Journal of Speech Language and Hearing Research最新文献

Introduction: Semi-occluded vocal tract exercises (SOVTEs) are widely used as a therapeutic tool to create flow resistance in the upper airway. The current study was a randomized controlled clinical trial to establish the efficacy of two SOVTE protocols, flow-resistant tube (FRT) and Lessac-Madsen Resonant Voice Therapy (LMRVT). Exploratory investigations included a noninferiority analysis of FRT to the widely adopted therapy protocol (LMRVT), as well as examining the dosing required to improve acoustic measures and subjective ratings.

Method: Sixty-seven participants with voice disorder were randomized into one of five groups: 4-week FRT (n = 14), 8-week FRT (n = 19), 4-week LMRVT (n = 15), 8-week LMRVT (n = 5), and control (n = 14). Voice Handicap Index (VHI) and Vocal Fatigue Index scores were collected pre- and posttreatment. Acoustic analysis using the Acoustic Voice Quality Index was completed. We compared VHI between controls and 8-week FRT and LMRVT, adjusting for pre-VHI using linear regression. We examined the efficacy of 4-week protocols relative to controls and conducted a noninferiority comparison of FRT (4 and 8 weeks) to LMRVT (4 and 8 weeks) using 5- and 10-point margins. Finally, we compared the 4- versus 8-week sessions for both therapies.

Results: A statistically significant reduction of VHI in both 8-week FRT relative to controls (-10.60, 95% CI [-19.80, -1.40], p = .025) and 8-week LMRVT (-15.74, 95% CI [-29.40, -2.08], p = .025) was found. We also found an improvement in 4-week FRT relative to controls (-10.11, 95% CI [-20.03, -0.20], p = .046), but the 4-week LMRVT result was not statistically significant (p = .057). FRT was found to be noninferior to LMRVT in terms of VHI using a 10-point margin (FRT - LMRVT: 0.69, 95% CI [-5.76, 7.15], p = .01), but not using a 5-point margin (p = .054). There were no statistically significant differences in VHI scores between 4- and 8-week sessions for either therapy.

Conclusions: Both FRT and LMRVT improved VHI scores relative to controls. FRT was noninferior to LMRVT in terms of VHI scores. There were no statistically significant differences in VHI scores between 4- and 8-week therapy sessions.

Purpose: As artificial intelligence (AI) takes an increasingly prominent role in health care, a growing body of research is being dedicated to its application in the investigation of communication sciences and disorders (CSD). This study aims to provide a comprehensive overview, serving as a valuable resource for researchers, developers, and professionals seeking to comprehend the evolving landscape of AI in CSD research.

Method: We conducted a bibliometric analysis of AI-based research in the discipline of CSD published up to December 2023. Utilizing the Web of Science and Scopus databases, we identified 15,035 publications, with 4,375 meeting our inclusion criteria. Based on the bibliometric data, we examined publication trends and patterns, characteristics of research activities, and research hotspot tendencies.

Results: From 1985 onwards, there has been a consistent annual increase in publications, averaging 16.51%, notably surging from 2012 to 2023. The primary communication disorders studied include autism, aphasia, dysarthria, Parkinson's disease, and Alzheimer's disease. Noteworthy AI models instantiated in CSD research encompass support vector machine, convolutional neural network, and hidden Markov model, among others.

Conclusions: Compared to AI applications in other fields, the adoption of AI in CSD has lagged slightly behind. While CSD studies primarily use classical machine learning techniques, there is a growing trend toward the integration of deep learning methods. AI technology offers significant benefits for both research and clinical practice in CSD, but it also presents certain challenges. Moving forward, collaboration among technological, research, and clinical domains is essential to empower researchers and speech-language pathologists to effectively leverage AI technology for the study, diagnosis, assessment, and rehabilitation of CSD.

Supplemental material: https://doi.org/10.23641/asha.27162564.

Purpose: Categorical perception (CP) manifests in various aspects of human cognition. While there is mounting evidence for CP in facial emotions, CP in vocal emotions remains understudied. The current study attempted to test whether individuals with a tonal language background perceive vocal emotions categorically and to examine how factors such as gender and age influence the plasticity of these perceptual categories.

Method: This study examined the identification and discrimination performance of 24 Mandarin-speaking children (14 boys and 10 girls) and 32 adults (16 males and 16 females) when they were presented with three vocal emotion continua. Speech stimuli in each continuum consisted of 11 resynthesized Mandarin disyllabic words.

Results: CP phenomena were detected when Mandarin participants perceived vocal emotions. We further found the modulating effect of age and gender in vocal emotion categorization.

