Journal of Speech Language and Hearing Research最新文献

Objective: The objective of this study was to examine the relationship between laryngeal aerodynamics, acoustics, and hypernasality in children with cleft palate with or without lip (CP ± L).

Method: This study used a prospectively performed cross-sectional design. Fifty-six children between the ages of 6 and 17 years with CP ± L participated (M_age= 11.7, SD = 3.4; male = 32, female = 24). Children were separated into four groups based on auditory-perceptual ratings of hypernasality made using the Cleft Audit Protocol for Speech-Augmented-Americleft Modification protocol. Laryngeal aerodynamic measures including subglottal pressure, transglottal airflow, laryngeal aerodynamic resistance (LAR), and phonation threshold pressure were collected. Acoustic measures of smoothed cepstral peak prominence (CPP) and low-to-high ratio on sustained vowels and connected speech were also considered. Analyses controlled for age, sex, auditory-perceptual ratings of voice quality, and speech intelligibility.

Results: Children with minimally or mildly hypernasal resonance demonstrated significantly increased subglottal pressure, reduced transglottal airflow, and increased LAR, when compared with children with balanced or moderately hypernasal resonance. CPP on sustained vowel was significantly lower for children with moderate hypernasality when compared with all other groups-suggesting poorer voice quality. Other acoustic measures were in or near normative pediatric range.

Conclusions: Children with CP ± L and minimal or mildly hypernasal resonance demonstrated aerodynamic voice measures indicative of vocal hyperfunction. These findings suggest that children with CP ± L may compensate for velopharyngeal dysfunction on a laryngeal level, thus increasing the risk of laryngeal pathology. Future study should explore the relationship between laryngeal function and velopharyngeal port closure and consider how voice problems can be prevented or mitigated in children with CP ± L.

Purpose: This study primarily aimed at observing whether high-frequency vibration devices generate tissue mobilization on facial, neck, and chest tissues. An additional objective was to inspect resulting self-perceived sensation of massage-like sensation.

Method: Fifty-two participants engaged in a set of three phonatory tasks: (a) phonation with Shaker Medic Plus device, (b) phonation with Acapella Choice device, and (c) sustained vowel [a:] (control task). Self-perceived massage-like sensation was also assessed. All exercises were performed at three loudness levels. Tissue mobilization was captured by four accelerometers placed in four different locations: (a) over the cheek, (b) over the neck, (c) over the thyroid cartilage, and (d) over the suprasternal notch. Frequency, amplitude, and regularity of tissue oscillation were measured.

Results: Analyses of variance showed significant second-order interactions for vibration amplitude and frequency. A two-way interaction (Task × Location) was observed for jitter, and no significant interactions were found for shimmer. Self-perceived massage-like sensation results showed that Acapella and Shaker generate almost identical effects, both being significantly higher to the one delivered by vowel [a:].

Conclusion: Both Acapella and Shaker devices are able to mobilize tissues. Tasks, loudness level, and location could produce an effect on tissue oscillation variables. The Acapella device tends to produce a larger amplitude of vibration than the Shaker does. However, self-reported sensation of massage is virtually the same for both devices. Control of dependent variables of tissue oscillation (frequency, amplitude, and regularity) is apparently relevant to obtain the greatest massage-like effect in patients.

Purpose: Hearing loss is the third most prevalent chronic health condition among adults in the United States. Rural adults face disproportionately high rates of hearing loss and numerous systemic barriers to hearing health care (HHC). This study aims to explore experiences of hearing loss, identify factors that impact access, and assess the potential acceptability of a patient navigation program. Perspectives of patients experiencing hearing loss and rural health care providers are vital for designing an intervention that addresses barriers to HHC experienced in rural settings.

Method: As the first phase of a larger project guided by the PRECEDE-PROCEED planning model, a qualitative needs assessment was conducted using semistructured interviews with 21 adult primary care patients with hearing loss and 11 health care personnel from primary care clinics in rural Kentucky. Thematic analysis identified predisposing, enabling, and need factors perceived as influencing whether HHC is accessed by rural adults with hearing loss.

Results: Analyses revealed that patients accessing HHC was perceived to be affected by predisposing (concerns about noise exposure and attitudes about HHC), enabling (connection to HHC and resources, lack of local HHC services, communication challenges, transportation challenges, and cost of care), and need factors (experience with hearing loss). Participants agreed that a patient navigator (PN) could increase access to HHC by providing social support and by connecting patients to education and resources.

Conclusions: Results from this analysis will inform the development of a patient navigation intervention for HHC for rural adults. PNs will receive specialized training to help patients meet stated needs and overcome commonly reported barriers.

Supplemental material: https://doi.org/10.23641/asha.28620104.

Purpose: The purpose of this work is to examine whether therapy-related improvements in trained versus untrained items (acquisition and response generalization, respectively) are differentially affected by phonological versus semantic language treatments and to investigate individual variables associated with treatment response.

