Residual /s/ and /r/ distortions: The perspective of the speaker

Abstract

The purpose of this study was to investigate the impact of residual distortions from the perspective of the speaker. Eighty adult speakers of Brazilian Portuguese with a distortion of the alveolar fricative /s/, the alveolar tap , or both, completed a questionnaire that documented their therapy history, awareness of the speech distortion, and perceived impact of the disorder. Only a small number of the participants reported that they received negative reactions to their speech and only a minority were of the opinion that their speech interfered with work or social life. Yet a considerable number were of the opinion that their speech was different from that of other people and felt insecure in speech situations. The results suggest that there is a high tolerance toward minor speech errors in present day society that may be related to the fact that such disorders are not at all rare.     

Cortical processing of degraded speech sounds: effects of distortion type and continuity

Human speech perception is highly resilient to acoustic distortions. In addition to distortions from external sound sources, degradation of the acoustic structure of the sound itself can substantially reduce the intelligibility of speech. The degradation of the internal structure of speech happens, for example, when the digital representation of the signal is impoverished by reducing its amplitude resolution. Further, the perception of speech is also influenced by whether the distortion is transient, coinciding with speech, or is heard continuously in the background. However, the complex effects of the acoustic structure and continuity of the distortion on the cortical processing of degraded speech are unclear. In the present magnetoencephalography study, we investigated how the cortical processing of degraded speech sounds as measured through the auditory N1m response is affected by variation of both the distortion type (internal, external) and the continuity of distortion (transient, continuous). We found that when the distortion was continuous, the N1m was significantly delayed, regardless of the type of distortion. The N1m amplitude, in turn, was affected only when speech sounds were degraded with transient internal distortion, which resulted in larger response amplitudes. The results suggest that external and internal distortions of speech result in divergent patterns of activity in the auditory cortex, and that the effects are modulated by the temporal continuity of the distortion.     

Teacher identification of speech and language impairment in kindergarten students using the Kindergarten Development Check

The purpose of this paper was to profile the extent and accuracy of teacher identification of speech and language impairment within a kindergarten student population in Tasmania, Australia, using the Kindergarten Development Check (KDC). A total of 286 kindergarten students (aged 4–5 years and in their first year of formal schooling) were screened by teachers with the KDC on two separate occasions over their kindergarten year. In the following academic year, each of the same 286 students were assessed by a speech-language pathologist, and diagnosed with either typically developing or impaired speech and/or language skills. Review of KDC data determined the number of students identified by teachers with speech and language impairment at each occasion during their kindergarten year. Comparison of data from the later KDC administration and speech-language pathology assessment then determined the correspondence between identification of speech and language impairment by teachers and speech-language pathologists. Upon initial administration of the KDC, 51 (17.8%) students were identified by teachers with language impairment and 47 (16.4%) students with speech impairment. Following the second administration of the KDC 3 months later, 20 (7.0%) students continued to be identified with language impairment, and 39 (13.6%) with speech impairment. Comparison of speech-language pathology testing results and KDC data from the second administration found the overall validity of teacher identification was 86.4% and 71% for speech and language impairment respectively. Specificity rates were high, with 93% and 97% of students with typically developing speech and language skills respectively, correctly classified on the KDC. However, the sensitivity was only 50% for speech impairment and 15% for language impairment, indicating that 50% of students presenting with speech impairment and 85% of students with language impairment in their subsequent academic year were not recorded by teachers as having such a difficulty on the later KDC administration during their kindergarten year. The KDC appears to be ineffective in supporting kindergarten teachers to identify students with ongoing speech and to a greater extent, language impairment. Measures to improve the sensitivity of the KDC in particular need to be considered by speech-language pathologists and educational professionals in Tasmania.     

