 86), and MED-EL (n = 80) implants were the participants. The patients filled out a questionnaire about CI sound quality for two time points: For the time near activation (T1) from memory and at the time of filling out the questionnaire (T2). The mean CI experience at T2 for the three groups ranged from 4 to 8 years. The questionnaire was composed of 25 adjectives describing sound quality.

Results: For T1, the most commonly used descriptors were Computer-like, Treble-y, Metallic, and Mickey Mouse-like. A superordinate category of HiPitched (High Pitched) gathered significantly more responses from patients with shorter electrode arrays (AB and Cochlear) than patients with longer arrays (MED-EL). At T2, the most common descriptor was Clear and was chosen by approximately two thirds of the patients. The between-group differences in responses to items in the HiPitched category, present at T1, were absent at T2.

Conclusions: The questionnaire data from conventional CI patients differs from previous sound matching data collected from SSD-CI patients. Alterations to the spectral composition of the signal are less salient to experienced conventional patients than to experienced SSD-CI patients. This is likely due to the absence, for conventional patients, of an exemplar in an NH ear against which to judge CI sound quality.

Purpose: Listening is the gateway to learning in the mainstream classroom; however, classrooms are noisy environments, making listening challenging. Therefore, speech-in-noise tests that realistically incorporate the complexity of the classroom listening environment are needed. The aim of this article was to review the speech stimuli, noise stimuli, presentation mode, and presentation levels of current classroom speech-in-noise tests to determine how representative they are of real-world classroom listening.

Method: A comprehensive search of Scopus database following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines was conducted to identify classroom speech-in-noise tests used in the research literature. The search term was classroom AND (listening OR (speech AND (perception OR intelligibility OR recognition OR discrimination) AND noise) OR speech-in-noise) AND (test OR task OR measure OR assessment) AND children in the article title, abstract, and key word fields.

Results: A total of 97 papers met the criteria to be included in the review. While the speech and noise stimuli were generally presented at realistic speech and noise levels, the speech materials were not representative of real-world classroom listening. Additionally, unrealistic noise and presentation modes were used in several studies.

Conclusion: This review will help researchers choose appropriate speech-in-noise test stimuli in future research and also help researchers understand what to consider when creating new speech-in-noise tests for classroom listening.

Supplemental material: https://doi.org/10.23641/asha.27659619.

Purpose: Previous work suggested that phonation threshold pressure (PTP), phonation threshold flow (PTF), and phonation threshold power (PTW) could be effective aerodynamic measures for quantifying glottal incompetence. This study examined how these measures could reflect varying extent of incomplete glottal closure in individuals with voice disorders.

Method: Thirty individuals formally diagnosed with glottal incompetence, including 10 with hypofunctional disorders (hypo group) and 20 with hyperfunctional disorders (hyper group), and 30 individuals with normal voice (control group) participated in the study. PTP was measured indirectly by intra-oral pressure during production of bilabial stop consonant-vowel syllables, PTF was measured during the sustained vowel /a/, and PTW was obtained as the product of PTP and PTF. The extent of incomplete glottal closure was quantified by normalized glottal gap (NGG) and normalized glottal gap area (NGGA) based on image analysis of videostroboscopic recordings of sustained /i/.

Results: Significant differences in all threshold measures (p < .05) were found among three participant groups with medium-to-large effect sizes (η_p² = .128-.220), with significantly higher values for the hypo group than the control group and no significant differences between the hyper and control groups. Receiver operating characteristic (ROC) analysis showed the highest diagnostic or classification accuracy contrasting between the hypo and control groups (area under the ROC curve = .717-.757), with the highest classification accuracy for PTW. There were significant, moderate-to-strong positive correlations with NGG and NGGA for the disorders group (Pearson's r = .4244-.6226) and the hypo group (r = .5689-.8949).

Conclusions: These measures could be effective for identifying glottal incompetence, especially for hypofunctional disorders. PTW could be more sensitive than PTP and PTF in reflecting the extent of incomplete glottal closure, consistent with theoretical predictions. Their relative sensitivities for quantifying distinct incomplete glottal closures specific to different voice disorders should be evaluated in future studies.

Purpose: The purpose of the present study was to use a large swallowing database to explore and compare the swallow-physiology impairment profiles of five dysphagia-associated diagnoses: chronic obstructive pulmonary disease (COPD), dementia, head and neck cancer (HNC), Parkinson's disease (PD), and stroke.

