Listeners' perceptions of speech and language disorders

Using semantic differential scales with nine trait pairs, 445 adults rated five audio-taped speech samples, one depicting an individual without a disorder and four portraying communication disorders. Statistical analyses indicated that the no disorder sample was rated higher with respect to the trait of employability than were the articulation, voice, and language disorder conditions; and higher in self-esteem than the fluency, voice, and language disorders. In addition, there were differences among the disorders. Most notably, the language disordered condition was rated significantly lower in decisiveness and reliability and higher in stress level than all other conditions. Within-subject analyses indicated that the variables of age, gender, exposure to individuals with communication disorders, and urban versus rural residency did not affect ratings. These results support previous research indicating the existence of negative stereotypes toward individuals with communication disorders. In addition, they reveal differences in how various disorders were perceived. LEARNING OUTCOMES: Participants will be able to: (1) identify the different methods investigators have used to examine perceptions toward individuals with communicative disorder, (2) recognize that there are differences in how the various communicative disorders are perceived, and (3) discuss the need for public education in order to dispel stereotypes associated with communicative disorders.     

Genetic aspects of idiopathic speech and language disorders.

At the outset of this article, we posed the question of whether or not the current evidence from genetic studies of DLD and stuttering indicate that it would be fruitful to conduct studies aimed at determining the gene location for each of these disorders. As we pointed out, because these are behavioral development disorders, phenotypic variations and changes in characteristics through the life span pose problems when attempting to determine who is and is not affected. Further, because these disorders can be either idiopathic or secondary to a variety of causes, any genetic study must rule out or take account of cases secondary to other factors. Few studies conducted thus far have taken these problems into account, and the results must be considered tentative. Given these reservations, the results certainly point to a genetic component in both disorders, although the data collected thus far on DLD suggest a mendelian form of transmission. If further more intensive studies continue to support this model for DLD, linkage studies on this disorder are likely to be productive.     

Precursors to speech in infancy: the prediction of speech and language disorders.

During the canonical stage of infant babbling, infants produce well-formed syllables, often in reduplicated sequences such as "bababa." Although nearly all infants with normal hearing begin the canonical stage by 10 months of age, a few are delayed, and these infants may be of special interest. Recent studies indicate that late onset of canonical babbling may be a predictor of disorders. A simple screening procedure that focuses on canonical babbling was used to evaluate over 3400 infants at risk who were about 10 months of age. Among infants who showed late onset of canonical babbling, fewer than half had been previously diagnosed as having a significant medical problem that might have accounted for the delay. A follow-up study indicated that infants with delayed canonical babbling had smaller production vocabularies at 18, 24, and 30 months than did infants in the control group. The results suggest that late onset of canonical babbling, a factor that can be monitored effectively through an interview with a parent, can predict delay in the onset of speech production.     

Recent advances in laryngeal sensorimotor control for voice, speech and swallowing

PURPOSE OF REVIEW: This article reviews advances in knowledge on laryngeal sensorimotor control affecting the assessment, understanding, and treatment of laryngeal motor control disorders in voice, speech, and swallowing. Three topics are covered: new knowledge on laryngeal innervation and central nervous system control from basic research studies, the role of laryngeal sensation in normal swallowing and dysphagia in patients, and new approaches to the restoration of laryngeal motor control after recurrent laryngeal nerve disorders. RECENT FINDINGS: A significant advance this year was tracing the efferent pathways from the cortex to the brainstem in monkeys. This provided new information on subcortical and brainstem connections in the laryngeal efferent pathways. Laryngeal sensory feedback continued to receive attention, and the role of sensory feedback in the control of the pharyngeal phase of swallowing is now well established. Further developments in neuromotor monitoring of the recurrent laryngeal nerve during thyroidectomy were seen, and a large case series recommended that these techniques become standard practice for surgery for thyroid benign recurrence or malignancy. Finally, the first tissue engineering papers in the field of vocal fold tissue and nerve restoration were published this year, beginning an exciting new approach to restoration of laryngeal motor control. SUMMARY: Considerable attention has been given to laryngeal muscle physiology, denervation, and sensation in neurolaryngology. Relatively limited understanding is available regarding the central nervous system integrative control of laryngeal function for speech, respiration, and swallowing.     

