Perspectives of the ASHA special interest groups最新文献

Purpose: This study investigated the relationship between acoustic measures and Google's Speech-to-Text inaccuracies in recognizing speech of children ages 4-9 years who speak African American English (AAE).

Methods: Audio recordings were collected from 11 AAE speaking children with speech stimuli targeting final plosive variations observed within the AAE dialect. Dialectal density was measured using the Diagnostic Evaluation of Language Variation Language Screener. Recordings were transcribed using Google's Speech-to-Text application (Google Voice) and inaccuracies were determined through comparison to researcher extracted transcriptions. Acoustic measures from vowels preceding final plosives (including vowel duration, fundamental frequency, average F ₁) were extracted using Praat and a custom MATLAB algorithm. Individual mixed-effects logistic regression models were conducted to analyze the relationships between acoustic measures and transcription accuracy (accurate vs. inaccurate) for voiced and voiceless plosives separately.

Results: There were no significant differences between inaccuracy rates for voiced and voiceless plosive productions, nor were acoustic measures predictive of speech-to-text inaccuracy. However, age and dialect density were significantly related to voiceless plosive accuracy.

Conclusions: The complexities of voice, motor and articulatory development within children can be characterized by acoustic measures. These measures inform acoustic algorithms created for speech technology. Research on acoustic measures in young child AAE speech, with considerations for dialect variability and age, will enhance speech recognition technology and clinical best practices.

Clinical scenario: Although speech therapy (ST) has been frequently studied in children, the efficacy of motor-phonetic ST in adults with repaired cleft lip and palate (CLP) is unclear.

Clinical question: How does articulation change over time for an adult with CLP engaged in motor-phonetic ST?

Study sources: This study describes articulation and motor-phonetic intervention in a 33-year-old, monolingual Spanish-speaking woman presenting with CLP and associated velopharyngeal insufficiency. Case history, initial evaluation, surgical intervention, and progress during ST are described with reference to current literature.

Results: Upon initial evaluation, the patient presented with speech characterized by pervasive compensatory articulation errors and moderate hypernasality. As such, the patient completed 22 sessions of ST and underwent palatal surgery (between ST Sessions 3 and 4). Follow-up data were collected 49 days following treatment. Progress in ST was tracked using percent consonants correct (PCC) on the targets /p, t, k, s/. All therapy targets were produced at baseline as glottal stops (0% PCC). Following surgery, PCC was 56% for /p/, 31% for /t/, and 0% for /s/. In Session 11, /k/ was introduced (PCC = 45%). At Session 22, PCC was 100% for /p/, 46% for /t/, 100% for /s/, and 70% for /k/. PCC values were maintained across all target phonemes at follow-up.

Conclusions: PCC improved following intervention, and gains were maintained at follow-up. Data suggest that a motor-phonetic approach may effectively address speech sound disorders in adults with CLP. Future research is needed to explore this intervention on a larger scale and compare to other approaches.

Purpose: Research in aphasiology is largely not accessible. Almost none of the articles published in the field's rich, over 150-year history are communicated in a way that is understandable to those who could benefit from them the most-individuals with aphasia and their loved ones. In this tutorial, we detail how researchers in any field of aphasiology can create aphasia-friendly research summaries of their scientific publications. This step-by-step guide in eight simple parts covers principles of aphasia-friendly written communication (e.g., use of plain language and supportive icons and images) and makes use of freely available resources. We also introduce a prototype tool-Article Friend-that automatically generates aphasia-friendly abstracts to jump-start this process for researchers; this preliminary tool serves as a proof of concept that creating accessible research can be an efficient, sustainable practice in the scientific publishing landscape.

Conclusions: The tutorial provides researchers with specific tools and examples to effectively and easily create aphasia-friendly summaries of their publications. Principles from our tutorial extend beyond aphasia and can apply to consumers affected by other communication and cognitive disorders, such as developmental language disorder, dementia, and traumatic brain injury. Making research available to patient stakeholders and their loved ones can empower them to access and understand the research they have contributed to, ultimately furthering increased community engagement and interchange between researchers, clinicians, consumers with aphasia, and policymakers.

Supplemental material: https://doi.org/10.23641/asha.28590227.

