Journal of Speech Language and Hearing Research最新文献

Purpose: Floating ball voice therapy (FBVT) is a voice-controlled virtual environment based on a common treatment component across multiple evidence-based therapies: improved vocal efficiency (target) via practicing voicing with modified resonance and airflow (ingredient). This study preliminarily tested FBVT's effects on outcomes and the potential for its novel variability metrics to predict individual patient generalization.

Method: Ten patients with nonphonotraumatic vocal hyperfunction (NPVH) practiced FBVT for 10 days. Outcomes were assessed by a vocal efficiency ratio, a validated NPVH index, the patient-reported Voice-Related Quality of Life (V-RQOL), and forced-choice auditory judgments of overall severity. Exploration in early practice (Day 1) was estimated by how the patient's two-dimensional variability (mean airflow and intensity) related to error (difference between the patient-produced and normative vocal efficiency ratio). Generalization from the game to spontaneous speech was evaluated using the validated NPVH index.

Results: Ten days of FBVT were associated with improved vocal efficiency (Cohen's d = 1.3), NPVH index (d = -1.1), V-RQOL total score (d = 0.9), and overall severity (odds ratio = 2.5). Patients who generalized on Day 10 exhibited airflow/intensity exploration that was more aligned with the error gradient on Day 1 (d = 0.6-1.2).

Conclusions: A relatively small dosage of FBVT (i.e., 10 practice sessions) was associated with multiple improved voice therapy outcomes. The FBVT variability metrics on Practice Day 1 demonstrated strong potential to predict which patients generalized to connected speech. Future work can more thoroughly evaluate effects on outcomes and characterizing the quality of vocal exploration with a larger patient population.

Supplemental material: https://doi.org/10.23641/asha.27040873.

Purpose: Word learning requires the creation of phonological and semantic representations and links in long-term memory. Phonological distance of a given word from the spoken language affects children's lexical-phonological representations and processing. The study investigates the role of the phonological distance of Modern Standard Arabic (StA) words from the child's Spoken Arabic (SpA) vernacular in word learning in Arabic diglossia. It also examines whether, given their vulnerable phonological skills, children with developmental language disorder (DLD) show a stronger impact of phonological distance on word learning than children with typical language development (TLD).

Method: One hundred children with TLD and DLD in kindergarten and in first grade (25 per group) were tested on comprehension and production word-learning probes manipulating phonological distance. Learning monosyllabic and disyllabic nonwords encoding only SpA phonemes was compared with the learning of parallel nonwords encoding one unique StA consonant each.

Results: Repeated-measures analyses of variance showed higher word learning scores in children with TLD on both probes and for both syllable lengths. Moreover, all children fared significantly lower, in both comprehension and production probes, when the target stimulus was phonologically distant from the spoken language. Finally, an interaction effect was observed on the production probes, revealing differences in the developmental dynamics of phonological distance effects between the groups: Phonological distance hindered word learning among children with TLD in kindergarten, but among children with DLD in the first grade.

Conclusions: The results support the role of phonological distance as a phonological complexity factor in word learning in Arabic diglossia. Furthermore, they show that the effect of phonological distance is complex and it interacts with modality, language aptitude, and grade level. The theoretical and clinical implications are discussed.

Purpose: Greater recognition of the impact of hearing loss on cognitive functions has led speech/hearing clinics to focus more on auditory memory outcomes. Typically evaluated by scoring participants' recall on a list of unrelated words after they have heard the list read out loud, this method implies pitch and timing variations across words. Here, we questioned whether these variations could impact performance differentially in one language or another.

Method: In a series of online studies evaluating auditory short-term memory in normally hearing adults, we examined how pitch patterns (Experiment 1), timing patterns (Experiment 2), and interactions between the two (Experiment 3) affected free recall of words, cued recall of forgotten words, and mental demand. Note that visual memory was never directly tested; written words were only used after auditory encoding in the cued recall part. Studies were administered in both French and English, always conducted with native listeners.

Result: Confirming prior work, grouping mechanisms facilitated free recall, but not cued recall (the latter being only affected by longer presentation time) or ratings of mental demand. Critically, grouping by pitch provided more benefit for French than for English listeners, while grouping by time was equally beneficial in both languages.

