Journal of Speech Language and Hearing Research最新文献

Purpose: Cough reflex testing (CRT) is an adjunct to the clinical swallowing evaluation (CSE), providing information on patients' risk of silent aspiration. CRT has been shown to influence diet recommendations, but in previous work, the many varied patient characteristics are not controlled. Therefore, the specific role of CRT results in these decisions remains unclear as this relationship has not been directly assessed.

Method: An online survey was sent to speech language therapists working in dysphagia. Two patient cases were presented that differed only by the presence of risk factors for the development of aspiration pneumonia. For each patient case, there were three assessment scenarios: CSE information only, CSE information with a "pass" CRT result, and CSE information with a "fail" CRT result. Clinicians outlined their patient management plans for each of the six scenarios.

Results: Ninety-seven data sets were used in the final analysis. A "fail" result was found to lead to the most restrictive patient management. Decisions made when provided with only CSE information were very similar to decisions made for a CSE with a "pass" result. Aspiration pneumonia risk factors were shown to influence decision making, with the low-risk patient more likely to be recommended a less restrictive diet.

Conclusions: When information was available regarding silent aspiration risk, clinicians factored the results into their decision making. However, in the absence of a CRT result, airway sensation was assumed to be intact in the absence of information. This finding warrants further investigation given the impact this assumption may have on a patient's pulmonary health.

Purpose: Health care is advancing toward a collaborative and integrative approach that promotes general health and wellness while addressing health inequities through the consideration of broader social and economic factors that influence the well-being of the entire population. Recently, there has been growing evidence of public health concept applications in fields related to speech, language, and hearing. However, there is an outstanding need to explicitly define the intersection of public health, including prevention and health promotion, and the discipline of communication sciences and disorders (CSD) across the areas of education, clinical practice, research, and policy. The authors propose a definition for this intersection using the new term communication public health.

Method: This tutorial provides guidance on how to conceptualize communication public health and invites refinement and expansion of the intersection between public health and CSD. Because readers are experts in CSD, this tutorial aims to supplement existing knowledge with information on public health to achieve three main objectives: (a) increase knowledge of the application of public health concepts among speech, language, hearing, and related professionals (SLHP+); (b) introduce the concept of communication public health; and (c) discuss the relevance of communication public health across domains within CSD. The authors utilize the socioecological model to provide examples of applications.

Results: The concept of communication public health is proposed as the collaborative area of CSD and public health, which encompasses prevention and promotion of equity in communication health through individual-, community-, and population-level efforts. The goals of communication public health are achieved through applications of public health principles in CSD education, clinical practice, research, and policy.

Conclusion: Communication public health defines an area of collaboration between public health and CSD in which SLHP+ can apply public health concepts to both advance communication health and address health disparities.

Purpose: Cross-language studies suggest more similarities than differences in how dysarthria affects the speech of people with Parkinson's disease (PwPD) who speak different languages. In this study, we aimed to identify the relative contribution of acoustic variables to distinguish PwPD from controls who spoke varieties of two Romance languages, French and Portuguese.

Method: This bi-national, cross-sectional, and case-controlled study included 129 PwPD and 124 healthy controls who spoke French or Portuguese. All participants underwent the same clinical examinations, voice/speech recordings, and self-assessment questionnaires. PwPD were evaluated off and on optimal medication. Inferential analyses included Disease (controls vs. PwPD) and Language (French vs. Portuguese) as factors, and random decision forest algorithms identified relevant acoustic variables able to distinguish participants: (a) by language (French vs. Portuguese) and (b) by clinical status (PwPD on and off medication vs. controls).

Results: French-speaking and Portuguese-speaking individuals were distinguished from each other with over 90% accuracy by five acoustic variables (the mean fundamental frequency and the shimmer of the sustained vowel /a/ production, the oral diadochokinesis performance index, the relative sound level pressure and the relative sound pressure level standard deviation of the text reading). A distinct set of parameters discriminated between controls and PwPD: for men, maximum phonation time and the oral diadochokinesis speech proportion were the most significant variables; for women, variables calculated from the oral diadochokinesis were the most discriminative.

Conclusions: Acoustic variables related to phonation and voice quality distinguished between speakers of the two languages. Variables related to pneumophonic coordination and articulation rate were the more effective in distinguishing PwPD from controls. Thus, our research findings support that respiration and diadochokinesis tasks appear to be the most appropriate to pinpoint signs of dysarthria, which are largely homogeneous and language-universal. In contrast, identifying language-specific variables with the speech tasks and acoustic variables studied was less conclusive.