Method: Sixty-three participants with chronic poststroke aphasia were included in this retrospective analysis of data from a large, multisite clinical trial with an unblinded cross-over design in which all participants underwent 3 weeks of semantic treatment and 3 weeks of phonological treatment. A linear mixed-effects model was used to examine treatment acquisition and generalization effects for the two treatment types. Multiple regression analyses were also conducted to examine individual participant factors associated with acquisition compared to generalization.

Results: Results showed main effects of outcome type (acquisition vs. response generalization) and treatment type (semantic vs. phonological) on posttreatment changes in naming and an interaction between these factors: For acquisition, phonological treatment resulted in better gains than semantic treatment, whereas for response generalization, semantic treatment resulted in slightly better gains than phonological treatment. There were no significant associates of generalization gains. However, acquisition after phonological treatment was associated with less severe aphasia and higher nonverbal semantic processing abilities at baseline, whereas acquisition after semantic treatment was associated with apraxia of speech.

Conclusions: On average, phonological treatment may be more effective for acquiring trained items, whereas semantic treatment may be more effective for response generalization to untrained items. Moreover, acquisition gains are associated with individual baseline variables. These findings could have clinical implications for treatment planning.

Supplemental material: https://doi.org/10.23641/asha.28410212.

Purpose: Aberrant speech rhythm has previously been identified as a hallmark of stuttering. However, evidence of dysrhythmic speech in adults who stutter (AWS) has largely been limited to qualitative research. Here, we conduct a quantitative analysis of speech rhythm in AWS and adults who do not stutter (AWNS). We also investigate potential differences in speech rhythm as a likely marker of articulatory stability in speech preceding moments of stuttering-like disfluency versus not preceding moments of stuttering-like disfluency. We hope to establish rhythm of speech as a supplementary diagnostic criterion for the assessment of stuttering.

Method: Rhythm metrics were computed for speech produced by 16 self-identified AWS and 16 AWNS. Speech was recorded in reading and spontaneous speaking tasks. Following previous literature, we hypothesized that the nonstuttered utterances of AWS would be less rhythmic than those of AWNS. Furthermore, it was expected that speech rhythm would be disrupted immediately preceding the production of stuttering-like disfluency in AWS. We conducted statistical tests to determine differences in speech rhythm metrics between participant groups (i.e., AWS and AWNS) and utterance types (i.e., preceding stuttering-like disfluency and not preceding stuttering-like disfluency).

Results: Multiple metrics revealed reduced speech rhythmicity in AWS compared to AWNS for both nonstuttered oral reading and spontaneous speech tasks. Furthermore, speech rhythmicity in AWS was significantly reduced immediately preceding stuttering-like disfluency compared to not preceding stuttering-like disfluency in both the reading and spontaneous speech tasks.

Conclusions: We present quantitative evidence of reduced speech rhythm as a characteristic of developmental stuttering. AWS exhibited relatively less rhythmic speech overall and particularly immediately preceding a stuttering-like disfluency. This reduction in the temporal stability of speech may be interpreted as a sign of imminent breakdown in articulatory coordination. The potential significance of rhythm metrics to speech science and clinical diagnostics is discussed.

Purpose: Assessing social communication and measuring its changes among young autistic children presents significant challenges, particularly when tracking intervention effects within short timeframes. Existing measures, mostly validated in Western contexts, may not be suitable for culturally diverse populations. Addressing this gap, the Social Communication Scale (SCS) was developed to provide a culturally accessible and reliable measure for the Chinese population. This study explores the psychometric properties of the SCS and its ability to capture intervention-induced changes.

Method: Fifty-two autistic children aged 2-5 years were recruited from China. One parent per family participated in a 20-week support program aimed at enhancing parents' communication strategies to prompt social communication with their children at home. The SCS was administered before and after the program.

Results: The SCS exhibited outstanding overall interrater reliability (ICC = .91) and convergent validity with established measures, including the Autism Diagnostic Observation Schedule-Second Edition, the Communication subdomain of the Mullen Scales of Early Learning, and the Vineland Adaptive Behavior Scales-Third Edition. Notably, the SCS effectively captured subtle changes during the 20-week intervention.

Conclusions: As the first social communication scale developed for Chinese autistic preschoolers, the SCS proves to be a reliable and valid measure. This addresses unique challenges in autism assessment and intervention in China. To strengthen its broader applicability, future research should prioritize validating the SCS with larger and more diverse samples across various regions, contributing to a comprehensive understanding of its value and limitations.

Supplemental material: https://doi.org/10.23641/asha.28569035.

Purpose: Some bilinguals may exhibit lower performance when recognizing speech in noise (SiN) in their second language (L2) compared to monolinguals in their first language. Poorer performance has been found mostly for late bilinguals (L2 acquired after childhood) listening to sentences containing linguistic context and less so for simultaneous/early bilinguals (L2 acquired during childhood) and when testing context-free stimuli. However, most previous studies tested younger participants, meaning little is known about interactions with age; the purpose of this study was to address this gap.

Method: Context-free SiN understanding was measured via the Modified Rhyme Test (MRT) in 3,803 young and middle-aged bilingual and monolingual adults (ages 18-57 years; 19.6% bilinguals, all L2 English) with normal to near-normal hearing. Bilingual adults included simultaneous (n = 462), early (n = 185), and late (n = 97) bilinguals. Performance on the MRT was measured with both accuracy and response time. A self-reported measure of current English use was also collected for bilinguals to evaluate its impact on MRT performance.