A study of developmental speech and language disorders in twins.

Fifty-seven same-sex twin sets (32 monozygotic and 25 dizygotic) were examined for concordance of speech and language disorders. Results showed monozygotic twins to have higher concordance than dizygotic twins. In addition, monozygotic twins were more similar in the types of disorders they presented than dizygotic twins. Positive family histories for speech, language, and learning disorders were reported in the nuclear families of the twins.     

人工耳蜗植入患者术后言语康复效果的问卷评估

目的评价两种问卷式分级标准对人工耳蜗植入效果的直观评估效能。方法应用问卷式听觉行为分级标准和言语识别率分级标准分别评估人工耳蜗植入患者术后的言语感知能力和言语产生能力，并对患者的病程、术前助听器使用情况、植入时间、康复模式4个因素与康复效果之间的相关性进行统计学分析。结果人工耳蜗植入效果与患者的病程、植入时间的长短以及康复模式有关，而与术前助听器使用情况无关。结论听觉性行为分级标准及言语识别率分级标准能较客观地反映人工耳蜗植入患者术后听觉言语能力的真实水平。     

School-aged children with phonologic disorders: coexistence with other speech/language disorders

Subjects in grades 1-12 with phonologic disorders were identified and categorized into either Residual or Delayed groups. Group selection was based on a subject rating system of communicative defectiveness and number and type of phonologic errors. The subjects' performance was compared with that of normal individuals on a number of speech and language parameters. The results indicated that voice disorders, deficits in expressive language, and hearing problems occurred in persons exhibiting phonologic disorders with a higher frequency than in the normal individuals.     

Voice,speech, and swallowing outcomes in laser-treated laryngeal cancer

OBJECTIVE: To describe preliminary voice, speech, and swallowing outcomes in patients treated by endoscopic laser excision of laryngeal cancer with or without adjuvant radiation therapy. STUDY DESIGN: Retrospective review. METHODS: Seventeen surgically treated patients (five T2 glottic and 12 clinically staged T2 supraglottic squamous cell carcinomas) participated in the study. Self-ratings of voice (Voice Handicap Index) and swallowing (M. D. Anderson Dysphagia Inventory) were completed, as well as independent auditory-perceptual ratings of voice and speech recordings. RESULTS: Although no significant difference between Voice Handicap Index, M. D. Anderson Dysphagia Inventory, and listener ratings was identified based on tumor site and irradiation status, there was a trend toward poorer outcomes in patients who received adjuvant radiation therapy. Whereas the patients having supraglottic cancer tended to report better voice but poorer swallowing outcomes, the glottic cancer group displayed the opposite pattern. Severity on Voice Handicap Index correlated significantly with listener severity ratings of speech, suggesting that the patients' perception of their voice handicap was similar to the listeners' judgments of their speech severity. CONCLUSIONS: The results suggest the following trends: 1) Adjuvant radiation therapy was associated with poorer outcomes for voice, speech, and swallowing and may be associated with more impairment than surgery alone and 2) poorer outcomes on voice and swallowing were observed for the glottic and supraglottic cancer groups, respectively. To bolster these preliminary findings, additional outcomes studies in patients treated with conservation therapy are needed.     

The relationship between psychopathology and speech and language disorders in neurologic patients

Depression, anxiety, and conversion reaction are common in neurologic patients. These disorders can produce neurologic-like symptoms that either mask or intensify those produced by the neurologic disease. This paper reviews clinical and research findings relating psychopathology to the formation and remediation of speech and language disorders in neurologic patients. The need to consider the psychosocial and psychopathological aspects of neurologic communicative disorders, and the link between emotional and communicative processes, are emphasized. Diagnostic criteria for the identification of psychogenic communicative disorders are outlined.     