Purpose: There is existing and emerging evidence showing that people living with dementia may experience episodes of lucidity (EL) near the end of life. ELs involve a transient recovery of function that was presumably lost, often manifesting as a return of communication functions, demonstration of increased awareness of surroundings, and/or a return of daily living abilities. Given the centrality of communication to most definitions of EL, this scoping review seeks to assess the existing body of knowledge, describe the disciplines involved in research of EL, and formulate recommendations for SLPs working with people living with dementia near the end-of-life. Ultimately, we aim to guide future research and stimulate the development of clinical strategies for speech-language pathologists engaging in end-of-life care for this population.

Method: We conducted a systematic literature search and scoping review across five major databases using relevant terms such as "dementia," "end-of-life," and "lucidity," covering all records up to May 2023. Quantitative, qualitative, and mixed methods studies [focused on lucid episodes at end of life] were included.

Results: Of 5,780 articles that were independently screened for inclusion by two independent reviewers, 10 met criteria and were synthesized using narrative methods. Data extraction and quality assessment were independently performed by these reviewers. Among the selected studies, three were case reports, while the remaining seven employed qualitative assessments based on caregiver or informant reports. The majority of studies featured contributions from disciplines such as nursing, medicine, and psychology. All definitions and reports of lucidity involved aspects of verbal and nonverbal communication by the individuals living with dementia.

Conclusions: The scoping review of lucid episodes in people with severe dementia near the end of life represents a valuable synthesis of evidence at a time when research on this understudied phenomenon is growing. There is growing interest in unraveling the neurobiological and behavioral aspects of lucidity in dementia, with the ultimate aim of enhancing care for older adults. Given the fundamental role of communication in the definition of lucidity, speech-language pathologists are well-positioned to participate in this research and care continuum.

Purpose: The lack of appropriate assessments affects populations presumed to be most at risk for speech and language concerns, one of them being children with a history of preterm birth. This study aims to examine whether bias is present in the currently available tests for Black children under age three to examine potential cultural bias in the Communication and Symbolic Behavior Scales (CSBS) and the MacArthur Bates Communicative Inventory (CDI).

Method: This study uses data from the Early Development of NICU graduates' study (EDeN), a National Institutes of Health-funded, ongoing prospective, multicenter cohort investigation of very preterm (VPT) infants. A total of 54 (18 Black; 36 White) children born VPT were included in this study. The outcome measures were the Black and White children's CSBS cluster scores and their CDI: Words and Gestures (WG) scores. T-tests and a mixed model approach were used to compare the scores of the CSBS and CDI: WG based on matched pairs. Spearman rank correlation was used to examine the relationship between the CSBS and CDI: WG scores.

Results: There was no significant difference between CSBS scores of Black and White children. There were no significant differences between the Black and White children's total scores on the CDI: WG based on the parent responses. There was a weak correlation between the CSBS and the CDI: WG Gesture subtests scores for the total group and a moderate correlation for Black children.

Conclusion: The comparison of scores on the CSBS and the CDI: WG showed no significant difference between the Black and White children, indicating that there may not be evidence to support bias for the premature children in this study. The correlation between the gestural subtest of the CSBS and the CDI: WG showed that direct observation by clinicians was similar to the observations of the parents.

Purpose: The purpose of this article is to orient both clinicians and researchers to machine learning (ML) approaches as applied to the field of speech-language pathology. We first introduce key ML concepts and terminology and proceed to feature exemplar papers of recent work utilizing ML techniques in speech-language pathology. We also discuss the limitations, cautions, and challenges to the implementation of ML and related techniques in speech-language pathology.

Conclusions: Readers are introduced to broad ML concepts, including common ML tasks (e.g., classification, regression), and specific types of ML models (e.g., linear/logistic regression, random forest, support vector machines, neural networks). Key considerations for developing, evaluating, validating, and interpreting ML models are discussed. An application section reviews six exemplar published papers in the aphasiology literature that have utilized ML approaches. Lastly, limitations to the implementation of ML approaches are discussed, including issues of reliability, validity, bias, and explainability. We highlight emergent solutions and next steps to facilitate responsible and clinically meaningful use of ML approaches in speech-language pathology moving forward.