Conclusion: Pitch is more useful to French- than to English-speaking listeners for encoding spoken words in short-term memory, perhaps due to the syllable-based versus stress-based rhythms inherent to each language.

Supplemental material: https://doi.org/10.23641/asha.27048328.

Purpose: Understanding how older adults perceive and interpret emotional cues in speech prosody contributes to our knowledge of cognitive aging. This study provides a systematic review with meta-analysis to investigate the extent of the decline in affective prosody recognition (APR) among older adults in terms of overall and emotion-specific performance and explore potential moderators that may cause between-studies heterogeneity.

Method: The literature search encompassed five electronic databases, with a specific emphasis on studies comparing the APR performance of older adults with that of younger adults. This comparison was focused on basic emotions. Meta-regression analyses were executed to pinpoint potential moderators related to demographic and methodological characteristics.

Results: A total of 19 studies were included in the meta-analysis, involving 560 older adults with a mean age of 69.15 years and 751 younger adults with a mean age of 23.02 years. The findings indicated a substantial negative effect size (g = -1.21). Furthermore, the magnitude of aggregated effect sizes showed a distinct valence-related recognition pattern with positive prosody exhibiting smaller effect sizes. Language background and years of education were found to moderate the overall and emotion-specific (i.e., disgust and surprise) performance effect estimate, and age and gender significantly influenced the effect estimate of happiness.

Conclusions: The results confirmed a significant decline in APR ability among older adults compared to younger adults, but this decline was unbalanced across basic emotions. Language background and educational level emerged as significant factors influencing older adults' APR ability. Moreover, participants with a higher mean age exhibited notably poorer performance in recognizing happy prosody. These findings underscore the need to further investigate the neurobiological mechanisms for APR decline associated with aging.

Supplemental material: https://doi.org/10.23641/asha.26407888.

Purpose: Typically developing toddlers extract patterns from their input to add words to their spoken lexicons, yet some evidence suggests that late talkers leverage the statistical regularities of the ambient language differently than do peers. Using the extended statistical learning account, we sought to compare lexical-level statistical features of spoken vocabularies between late talkers and two typically developing comparison groups.

Method: MacArthur-Bates Communicative Developmental Inventories American English Words and Sentences (N = 1,636) were extracted from Wordbank, a database of CDIs. Inventories were divided into three groups: (a) a late talker group (n = 202); (b) a typically developing age-matched group (n = 1,238); and (c) a younger, typically developing group (n = 196) matched to the late talkers on expressive language. Neighborhood density and word frequency were calculated for each word produced by each participant and standardized to z scores. Mixed-effects models were used to evaluate group differences.

Results: The late talker and younger, language-matched groups' spoken vocabularies consist, on standardized average, of words from denser phonological neighborhoods and words higher in frequency of occurrence in parent-child speech, compared to older, typically developing toddlers.

Conclusions: These findings provide support for the extended statistical learning account. Late talkers appear to generally be extracting and using similar patterns from their language input as do younger toddlers with similar levels of expressive vocabulary. This suggests that late talkers may be following a delayed, not deviant, trajectory of expressive language growth.

Purpose: The purpose of this tutorial is to (a) provide an updated review of the literature pertaining to proposed early features of childhood apraxia of speech (CAS), (b) discuss the findings of recent treatment studies of infants and toddlers with suspected CAS (sCAS), and (c) present evidence-based strategies and tools that can be used for the identification of and intervention for infants and toddlers with sCAS or at high risk for the disorder.

Method: Since Davis and Velleman's (2000) seminal work on assessment and intervention in infants and toddlers with sCAS, limited research has guided clinicians in the complex task of identifying and treating early speech motor difficulties prior to a definitive diagnosis of CAS. Following the structure of Davis and Velleman, we explore the proposed early characteristics of CAS with reference to contemporary research. Next, we describe the limited treatment studies that have investigated intervention for infants and toddlers at risk of or suspected of having CAS. Finally, we present practical suggestions for integrating this knowledge into clinical practice.

Conclusions: Many of the originally proposed correlates of CAS in infants and toddlers now have research supporting their presence. However, questions remain about the developmental trajectory of the disorder. Although limited in number and restricted by lack of experimental control, emerging treatment studies can help guide clinicians in providing appropriate intervention to infants and toddlers with sCAS who need not wait for a definitive diagnosis to initiate intervention.