The perspectives of speech–language pathologists: Providing teletherapy to patients with speech,language and swallowing difficulties during a COVID-19 context

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has had a huge impact on every facet of life. This directly included the delivery of health care from allied health professionals such as speech–language pathologists (SLPs) in South Africa. Research has shown that there is limited research done locally on the impact of COVID-19 relating to stroke care. Consequently, this results in a lack of research on the provision of speech, language and swallowing intervention using teletherapy after a stroke from an SLP point of view.ObjectivesThe aim of this study was to explore the experiences of SLPs with regard to their use of teletherapy in a COVID-19 context when providing speech, language and swallowing intervention for patients after a stroke.MethodsThis study made use of a qualitative approach. An electronic questionnaire was sent to SLPs inviting them to participate in the study. Purposive sampling was used to recruit participants and thematic content analysis was used to analyse the open-ended qualitative questions.ResultsThe findings show that SLPs experienced a variety of facilitators and barriers to using teletherapy. Additionally, issues of access differ across the private and public sector SLPs for both the clients and the SLPs.ConclusionThe current study provided research in the field of teletherapy, which is relatively new in the South African context. The study, whilst small in scale, provided some insight into the changes experienced from the shift to teletherapy.     

人工耳蜗植入儿童言语语言康复效果跟踪评估

目的 通过对615例人工耳蜗植入儿童的言语语言康复效果进行跟踪评估,探讨康复教育方案的有效性及听力障碍儿童言语语言发展规律.方法 评估使用中国聋儿康复系统通用的听力障碍儿童语言能力评估标准及方法,采用三因素重复测量实验设计,选择性别、植入年龄和康复时间作为自变量,因变量为言语语言能力评估结果.结果 听力障碍儿童言语语言...     

Surgical rehabilitation of neuromuscular swallowing disorders with special regard to cricopharyngeal myotomy and glottopexy]

Surgical Rehabilitation of Neuromuscular Swallowing Disorders with Special Regard to Cricopharyngeal Myotomy and Glottopexy. BACKGROUND: The surgical rehabilitation of patients with swallowing disorders caused by neuromuscular insufficiency with life-threatening aspiration presents a special challenge to the ENT-surgeon. METHODS: In a period of 5 years we decided on a surgical treatment in altogether 12 patients with paralytical dysphagia. In 6 patients we combined a cricopharyngeal myotomy with a complete closure of the glottis, in 5 patients we performed a sole cricopharyngeal myotomy. In another patient we restricted ourselves to glottopexy only. RESULTS: In all cases the dysphagia giving rise to the surgical intervention was regredient so far that the removal of the percutan endoscopic gastrostomy postsurgically was possible. 3 special cases are presented in detail. DISCUSSION: The main part of the therapy is the subtle and complete cricopharyngeal myotomy. Particulary good results are available with a combination of the latter with a reversible glottopexy. CONCLUSIONS: After the failure of conservative therapy the indication for a surgical treatment should be made on a large scale.     

Indications for tracheoesophageal puncture speech rehabilitation

Many methods of speech rehabilitation after total laryngectomy have been attempted and abandoned. As experience increased with the tracheoesophageal puncture technique, we found it to be a reliable and reproducible form of speech rehabilitation when certain criteria are met. This study reviews our experience and analyzes the reasons for failure in those populations. Factors analyzed include the evidence of hypopharyngeal stenosis, patient education, XRF, and the flanged prosthesis versus the nonflanged prosthesis. The indications for this type of speech rehabilitation procedure are presented based on our findings.     

Salivary gland dysfunction and swallowing disorders

We have reviewed the functions of salivary secretions and the major role that saliva plays in maintaining oral homeostasis by protection, repair, and lubrication as well as in the initial phase of digestion. Diseases affecting the salivary glands per se as well as systemic diseases that may alter salivary function were discussed, as were treatments of diseases that may disrupt normal salivary function. Simple yet reliable methods of evaluating salivary function to validate subjective complaints were presented.     

Concomitant speech and language disorders in stuttering children: a critique of the literature

This article presents a critical review of the literature concerning concomitant speech and language disorders in stuttering children. Studies published since the 1920s that examined language onset and disorders of articulation, syntax and morphology, semantics, and word finding are analyzed. Collectively, the studies present a mixed impression of stutterers, not only because of methodological variations, but also because of the tremendous variability that exists among children who stutter. Although the evidence is not convincing that stutterers as a group are more likely than nonstutterers to have deficits in any of these areas, it is clear that some stutterers do have concomitant speech and language problems that may bear some relationship to their stuttering. The message from this body of research is that individual differences among stuttering children should not be ignored during clinical or research activities.