Results: Current age impacted MRT accuracy scores differently for each listener group. Relative to monolinguals, simultaneous and early bilinguals showed decreased performance with older age. Response times slowed with increasing current age at similar rates for all groups, despite faster overall response times for monolinguals. Among all bilingual listeners, greater current English language use predicted higher MRT accuracy. For simultaneous bilinguals, greater English use was associated with faster response times.

Conclusions: SiN outcomes in bilingual adults are impacted by age at time of testing and by fixed features of their language history (i.e., age of acquisition) as well as language practices, which can shift over time (i.e., current language use). Results support routine querying of language history and use in the audiology clinic.

Supplemental material: https://doi.org/10.23641/asha.28405430.

Purpose: When words are misperceived, listeners can rely on later context to repair an auditory perception, at the cost of increased effort. The current study examines whether the effort to repair a missing word in a sentence is alleviated when the listener has some advance knowledge of what to expect in the sentence.

Method: Sixteen adults with hearing aids and 17 with typical hearing heard sentences with a missing word that was followed by context sufficient to infer what the word was. They repeated the sentences with the missing words repaired. Sentences were preceded by visual text on the screen showing either "XXXX" (unprimed) or a priming word previewing the word that would be masked in the auditory signal. Along with intelligibility measures, pupillometry was used as an index of listening effort over the course of each trial to measure how priming influenced the effort needed to mentally repair a missing word.

Results: When listeners were primed for the word that would need to be repaired in an upcoming sentence, listening effort was reduced, as indicated by pupil size returning more quickly toward baseline after the sentence was heard. Priming reduced the lingering cost of mental repair in both listener groups. For the group with hearing loss, priming also reduced the prevalence of errors on target words and words other than the target word in the sentence, suggesting that priming preserves the cognitive resources needed to process the whole sentence.

Conclusion: These results suggest that listeners with typical hearing and with hearing loss can benefit from priming (advance cueing) during speech recognition, to accurately repair speech and to process the speech less effortfully.

Purpose: This pilot study systematically compared voice symptomatology across varied sensory trick conditions in those with laryngeal dystonia (LD), those with essential vocal tremor (EVT), and vocally normal controls (NCs). Sensory tricks are considered signature characteristics of dystonia and were hypothesized to reduce voice symptoms in those with LD compared to EVT and NC groups.

Method: Five participants from each group (LD, EVT, and NC) completed speech recordings under control and sensory trick conditions (delayed auditory feedback [DAF], vibrotactile stimulation [VTS], and nasoendoscopic recordings with and without topical anesthesia). Comparisons between groups and conditions were made using (a) a paired-comparison paradigm (control vs. sensory condition) listener ratings of voice quality, (b) participant-perceived vocal effort ratings, and (c) average smoothed cepstral peak prominence (CPPS).

Results: Participants with EVT displayed significantly worse listener ratings under most sensory trick conditions, whereas participants with LD were rated significantly worse for DAF and VTS conditions only. However, participant vocal effort ratings were similar across all sensory trick conditions. Average CPPS values generally supported listener ratings across conditions and speakers except during DAF, wherein CPPS values increased (i.e., measurably improved voice quality), whereas listener ratings indicated worsened voice quality for both voice disorder groups.

Conclusions: Outcomes of this study did not support the hypothesized influences of sensory trick conditions on LD voice symptoms, with both LD and EVT groups experiencing worsened symptoms under VTS and DAF conditions. These adverse effects on voice symptoms warrant further research to further evaluate neural pathways and associated sensorimotor response patterns that distinguish individuals with LD and EVT.

Supplemental material: https://doi.org/10.23641/asha.28462292.

Purpose: Cognitive load and autonomic arousal are hypothesized to affect voice production, yet the nature of these relationships is unclear. The purpose of this study was to assess how cognitive load and autonomic arousal differentially affect voice production and vocal motor control.

Method: Physiological measures of autonomic arousal were recorded from 30 adults under different cognitive loads elicited by a Stroop task. In Experiment 1, voice acoustic measures were measured during speech production. In Experiment 2, fundamental frequency (f_o) responses to predictably altered auditory feedback (sensorimotor adaptation) were measured. Mixed linear-effects models assessed relationships between variables. Changes between cognitive loads were compared among the two experiments.

Results: In Experiment 1, increased cognitive load was associated with increases in sound pressure level, whereas increases in autonomic arousal measures (i.e., decreases in skin conductance rise time, pulse amplitude, and period) were related to decreases in cepstral peak prominence. Increased autonomic arousal (i.e., decreased pulse amplitude) was related to increased adaptation in Experiment 2. Participants who responded to increased cognitive load by decreasing f_o during Experiment 1 showed more adaptation in Experiment 2.

Conclusion: Differential effects of cognitive load and autonomic arousal emphasize the importance of individual physiological variability when assessing how stress affects the voice.