成年功能性构音障碍患者的语音训练及临床特点分析

目的探讨成年功能性构音障碍（FAD）患者的临床特点与语音训练方法。 方法对37例成年FAD患者进行语音评估,分析其临床特点并进行针对性的语音训练。 结果37例成年FAD患者主要的构音错误类型为置换、歪曲,其次为脱落。构音错误方式有舌前音化（19例）、非送气化（11例）、侧化构音（10例）、舌后音化（7例）、辅音脱落（7例）、混合型（4例）、唇齿音化（3例）、舌面音化（2例）。经过1～5个疗程的语音训练,28例治愈,8例好转,1例无效,训练后的语音清晰度测定值［（91.22±10.10）%］较训练前［（56.03±14.71）%］提高,差异有统计学意义（P<0.05）。 结论成年FAD患者主要的构音错误类型是置换和歪曲,基于构音错误方式开展针对性语音训练是治疗成年FAD的有效措施。     

Speech distortion measures for hearing aids

Advances in digital technology and the associated introduction of new forms of distortion led us to investigate supplementary measures of electroacoustic distortion for hearing aids. Mathematical techniques were used to formulate a working model in which the hearing aid acts as a time varying linear filter. This model embodies an approach to separating distortion into perceptually relevant and irrelevant categories. Digitized speech was converted to analog form, routed through a commercial hearing aid, and the output of the aid was redigitized and stored. For a given input signal, output speech waveforms were then compared to the model output and performance measures were derived. Distortion was plotted in three dimensions to permit interpretation with respect to time, frequency, and amplitude. These results provide a more comprehensive and general format for the analysis of hearing aid distortion.     

Effects of synthetic speech output in the learning of graphic symbols of varied iconicity

PURPOSE: To examine the effects of additional auditory feedback from synthetic speech on the learning of high translucent symbols versus low translucent symbols. METHOD: Two adults with little or no functional speech and severe intellectual disabilities served as participants. A single-subject ABACA/ACABA design was used to study the relative effects of two treatments: symbol training in the presence and absence of synthetic speech output. RESULTS: The results clearly indicated that the two treatments, rather than extraneous variables were responsible for gains in the symbol learning. Both participants learned either more low translucent symbols or reached their maximum learning of low translucent symbols in the speech output condition. CONCLUSIONS: The results of this preliminary study replicate and extend the iconicity hypothesis to a new set of learning conditions involving speech output, and suggest that feedback from speech output may assist adults with profound intellectual disabilities in coding particularly those symbols whose association with their referent cannot be coded via their visual resemblance with the referent.     

Compression systems for hearing aids and cochlear prostheses

Audio and speech compression systems have suffered several characteristic deficiencies. Single-channel compression systems cannot compress wideband signals without suffering from either spectral distortion or the inability to respond quickly to fast transients. When the input signal contains noise in addition to the desired speech signal, single-channel systems unnecessarily attenuate speech information. Single-channel compressors cannot compress the input signal differentially as a function of frequency. Multichannel compressors are capable of different levels of compression as a function of frequency. However, standard multichannel compressors unnecessarily attenuate important information about the shape of the short-term speech spectrum. This has resulted in poorer speech perception when using standard multichannel systems as compared with single-channel compression systems. A more general form of multichannel compression can emphasize information about the shape of the short-term speech spectrum. Susceptibility to many forms of noise is also reduced with such multichannel systems. Spectral distortion and undesired rapid overshoots and undershoots of signal level, characteristic of many single- and multi-channel systems, can be substantially reduced with such systems.     

Effects of synthetic speech output in the learning of graphic symbols of varied iconicity

Purpose: To examine the effects of additional auditory feedback from synthetic speech on the learning of high translucent symbols versus low translucent symbols. Method: Two adults with little or no functional speech and severe intellectual disabilities served as participants. A single-subject ABACA/ACABA design was used to study the relative effects of two treatments: symbol training in the presence and absence of synthetic speech output. Results: The results clearly indicated that the two treatments, rather than extraneous variables were responsible for gains in the symbol learning. Both participants learned either more low translucent symbols or reached their maximum learning of low translucent symbols in the speech output condition. Conclusions: The results of this preliminary study replicate and extend the iconicity hypothesis to a new set of learning conditions involving speech output, and suggest that feedback from speech output may assist adults with profound intellectual disabilities in coding particularly those symbols whose association with their referent cannot be coded via their visual resemblance with the referent.     