Method: A total of 8,190 patients across five diagnoses were extracted from a de-identified swallowing database, that is, the Modified Barium Swallow Impairment Profile Swallowing Data Registry, for the present exploratory cross-sectional analysis. To identify the impairment profiles of the five diagnoses, we fit 18 partial proportional odds models, one for each of the 17 Modified Barium Swallow Impairment Profile components and the Penetration-Aspiration Scale, with impairment score as the dependent variable and diagnoses, age, sex, and race as the independent variables with interactions between age and diagnoses and between PD and dementia (in effect creating a PD with dementia [PDwDem] group). For components with > 5% missingness, we applied inverse probability weighting to correct for bias.

Results: PD and COPD did not significantly differ on 13 of the 18 outcome variables (all ps > .02). Dementia, stroke, and PDwDem all showed worse impairments than COPD or PD on five of six oral components (all ps < .007). HNC had worse impairment than all diagnoses except PDwDem for nine of 10 pharyngeal components (all ps < .006). Stroke and HNC had worse penetration/aspiration than all other diagnoses (all ps < .003).

Conclusions: The present results show that there are both common and differing impairment profiles among these five diagnoses. These commonalities and differences in profiles provide a basis for the generation of hypotheses about the nature and severity of dysphagia in these populations. These results are also likely highly generalizable given the size and representativeness of the data set.

Supplemental material: https://doi.org/10.23641/asha.27478245.

Purpose: This systematic review covers the current stage of research on subtle cognitive impairment with connected speech. It aims at surveying the linguistic features in use to single out those that can best identify patients with mild neurocognitive disorders (mNCDs), whose cognitive changes remain underdiagnosed.

Method: We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and proposed a full definition of features for the analysis of speech features. Fifty-one studies met the inclusion criteria. Most of them focused on age-related progressive diseases and included fewer than 30 subjects.

Results: A total of 384 features labeled with 335 different names was retrieved, yielding various results in discriminating individuals with mNCDs from controls.

Conclusions: This finding highlights the need for harmonized labels to further investigate mNCDs with linguistic markers. We suggest two different ways of assessing a feature's reliability. We also point out potential methodological issues that remain to be resolved, along with recommendations for reproducible research in the field.

Purpose: Speakers with primary progressive apraxia of speech (PPAOS) have an insidious onset of motor speech planning/programming difficulties. As the disease progresses, the apraxia of speech (AOS) becomes more severe and a co-occurring dysarthria often emerges. Here, longitudinal data from speakers with phonetic- and prosodic-predominant PPAOS are used to characterize the progression of their motor speech impairment, including the development of dysarthria and mutism.

Method: Data are presented from 52 speakers who had PPAOS at enrollment (i.e., progressive AOS in the absence of aphasia, cognitive, or other neurologic symptoms). Twenty-one had predominantly phonetic features, whereas 31 had primarily prosodic features. All participants underwent a comprehensive motor speech evaluation at their enrollment visit and each annual return visit, with a median of three visits per participant.

Results: Almost 25% of the speakers with PPAOS presented with dysarthria at their enrollment visit (median disease duration of 3.65 years), whereas more than 70% of them had developed dysarthria by their last visit (median disease duration of 6.85 years). Neither the likelihood to develop dysarthria nor the disease duration at which it was detected differed significantly between the phonetic and prosodic groups. However, muteness emerged sooner for speakers with phonetic-predominant PPAOS; the median disease duration at which they became mute was 1.5 years shorter than for their prosodic counterparts.

Conclusions: Clinically, these results facilitate more accurate prognostication of motor speech symptoms in speakers with PPAOS, allowing for timely introduction of alternative means of communication. The results also support the differentiation between progressive AOS and dysarthria as distinct motor speech disorders that often co-occur in these individuals.

Purpose: This study investigates the effect of voice-focus adjustments on oronasal balance and auditory feedback control of speech via analyzing spectral distribution, perceived loudness, and nasal vibrations during sustained phonation and passage reading.

Method: Twenty-five speech-language pathologists sustained /a/ and read passages with forward, backward, and natural voice focuses in quiet and noisy conditions. The low-frequency power (LFP) below 3 Hz of vocal fundamental frequency was analyzed to access audio-vocal feedback control. Long-term average spectra of speech were converted to phon spectra based on equal-loudness contours ISO 226:2003 to estimate perceived loudness of self-voice across different conditions. Nasal vibrations were also recorded using a digital accelerometer to measure oronasal coupling.

Results: Forward-focused voice enhanced the nasal acceleration and reduced LFP, suggesting that increasing the degree of oronasal coupling can improve audio-vocal feedback control compared to natural and backward-focused voices. Voice-focus adjustments were most related to average power and phon values in the 0.2- to 0.3-kHz band. In noise, perceived loudness in the 0.5- to 2.3-kHz band effectively predicted LFP, outperforming the average spectral power of the same band.

