Journal of speech and hearing research最新文献

Distortion product otoacoustic emissions (DPOAEs) measured from the ear canal can be a sensitive tool to detect changes in cochlear function over time. However, if multiple-measurement procedures are to be useful clinically, testing needs to be reliable and sources of variability within individuals should be known. Herein, the influence of time-of-day (TOD), stimulus frequency, stimulus sound pressure level (SPL), and gender were evaluated on 2f1-f2 DPOAE amplitude in 16 adult volunteers with normal hearing. The effects of oral temperature and resting-pulse rate were also assessed. This study demonstrated a TOD main effect, with a period approximating one cycle-per-day. The magnitude of this effect averaged less than one dB and was not dependent on stimulus (frequency or SPL) or participant variables (gender, oral temperature, or resting-pulse rate), nor was it synchronized to a particular point-in-time. Stimulus level and gender effects on DPOAEs across frequency were also observed. Using generalizability theory (GT), DP iso-level/frequency profiles (DPILFPs) were found to be reliable measures within-subjects over a contiguous 24-hour time period. Significant and reliable between-subject differences were also documented. This study demonstrates the influence of stimulus and participant variables, quantifies the within-subject reliability over a 24-hour time period, and confirms that significant and reliable between-subject differences exist on DPOAEs across frequency, SPL, and gender.

The purpose of this article is to review the state of the art regarding treatment efficacy for stuttering in children, teenagers, and adults. Available evidence makes it apparent that individuals who stutter benefit from the services of speech-language pathologists, but it is also apparent that determining the outcome of stuttering treatment is neither easy nor simple. Whereas considerable research has documented the positive influence of treatment on stuttering frequency and behavior, far less attention has been paid to the effects of treatment on the daily life activities of people who stutter and their families. Although it seems reasonable to assume that ameliorating the disability of stuttering lessens the handicap of stuttering, considerably more evidence is needed to confirm this assumption. Despite such concerns, it also seems reasonable to suggest that the outcomes of treatment for many people who stutter are positive and should become increasingly so with advances in applied as well as basic research.

The dysarthrias form a group of diverse, chronic motor speech disorders. The disorders of Parkinson's disease, stroke, traumatic brain injury, amyotrophic lateral sclerosis, and cerebral palsy are reviewed because they represent important clinical diagnoses in which dysarthria is a frequent and debilitating symptom. The roles played by speech-language pathologists include participation in differential diagnosis, provision of speech treatment, staging of treatment, and timely education so that clients and families can make informed decisions about communication alternatives. Both scientific and clinical evidence is presented that suggests that individuals with dysarthria benefit from the services of speech-language pathologists. Group-treatment studies, single-subject studies, and case reports illustrate the effectiveness of various types of speech treatment. Research into the effectiveness of augmentative and alternative communication systems for individuals with cerebral palsy is also presented.

Eight preschoolers with word-finding (WF) deficits and 16 controls with normal word-finding abilities (8 preschoolers and 8 adults) named 40 pictured objects under primed and unprimed conditions. Each picture could be correctly labeled with a simple noun or a compound (e.g., cane or walking stick). The primed condition involved semantic primes for both the simple and compound targets as well as a partial lexical prime for the compound targets. All participant groups decreased naming errors when given the primes. Two results indicated that the participants made use of the lexical primes. The first was a shift in form of correct responses from simple nouns in the unprimed condition to compound nouns in the primed condition. The second was an increase in errors that incorporated the lexical prime in the primed condition. There were limits to the benefit that the WF group derived from the primes. First, the primes did not enable the WF group to compensate fully for their naming problems. The gap between the error rates of the WF group and the control groups was not reduced in the primed condition. Second, the quality of errors made by the WF group did not improve in response to primes. Compared to the controls, the WF group made proportionately more errors that indicated no access to the target neighborhood (particularly "I don't know" responses) in the unprimed condition. With primes, the controls further reduced their use of these errors, but the WF group did not. When members of the control groups did make errors, they were more likely than the WF children to produce a word substitution that bore a close semantic, visual, or phonological relation to the target in both unprimed and primed conditions. These limitations on the benefit of priming for participants in the WF group suggest deficiencies in size, elaboration, or organization of their lexicons.