Designed sound and music environment in postanaesthesia care units--a multicentre study of patients and staff.

A multicentre study in five postanaesthesia care units (PACUs) was performed to investigate patient and staff opinion of a specially designed music environment (DME), related to geographical location. Patients (325) and staff (91) described their opinion by means of a questionnaire-anonymously in the case of staff. Patients were not asked beforehand for permission to play music. Amongst patients 267 (83%) found the sound environment with DME pleasant or very pleasant, 26 (6%) found it unpleasant, whereas 32 (11%) answered "no opinion". The opinion of the patients did not differ significantly with geographical location. A strong correlation (P<0.05) between a positive attitude towards DME and degree of relaxation and satisfaction with stay was found. The staff had an equally positive attitude towards the DME; but theirs varied significantly with location. The opinion of the staff was more similar concerning the beneficial effect on working conditions and distress, but varied still significantly. The opinion of the staff had no demonstrable impact on that of the patients.     

Patient and carer preference for, and satisfaction with, specialist models of palliative care: a systematic literature review.

This systematic literature review examined the impact of specialist models of palliative care on consumer satisfaction, opinion and preference over the past 20 years. From the literature search, 83 relevant papers were identified. Research findings from North America did not reveal any reliable or consistent trends, and this was due primarily to methodological flaws in the research. In the UK, consumers are more satisfied with all types of palliative care, whether provided by inpatient units or in the community, than with palliative care provided by general hospitals. Even though research findings consistently indicate that consumers appreciate the psychosocial climate in hospices, this research was based on small-scale local studies which were mainly focused on a single hospice. The dearth of high quality, comprehensive research was notable on the impact on consumer preference, opinion or satisfaction of hospice home care services, and other forms of palliative care in the community. It was concluded that further research is needed into consumer priorities for patients dying of noncancer diseases, and into the possible impact of patient characteristics on consumer satisfaction, opinion and preference for specialist models of palliative care.     

The effectiveness of traditional methods and altered auditory feedback in improving speech rate and intelligibility in speakers with Parkinson's disease

Communication problems are a frequent symptom for people with Parkinson's disease (PD) which can have a significant impact on their quality-of-life. Deciding on the right management approach can be problematic though, as, with the exception of LSVT®, very few studies have been published demonstrating the effectiveness of treatment techniques. The aim of this study was to compare traditional rate reduction methods with altered auditory feedback (AAF) with respect to their effectiveness to reduce speech rate and improve intelligibility in speakers with PD. Ten participants underwent both types of treatments in once weekly sessions for 6 weeks. Outcomes measures were speech rate for passage reading as well as intelligibility on both a passage reading and a monologue task. The results showed that, as a group, there was no significant change in either speech rate or intelligibility resulting from either treatment type. However, individual speakers showed improvements in speech performance as a result of each therapy technique. In most cases, these benefits persisted for at least 6 months post-treatment. Possible reasons for the variable response to treatment, as well as issues to consider when planning to use AAF devices in treatment are discussed.     