Conclusions: Our results demonstrate for the first time that a categorical strategy is used by Mandarin speakers when perceiving vocal emotions. Furthermore, our findings reveal that the categorization ability of vocal emotions follows a prolonged course of development and the maturation patterns differ across genders. This study opens a promising line of research for investigating how sensory features are mapped to higher order perception and provides implications for our understanding of clinical populations characterized by altered emotional processing.

Supplemental material: https://doi.org/10.23641/asha.27204057.

Purpose: Retrieval practice has been shown to assist the word learning of children with developmental language disorder (DLD). Although this has been true for learning new verbs as well as new nouns and adjectives, these children's overall verb learning has remained quite low. In this preregistered study, we presented novel verbs in transitive sentences with varying subjects/agents and objects/patients to determine if recall could be improved and if retrieval practice continued to be facilitative.

Method: Fourteen children with DLD aged 4-5 years and 13 same-age peers with typical language development (TD) learned eight novel verbs over two sessions. Half of the novel verbs were presented with spacing between study and retrieval trials, and half were presented with the same frequency in study trials without the opportunity for retrieval. All novel verbs were presented in sentences such as, "The woman is deeking the shoe." Children's ability to recall and use the novel verbs in the same sentence structure was tested after the second session and 1 week later. The children were also required to use the novel verbs in bare-stem form in a new structure, as in, "That woman likes to deek the towel."

Results: Both groups of children showed increased recall relative to a previous novel verb study. The children with TD showed the expected advantages of spaced retrieval over repeated study and could use the novel verbs in the new morphological form and sentence structure. The children with DLD, however, showed an advantage for spaced retrieval only shortly after the learning period. These children had great difficulty changing the novel verbs to a bare stem and using them in a new structure.

Conclusion: Although spaced retrieval assists children's novel verb recall, children with DLD in particular require additional help using these verbs with morphological and syntactic flexibility.

Purpose: Respiratory-swallow coordination (RSC) frequently changes in people with Parkinson's disease (PwPD). Little is known about how these changes relate to impairments in swallowing safety (penetration and aspiration) and efficiency (pharyngeal residue). Therefore, the aims of this study were to assess the relationships between RSC, pharyngeal residue, penetration, and aspiration in PwPD.

Method: Twenty-four PwPD were recruited to undergo simultaneous assessment of RSC, swallowing safety, and swallowing efficiency. RSC was assessed using respiratory inductive plethysmography and nasal airflow and included measurements of respiratory pause duration, respiratory phase patterning, and lung volume during swallowing. Swallowing safety and efficiency were assessed using flexible endoscopic evaluation of swallowing, analyzed using the Visual Analysis of Swallowing Efficiency and Safety, and included measurements of pharyngeal residue, penetration, and aspiration. All data were blindly analyzed, with 20% of the data repeated for interrater reliability assessment. Multilevel statistical models were used to examine the relationships between RSC and swallowing.

Results: A total of 812 swallows were analyzed from 24 participants. Only 33.4% of swallows exhibited the typical exhale-swallow-exhale pattern. Additionally, 95% of participants exhibited abnormal swallow function. More severe hypopharyngeal residue ratings were associated with inhaling before the swallow compared to exhaling before the swallow. Additionally, more severe events of penetration and aspiration were associated with (a) inhaling before the swallow compared to exhaling before the swallow, (b) inhaling after the swallow compared to exhaling after the swallow, and (c) longer swallow-related respiratory pause durations. Inhaling after the swallow exhibited the strongest relationship with impairments in swallowing safety when compared to all other RSC variables.

Conclusions: RSC exhibited significant relationships with pharyngeal residue, penetration, and aspiration in these PwPD. Clinicians should attend to RSC when assessing swallowing in PwPD. Future research is needed to examine if training an exhale-swallow-exhale pattern can be used to improve disordered swallowing in PwPD.

Open science form: https://doi.org/10.23641/asha.27211770.

Purpose: This study examines the effectiveness of automatic speech recognition (ASR) for individuals with speech disorders, addressing the gap in performance between read and conversational ASR. We analyze the factors influencing this disparity and the effect of speech mode-specific training on ASR accuracy.

Method: Recordings of read and conversational speech from 27 individuals with various speech disorders were analyzed using both (a) one speaker-independent ASR system trained and optimized for typical speech and (b) multiple ASR models that were personalized to the speech of the participants with disordered speech. Word error rates were calculated for each speech model, read versus conversational, and subject. Linear mixed-effects models were used to assess the impact of speech mode and disorder severity on ASR accuracy. We investigated nine variables, classified as technical, linguistic, or speech impairment factors, for their potential influence on the performance gap.

Results: We found a significant performance gap between read and conversational speech in both personalized and unadapted ASR models. Speech impairment severity notably impacted recognition accuracy in unadapted models for both speech modes and in personalized models for read speech. Linguistic attributes of utterances were the most influential on accuracy, though atypical speech characteristics also played a role. Including conversational speech samples in model training notably improved recognition accuracy.