Conclusions: Voice-focus adjustments significantly impact both the acoustic transfer function of the vocal tract and the spontaneous fine-tuning of audio-vocal integration. This influence becomes particularly pronounced when sound intensity or perceived loudness is changed within the frequency range of 0.2-2.3 kHz, depending on the voice focus selected by the speakers.

Supplemental material: https://doi.org/10.23641/asha.27183483.

Purpose: Prior research introduced quantifiable effects of three methodological parameters (number of repetitions, stimulus length, and parsing error) on the spatiotemporal index (STI) using simulated data. Critically, these parameters often vary across studies. In this study, we validate these effects, which were previously only demonstrated via simulation, using children's speech data.

Method: Kinematic data were collected from 30 typically developing children and 15 children with developmental language disorder, all spanning the ages of 6-8 years. All children repeated the sentence "buy Bobby a puppy" multiple times. Using these data, experiments were designed to mirror the previous simulated experiments as closely as possible to assess the effects of analytic decisions on the STI. Experiment 1 manipulated number of repetitions, Experiment 2 manipulated stimulus length (or the number of movement units in the target phrase), and Experiment 3 manipulated precision of parsing of the articulatory trajectories.

Results: The findings of all three experiments closely mirror those of the prior simulation. Experiment 1 showed consistent underestimation of STI values from smaller repetition counts consistent with the theoretical model for all three participant groups. Experiment 2 found speech segments containing fewer movements yield lower STI values than longer ones. Finally, Experiment 3 showed even small parsing errors are found to significantly increase measured STI values.

Conclusions: The results of this study are consistent with the findings of prior simulations in showing that the number of repetitions, length of stimuli, and amount of parsing error can all strongly influence the STI independent of behavioral factors. These results further confirm the importance of closely considering the design of experiments, which employ the STI.

Purpose: Caregiver-mediated communication intervention outcomes are inconsistently measured, varying by assessment settings, materials, and activities. Standardized materials are often used for measuring outcomes, yet it remains unknown whether such standardized contexts equitably capture caregiver and child intervention outcomes representative of dyads' typical interactions. This within-subject study investigates how intervention outcomes differ between family-selected and standardized interactional contexts for autistic toddlers and their caregivers.

Method: Following an 8-week caregiver-mediated telehealth intervention delivered to 22 dyads, caregiver outcomes (fidelity of using responsive communication facilitation strategies) and child outcomes (total spontaneous directed communicative acts) were measured during two interactional contexts using (a) family-selected activities and (b) a standardized toy set. A routines checklist surveyed the activities dyads value, enjoy, complete frequently, and/or find difficult with their child.

Results: Caregiver outcomes and child outcomes did not significantly differ between the family-selected and standardized interactional contexts. Descriptive results suggest that the types of toys commonly included in standardized toy sets are representative of the materials many families choose when playing with their child at home. However, during the family-selected interactional context, the majority of dyads also chose materials or activities that were not available to them during the standardized context.

Conclusion: It is necessary to carefully consider a more expansive approach to standardization in which intervention outcomes are measured in ecologically valid contexts, which meaningfully, accurately, and equitably capture caregiver and child functional outcomes, and the translation of interventions to families' everyday routines.

Purpose: The purpose of this study was to investigate cortical tracking of speech (CTS) in adults who stutter (AWS) compared to typically fluent adults (TFAs) to test the involvement of the speech-motor network in tracking rhythmic speech information.

Method: Participants' electroencephalogram was recorded while they simply listened to sentences (listening only) or completed them by naming a picture (listening for speaking), thus manipulating the upcoming involvement of speech production. We analyzed speech-brain coherence and brain connectivity during listening.

Results: During the listening-for-speaking task, AWS exhibited reduced CTS in the 3- to 5-Hz range (theta), corresponding to the syllabic rhythm. The effect was localized in the left inferior parietal and right pre/supplementary motor regions. Connectivity analyses revealed that TFAs had stronger information transfer in the theta range in both tasks in fronto-temporo-parietal regions. When considering the whole sample of participants, increased connectivity from the right superior temporal cortex to the left sensorimotor cortex was correlated with faster naming times in the listening-for-speaking task.

Conclusions: Atypical speech-motor functioning in stuttering impacts speech perception, especially in situations requiring articulatory alertness. The involvement of frontal and (pre)motor regions in CTS in TFAs is highlighted. Further investigation is needed into speech perception in individuals with speech-motor deficits, especially when smooth transitioning between listening and speaking is required, such as in real-life conversational settings.

Supplemental material: https://doi.org/10.23641/asha.27234885.