Purpose: The aim of this study was to describe changes in speech intelligibility and interrater and intrarater reliability of naive listeners' ratings of words produced by young children diagnosed with childhood apraxia of speech (CAS) over a period of motor-based intervention (dynamic temporal and tactile cueing [DTTC]).

Method: A total of 120 naive listeners (i.e., listeners without experience listening to children with speech and/or language impairments; age range: 18-45 years) orthographically transcribed single-word productions by five children (age range: 2;6-3;11 [years;months]) across three time points over an intervention period (baseline, post-treatment, maintenance). Changes in intelligibility and interrater and intrarater reliability were examined within and across time points.

Results: Speech intelligibility significantly increased in children with CAS over the course of treatment, and these gains were also maintained at 6 weeks posttreatment. There was poor-to-fair consistency between listeners (interrater reliability) and excellent consistency within listeners (intrarater reliability) in ratings of speech intelligibility within and across time points.

Conclusions: Motor-based intervention increases speech intelligibility following a period of DTTC treatment. Variability among naive listeners of speech intelligibility was also present, with intrarater reliability (within listeners) yielding greater consistency than interrater reliability (between listeners). The implications for including naive listeners as raters of speech intelligibility for research and clinical purposes are discussed.

Purpose: Advancements in genetic testing and analysis have allowed improved identification of the genetic basis of childhood apraxia of speech, a rare speech presentation. This study aimed to understand speech-language pathologists' (SLPs') consideration of incorporation of genetics in clinical practice using a theory-informed qualitative approach.

Method: Semistructured interviews were conducted with 12 pediatric SLPs using a behavior change theory (Theoretical Domains Framework [TDF]) within a case study describing a child with complex co-occurring features, including childhood apraxia of speech. Interviews focused on three stages of the patient journey (prereferral, referral, and postreferral). Interviews were analyzed to identify barriers and enablers to considering incorporation of genetics in current clinical practice. Barriers and enablers were grouped and mapped onto a contextually relevant TDF-coded analysis framework.

Results: Barriers were identified across several TDF domains, through all stages of the patient journey. Lack of confidence, relevance, and level of experience were most common prereferral, and connection to and awareness of genetics services and contextual factors were barriers in the referral stage. Perception of professional role, knowledge, and beliefs about effects on families were barriers postreferral. Associated enablers were also identified, including seeing value in genetic diagnosis, support from other health care professionals, supervision, and relationships with genetics services.

Conclusions: Results of this qualitative study highlight barriers and enablers to incorporating genetics into speech-language pathology clinical practice. These findings will assist in the development of theory-informed implementation strategies to support SLPs into the future.

Supplemental material: https://doi.org/10.23641/asha.24112800.

Background: Speech and language are interconnected systems, and language disorder often co-occurs with childhood apraxia of speech (CAS) and non-CAS speech sound disorders (SSDs). Potential trade-off effects between speech and language in connected speech in children without overt language disorder have been less explored.

Method: Story retell narratives from 24 children (aged 5;0-6;11 [years;months]) with CAS, non-CAS SSD, and typical development were analyzed in Systematic Analysis of Language Transcripts (SALT) regarding morphosyntactic complexity (mean length of C-unit in words [MLCU]), lexical diversity (moving-average type-token ratio [MATTR]), and linguistic accuracy (any linguistic error/bound morpheme omissions) and compared to 128 age-matched children from the SALT database. Linear and mixed-effects logistic regressions were performed with speech accuracy (percent phonemes correct [PPC]) and diagnostic group as predictors of the narrative variables.

Results: PPC predicted all narrative variables. Poorer PPC was associated with lower MLCU and MATTR as well as a higher likelihood of linguistic errors. Group differences were only observed for the error variables. Comparison to the SALT database indicated that 13 of 16 children with CAS and SSD showed a higher-than-expected proportion of linguistic errors, with a small proportion explained by individual speech errors only.

Conclusions: The high occurrence of linguistic errors, combined with the relationship between PPC and linguistic errors in children with CAS/SSD, suggests a trade-off between speech accuracy and language output. Longitudinal studies are needed to investigate whether children with SSDs without language disorder show more language difficulties over time as linguistic demands increase.