Background: Bilingual assessment is particularly difficult in the very first period of children's second language (L2) exposure. This exploratory, longitudinal study examined L2 learning after 1 and 2 years of L2 exposure by young immigrants and how it is affected by their age at first exposure to the L2 (AoE).

Method: Participants were 18 immigrants ranging in age from 2;11 to 14;2 (years;months), all within their first year in Montreal at Time 1, enrolled in a French school or day care, and from a Mandarin first language background. Participants were tested again a year later. Measures included receptive and expressive French vocabulary tests and conversational language samples analyzed using traditional measures of mean length of utterance (MLU) and morphological accuracy as well as novel measures of semantic and sentence-level patterns.

Results: Performance was relatively high already at Time 1 and increased significantly at Time 2 in both vocabulary and MLU. At Time 2, vocabulary scores were below normative values, whereas MLU was within expected values relative to monolingual and simultaneous bilinguals for the majority of the participants. However, higher MLUs were accompanied by more instances of both semantic errors and creative semantic strategies. French performance was strongly related to AoE; with amount of exposure equivalent, older participants outperformed the younger ones on MLU and vocabulary. Semantic errors and creative uses were strongly predicted by AoE; however, morphological accuracy and number of agrammatical utterances were not.

Conclusions: This initial period of French learning involved a rapid growth spurt for most of the participants. We argue that the pattern observed, particularly among the older children, constitutes an early stage of L2 learning characterized by long utterances that are also frequently hard to understand as speakers encounter challenges and use creative strategies in their attempt to convey meaning. Comparison with normative reference bases for monolinguals and bilinguals with greater cumulative L2 exposure who have similar MLUs should be done with much caution during this early period.

Purpose: The purpose of this article is to raise awareness about the importance of diverting from English-centric approaches in the management of dysarthria associated with Parkinson's disease (PD) in the United States, and embracing a language- and culture-specific perspective when working with linguistically and culturally diverse populations within the context of culturally responsive, precision medicine.

Method: This tutorial is divided into two primary components: a critical review of language universal and language-specific characteristics of dysarthria associated with PD and their relationship with speech intelligibility, and a practical guide to culturally responsive evidence-based practice for speech-language pathologists.

Conclusions: We offer a framework for linguistically and culturally appropriate considerations when working with clients with dysarthria associated with PD. While "universal" representations of dysarthria may be part of the big picture, language-specific contributions to speakers' intelligibility should be carefully examined to maximize treatment outcomes. Additionally, an evidence-based model that fully embraces clients' wishes and values within the context of culturally responsive, precision medicine should be prioritized, a practice that may include the use of interpreters.

Purpose: Our goal was to compare statistical learning abilities between preschoolers with developmental language disorder (DLD) and peers with typical development (TD) by assessing their learning of two artificial grammars.

Method: Four- and 5-year-olds with and without DLD were compared on their statistical learning ability using two artificial grammars. After learning an aX grammar, participants learned a relatively more complex abX grammar with a nonadjacent relationship between a and X. Participants were tested on their generalization of the grammatical pattern to new sequences with novel X elements that conformed to (aX, abX) or violated (Xa, baX) the grammars.

Results: Results revealed an interaction between age and language group. Four-year-olds with and without DLD performed equivalently on the aX and abX grammar tests, and neither of the 4-year-old groups' accuracy scores exceeded chance. In contrast, among 5-year-olds, TD participants scored significantly higher on aX tests compared to participants with DLD, but the groups' abX scores did not differ. Five-year-old participants with DLD did not exceed chance on any test, whereas 5-year-old TD participants' scores exceeded chance on all grammar learning outcomes. Regression analyses indicated that aX performance positively predicted learning outcomes on the subsequent abX grammar for TD participants.

Conclusion: These results indicate that preschool-age participants with DLD show deficits relative to typical peers in statistical learning, but group differences vary with participant age and type of grammatical structure being tested.

Supplemental material: https://doi.org/10.23641/asha.26487376.

Purpose: The production of speech-like sequences composed of varying syllables has been reported to achieve higher syllable rates than the production of repeated syllables (commonly designed as sequential motion rate [SMR] and alternating motion rate [AMR] tasks, respectively). The faster rate for SMR relative to AMR sequences is explained by different interpretative hypotheses, which remain empirically unexplored. In the present study, we aimed to investigate whether the high syllable rates of SMR sequences are due to the specific sequences used in most studies that involve front-to-back articulatory movements.

Method: Syllable rates of SMR sequences composed of different articulatory trajectories (i.e., labial-alveolar-velar [/pateko/], alveolar-velar-labial [/tekopa/], and velar-labial-alveolar [/kopate/]) were compared with those of the AMR sequences /papapa/, /tetete/, and /kokoko/ in 20 participants.