Conclusions: We observed a significant performance gap in ASR accuracy between read and conversational speech for individuals with speech disorders. This gap was largely due to the linguistic complexity and unique characteristics of speech disorders in conversational speech. Training personalized ASR models using conversational speech significantly improved recognition accuracy, demonstrating the importance of domain-specific training and highlighting the need for further research into ASR systems capable of handling disordered conversational speech effectively.

Aims: We investigate the relationship between narrative macrostructure, current language exposure, and microstructure in second-grade Spanish-English bilingual children in the United States. Macrostructure knowledge has been claimed to be shared across languages in multilingual individuals. We examine the role of current language exposure and microstructure on macrostructure and how individual children organize their stories in English and Spanish. We use sociocultural theory to investigate differences in the macrostructural elements children choose to include in their stories by language.

Methodology: Using existing data, we used a two-sample t-test to compare average macrostructure and microstructure performance in English and Spanish in addition to performance on subcomponents of macrostructure. A correlational analysis was used to compare narrative performance in both languages. We used regression analysis to investigate to what extent current language exposure and microstructure influenced the macrostructure of 62 Spanish-English bilingual second graders' stories.

Results: Children used more words and a greater variety of words in Spanish compared to English. However, they demonstrated comparable use of overall macrostructure across languages, in addition to variation in what macrostructure subcomponents they use by language of story elicitation. No statistically significant relationship was found between current language exposure and macrostructure, except for Spanish story structure. Correlational analysis revealed a significant relationship between macrostructure performance in English and Spanish. A significant relationship was found within languages between microstructure and macrostructure and across languages between Spanish microstructure and English internal state terms.

Discussion: Findings are consistent with extant literature that claims macrostructure is shared across languages. Children require lexical diversity across languages to express their ideas organized within macrostructural elements. Although bilingual children tell comparably complex stories, they may be making culturally and linguistically specific decisions about what macrostructure components to include in their stories.

Objective: Clinical treatment strategies and progress metrics for patients with inducible laryngeal obstruction (ILO) and exercise-induced laryngeal obstruction (EILO) have not been systematically applied across clinics. The goals of this review were to identify the intervention strategies used to treat upper airway disorders and determine the clinical metrics by which improvement or resolution of ILO/EILO is determined in clinical studies of speech-language pathology intervention.

Method: A systematic review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Systematic Reviews Checklist. English language, full-text publications were identified through MEDLINE (Ovid), APA PsycINFO, and Web of Science for publications that described clinical outcomes following behavioral treatment for ILO provided by a speech-language pathologist (SLP).

Results: A total of 238 sources were retrieved, of which 75 were duplicates. Titles and abstracts of 163 were screened, with 22 sources included for full-text review. Citation review yielded nine additional resources. Thirty-one sources were included for data extraction. Most sources described use of respiratory/laryngeal retraining. There was a lack of consistency for clinical and standardized metrics used to evaluate improvement or resolution of upper airway symptoms.

Conclusions: Behavioral and standardized outcome metrics for evaluating therapy outcomes from SLP behavioral intervention of ILO/EILO are not consistently applied. Clinical metrics standards for clinicians are needed to provide a means to evaluate graded improvement in treatment and changes in health care utilization as well as for training less-experienced clinicians.

Supplemental material: https://doi.org/10.23641/asha.27172683.

Purpose: Automated remote assessment and monitoring of patients' neurological and mental health is increasingly becoming an essential component of the digital clinic and telehealth ecosystem, especially after the COVID-19 pandemic. This review article reviews various modalities of health information that are useful for developing such remote clinical assessments in the real world at scale.

Approach: We first present an overview of the various modalities of health information-speech acoustics, natural language, conversational dynamics, orofacial or full body movement, eye gaze, respiration, cardiopulmonary, and neural-which can each be extracted from various signal sources-audio, video, text, or sensors. We further motivate their clinical utility with examples of how information from each modality can help us characterize how different disorders affect different aspects of patients' spoken communication. We then elucidate the advantages of combining one or more of these modalities toward a more holistic, informative, and robust assessment.

Findings: We find that combining multiple modalities of health information allows for improved scientific interpretability, improved performance on downstream health applications such as early detection and progress monitoring, improved technological robustness, and improved user experience. We illustrate how these principles can be leveraged for remote clinical assessment at scale using a real-world case study of the Modality assessment platform.

Conclusion: This review article motivates the combination of human-centric information from multiple modalities to measure various aspects of patients' health, arguing that remote clinical assessment that integrates this complementary information can be more effective and lead to better clinical outcomes than using any one data stream in isolation.