Clinical scenario: Exercise-induced laryngeal obstruction (EILO) consists of exertion-induced laryngeal adduction that constricts the airway and causes dyspnea. Respiratory retraining (i.e., therapy) with a speech-language pathologist (SLP) is the primary treatment for EILO, yet there is limited work describing typical treatment course in adolescents.

Clinical question: What are some clinical procedures and considerations for treating EILO in an adolescent?

Study sources: This study describes a clinical case of EILO in a 13-year-old female. Case history, self-reported outcomes, and laryngeal imaging findings are reported with reference to current EILO literature.

Primary results: A 13-year-old female presented to the clinic with a 2-year history of episodic dyspnea. Symptoms included inhalation difficulty, throat tightness, and biphasic stridor. Symptoms were triggered by physical exertion, the scents of cleaners, and high humidity. Symptom onset following trigger exposure was rapid and resolved quickly upon exercise cessation or trigger removal. Symptoms prevented participation in athletic activities and caused emotional distress. Laryngeal imaging revealed arytenoid twitching and paradoxical vocal fold motion upon inhalation. Laryngeal adduction upon inhalation ranged from partial to complete. Respiratory retraining with an SLP was recommended. Following three treatment sessions, the patient demonstrated proficiency with rescue breathing techniques and reported improved EILO symptoms. Posttherapy Dyspnea Index score reflected a 14-point improvement when compared with baseline. Diagnostic procedures, treatment course, and implications are discussed in detail.

Conclusion: This case supports previous study and describes both the nature of EILO and the implications for clinical practice.

Purpose: Developmental language disorder (DLD) is a lifelong condition associated with poorer outcomes than neurotypical peers, yet relatively little is known about long-term quality of life in DLD. This preliminary study adopts a neurodiversity-informed approach by exploring self-reported quality of life in an adolescent and young adult DLD sample, as well as linguistic and risk factors contributing to quality of life.

Method: Participants were five individuals with DLD aged 12-20 years (M = 15.60, SD = 3.05). I administered two self-report quality-of-life scales, a language assessment, an experimental morphosyntax task, and measures of risk factors. Data were analyzed descriptively.

Results: Participants generally reported positive views about their quality of life, although accessing accommodations and health services emerged as barriers. Relatively better grammaticality judgment performance appeared to be linked with poorer ratings of happiness and the ability to "be yourself." Nonverbal ability represented a potential risk factor, although there may be a stronger cumulative role for risk factors.

Conclusions: Participants with DLD reported relatively good quality of life. Exploratory findings suggest barriers to quality of life in some contexts, as well as roles for individual differences in language and risk factors. These descriptive findings should be examined in larger scale studies and may represent areas of consideration when clinicians address functional challenges that impact mental health and well-being in individuals with DLD.

Purpose: Previous research and clinical practice guidelines indicate that it is best practice to support bilingual children with communication disorders in both of their languages. However, there is a shortage of bilingual speech-language pathologists (SLPs) in the United States. Therefore, it is important to examine how SLPs with varying linguistic backgrounds serve their bilingual clients. This study investigated the language practices of SLPs during intervention with bilingual children and identified needed resources.

Method: This convergent mixed-methods study included a survey and semi-structured interviews, with interviewees sampled purposively based on survey responses. Quantitative analyses were examined alongside qualitative themes to address each research question.

Results: Overall, 21.5% of the bilingual clients described by survey respondents were reported to receive intervention in both of their languages. SLPs who shared both languages with their clients and had a professional level of proficiency were more likely to provide services in both languages and to engage in code-switching during sessions. Qualitative analysis revealed creative strategies that SLPs used to overcome their own linguistic limitations when they lacked skills in a client's heritage language. Although practices varied based on the SLP's linguistic background, respondents identified similar priorities, including more bilingual providers and access to training, multilingual materials, and interpreters.

Conclusion: This study contributes insights into how SLPs serve their bilingual clients and what resources are needed to improve services. Although this study focused on Massachusetts and had a small sample, the findings may apply to other states, and there may be benefits to addressing these questions at a state level to provide targeted advocacy, training, and resources.