Results: The results show higher syllable rates for each of the three SMR sequences as compared to AMR, suggesting that the trajectory of the articulatory movements in the sequential sequences is not the key to achieving higher syllable rates.

Conclusion: The syllable rate advantage for SMR over AMR sequences is not explained by the articulatory trajectories included in the former task, indicating that the front-to-back movements generally included in SMR sequences (i.e., /pataka/) are not decisive in achieving a higher syllable rate.

Purpose: Listening effort is a broad construct, and there is no consensus on how to subdivide listening effort into dimensions. This project focuses on the subjective experience of effortful listening and tests if cognitive workload, mental fatigue, and mood are interrelated dimensions.

Method: Two online studies tested young adults (n = 74 and n = 195) and measured subjective workload, fatigue (subscales of fatigue and energy), and mood (subscales of positive and negative mood) before and after a challenging listening task. In the listening effort task, participants responded to intermittent 1-kHz target tones in continuous white noise for approximately 12 min.

Results: Correlations and principal component analysis showed that fatigue and mood were distinct but interrelated constructs that weakly correlated with workload. Effortful listening provoked increased fatigue and decreased energy and positive mood yet did not influence negative mood or workload.

Conclusions: The findings suggest that self-reported listening effort has multiple dimensions that can have different responses to the same effortful listening episode. The results can help guide evidence-based development of clinical listening effort tests and may reveal mechanisms for how listening effort relates to quality of life in those with hearing impairment.

Supplemental material: https://doi.org/10.23641/asha.26418976.

Purpose: Communication can be chronically impacted by severe traumatic brain injury (TBI), yet there is a critical lack of research investigating communication recovery beyond 12 months postinjury with discourse measures. This longitudinal study aimed to investigate quantitative and qualitative changes in important event recounts produced by a group of people with severe TBI up to 2 years postinjury.

Method: A prospective observational design with an inception cohort was adopted. Thirty-four participants with severe TBI were asked to produce an important event recount at 6, 12, and 24 months postinjury. A mixed-methods approach comprised a quantitative analysis of microlinguistic and macrostructural measures, using the automated discourse command EVAL in Computerized Language Analysis (CLAN) and the CLAN Collaborative Commentary tool, respectively. Statistical analysis included a repeated-measures analysis of variance and the Friedman test. An independent qualitative content analysis was also conducted.

Results: The measures revealed significant differences between 6 and 24 months, indicating a protracted recovery trajectory. The microlinguistic analysis showed increased use of revision and repetition over time. The macrostructural analysis indicated changes with orientation to recount characters, evaluative comments, and the number of events or complexity of the recount. The content analysis revealed categories of (a) childhood events, (b) family and relationships, (c) career and education, and (d) grief and loss. Topics at 6 months focused on childhood events and holidays, whereas career and education predominated at 24 months.

Conclusions: This is the first study to explore important event recounts told by people with severe TBI as they recovered. Participants showed discourse recovery beyond 12 months, highlighting the need for equivalent timing of service provision. The important event recount shows good potential as an ecologically valid assessment tool to evaluate communication recovery that can also be integrated with advances in computerized analysis. Analyses additionally provided insights into potential therapy targets and content categories for chronic discourse impairments.

Supplemental material: https://doi.org/10.23641/asha.26499271.

Purpose: The purpose of the current study was to assess dual-task interference (i.e., changes between the dual-task and baseline condition) in a listening effort dual-task paradigm in normal-hearing (NH) adults, hearing aid (HA) users, and cochlear implant (CI) users.

Method: Three groups of 31 participants were included: (a) NH adults, (b) HA users, and (c) CI users. The dual-task paradigm consisted of a primary speech understanding task in a quiet condition, and a favorable and unfavorable noise condition, and a secondary visual memory task. Dual-task interference was calculated for both tasks, and participants were classified based on their patterns of interference. Descriptive analyses were established and differences between the three groups were examined.

Results: The descriptive results showed varying patterns of dual-task interference between the three listening conditions. Most participants showed the pattern of visual memory interference (i.e., worse results for the secondary task in the dual-task condition and no difference for the primary task) in the quiet condition, whereas the pattern of speech understanding priority trade-off (i.e., worse results for the secondary task in the dual-task condition and better results for the primary task) was most prominent in the unfavorable noise condition. Particularly, in HA and CI users, this shift was seen. However, the patterns of dual-task interference were not statistically different between the three groups.

Conclusions: Results of this study may provide additional insight into the interpretation of dual-task paradigms for measuring listening effort in diverse participant groups. It highlights the importance of considering both the primary and secondary tasks for accurate interpretation of results.

Supplemental material: https://doi.org/10.23641/asha.26409088.