Twenty elderly persons with hearing impairment were fit with binaural in-the-ear hearing aids and followed for a 6-month period post-fit. Several hearing-aid outcome measures were obtained at 0, 7, 15, 30, 60, 90, and 180 days post-fit. Outcome measures included (a) objective measures of benefit obtained with nonsense-syllable materials in quiet (CUNY Nonsense Syllable Test, NST) and sentences in multitalker babble (Hearing in Noise Test, HINT); (b) two subjective measures of benefit, one derived from pre-fit/post-fit comparisons on a general scale of hearing handicap (Hearing Handicap Inventory for the Elderly, HHIE) and the other based on a subjective scale of post-fit hearing-aid benefit (Hearing Aid Performance Inventory, HAPI); (c) a questionnaire on hearing-aid satisfaction; (d) an objective measure of hearing-aid use; and (e) a subjective measure of hearing-aid use. Reliability and stability of each measure were examined through repeated-measures analyses of variance, a series of test-retest correlations, and, where possible, scatterplots of the scores against their corresponding 95% critical differences. Many of the measures were found to be both reliable and stable indicators of hearing-aid outcome.

To further investigate the effects that argument structure can have on language processing, reaction-time (RT) and event-related potential (ERP) data were collected for 14 younger subjects (M = 23 years) and 13 older subjects (M = 66 years). A cross-modal lexical decision (CMLD) task, involving online processing of high- and low-complexity verbs embedded in sentences, was used. Results of a baseline nonlinguistic visual ERP task indicated that the older group of subjects demonstrated significantly longer P300 latencies and significantly lower P300 amplitudes than the younger subjects. In the sentence task, younger subjects exhibited significantly higher P300 amplitudes when processing high- versus low-complexity verbs, with a similar pattern noted for the older subjects. P300 latencies were significantly shorter for the older group than the younger group. Neither P300 latencies nor RTs were significantly related to verb complexity, although medium to large effect sizes were present. Overall, these findings support earlier notions of argument structure effects.

The effects of single-band amplitude compression on the use by subjects with normal hearing of temporal speech information were assessed using speech stimuli that had been processed to remove most spectral information before being compressed. The resulting signal-related-noise (SRN) stimuli isolated the effects of compression on the temporal information in speech by making it impossible for subjects to identify stimulus items on the basis of spectral speech information. Subjects with normal hearing listened to /aCa/ SRN disyllables that had been subjected to single-band compression at various combinations of compression ratio (CR) and time constants (TC). Performance was reduced only in the most severe compression condition (CR = 8; TC = 50), and then only slightly. Additional testing showed that subjects could use both periodicity and compression-overshoot artifactual information--in addition to envelope information--to identify the compressed /aCa/ stimuli. When a list of 10 context-controlled sentences was converted to SRN and compressed at CR = 8 and TC = 50, the ability of subjects with normal hearing to identify the sentences was significantly affected. Results established that (a) subjects with normal hearing differ widely in their abilities to use temporal information for speech identification, even after training; (b) subjects can learn to use both temporal envelope and periodicity information for identification if disyllables, even though; (c) subjects with normal hearing need envelope but not periodicity information to identify SRN sentences in a closed set. These results suggest that single-band compression at CR = 8 and TC = 50 would be undesirable for persons with limited ability to resolve speech spectral information. It is currently not known how less severe compression conditions would affect envelope information in sentences.

Among children who stutter, more will be identified with articulation/phonological deficiencies than among normally fluent children of the same ages. Most current literature has focused on phonological differences between those children who stutter and those who do not. The present study examines early phonological differences between young children whose stuttering persisted and those who recovered from early stuttering. Thirty-six children, 12 whose stuttering persisted, 12 who recovered early, and 12 who recovered later, had been assessed by means of the Assessment of Phonological Processes--Revised (Hodson, 1986) soon after they were identified as exhibiting stuttering. After many months of longitudinal evaluation of their stuttering that led to their classification into the three groups, the early phonological assessments of these children were re-examined to identify differences. Overall mean percentage of error scores as well as error scores on specific phonological patterns showed that the persistent group differed significantly from normally fluent control subjects matched by age and sex. Scores of the two groups who recovered and their matched controls, however, did not differ significantly. Although poor phonological ability in the early stage of stuttering appears to be a contributing factor to the differentiation of persistence and recovery, the wide individual variations in scores within groups suggest that additional factors are necessary for reliable prediction.

Traumatic brain injuries (TBI) may result in a broad array of cognitive-communicative impairments. Cognitive-communicative impairments are the result of deficits in linguistic and nonlinguistic cognitive functions. The speech-language pathologist functions as a member of the multidisciplinary team of professionals that collaboratively assess and treat individuals with TBI. The role of the speech-language pathologist includes assessment of all aspects of communication, as well as the communicative implications of cognitive deficits, and swallowing; treatment planning and programming, as determined by the individual's stage of recovery; client and family training/counseling; and interdisciplinary consultation. The effectiveness of speech and language intervention for specific cognitive deficits (e.g., attention, memory, executive functions) as well as general issues of social-skills training and early intervention are illustrated by scientific and clinical evidence from group-treatment and single-subject studies as well as case studies.