Pulmonary tuberculosis in spontaneously diabetic goto kakizaki rats

As a clinical association is thought to exist between diabetes and tuberculosis, this study was set up to examine whether GK/Jcl diabetic rats are more susceptible to Mycobacterium tuberculosis infection than non-diabetic rats. GK/Jcl diabetic rats were infected aerially with M. tuberculosis and their capacity to control mycobacterial growth, granuloma formation, cytokine secretion by alveolar macrophages and nitric oxide (NO) production was examined. The rats developed large granulomas but not necrotic lesions in their lungs, liver or spleen. This is consistent with a significant increase in number of colony-forming units of M. tuberculosis in the lungs (p<0.01). Expression levels of interferon-gamma, tumor necrosis factor (TNF)-alpha and interleukin (IL)-12 mRNA were lower in GK/Jcl diabetic rats than those in control Wistar rats. Alveolar macrophages from GK/Jcl rats secreted less TNF-alpha and IL-12, and produced less NO compared with those from Wistar rats. No significant difference was observed between phagocytosis of tubercle bacilli by alveolar macrophages from GK/Jcl or Wistar rats. These data show that there is a close association between experimental tuberculosis and diabetes in animals, and that alveolar macrophages from GK/Jcl diabetic rats are not fully activated by M. tuberculosis infection.     

严重胸部创伤复合内毒素感染对肺泡与肺间质巨噬细胞吞噬功能的影响

目的 :观察正常大鼠肺泡与肺间质巨噬细胞吞噬功能的差异 ,比较两种细胞对严重胸部创伤、创伤复合内毒素感染的不同反应性。方法 :采用胸部撞击伤模型 ,造成动物严重胸部致伤 ;分离、纯化动物肺泡和肺间质巨噬细胞 ,检测两种细胞创伤前和创伤后 2、4、8、16和 2 4 h吞噬功能的动态变化。结果 :创伤早期 (2和 4 h)巨噬细胞吞噬功能增强 ,随后下降 ;肺泡巨噬细胞吞噬功能在创伤前后各时间点均显著强于间质巨噬细胞(P均 <0 .0 1) ;复合内毒素感染后 ,肺泡巨噬细胞吞噬功能未受影响 ,但间质巨噬细胞的吞噬能力进一步增强。结论 :肺泡和间质巨噬细胞具有功能异质性 ,而且两种细胞亚群对创伤及复合内毒素感染的反应性不同 ,提示两者在创伤后机体免疫功能紊乱中的地位不同。     

Clinical management of childhood apraxia of speech: A survey of speech-language pathologists in Australia and New Zealand

Abstract

Purpose: A number of studies have been published that have investigated the practices of speech-language pathologists in relation to speech sound disorder intervention; however, specific research about the treatment of childhood apraxia of speech is not available. This study aimed to describe the treatment approaches being used by speech-language pathologists, explore their perspectives of evidence-based practice and identify perceived barriers to implementing empirical research recommendations.

Method: An online survey was distributed to speech-language pathologists in Australia and New Zealand. In total, 109 valid surveys were completed by participants who answered a series of multiple choice, yes/no, short answer and Likert-scaled questions.

Result: Speech-language pathologists demonstrated a strong preference for eclectic interventions to treat childhood apraxia of speech. When asked to identify the primary treatment approach they used (whether as a stand-alone; or as the primary approach within an eclectic intervention), the most frequently used intervention was the Nuffield Dyspraxia Programme. Many speech-language pathologists reported valuing empirical research evidence, despite identifying a range of barriers that impact their ability to implement evidence-based practice in childhood apraxia of speech treatment.

Conclusion: Although many speech-language pathologists use the Nuffield Dyspraxia Programme as their primary intervention, most clinicians use it as part of an eclectic/hybrid intervention. The effectiveness of eclectic interventions for childhood apraxia of speech has not been empirically evaluated.     

The Role of the Speech Pathologist on the Craniofacial Team

In 1971, a team of specialists began to evaluate and treat young patients with severe orbito-cranio-facial disorders at the Hospital for Sick Children. This paper describes the functional role of the speech pathologist on the craniofacial team.

Preoperatively, each patient receives an assessment of speech and language, including a phonetic articulation inventory, tests of vocabulary and grammar comprehension, lateral cephalometric head and neck radiographs, and nasal airflow recordings. For any patient on whom procedures are contemplated which involve maxillary and/or mandibular re-alignment, the opinion of the speech pathologist is offered as to the likelihood of improving phonetic skills and the risk involved in causing speech deterioration. Post-operative speech status is evaluated to determine the results.

The paper presents several cases as examples of the surgical techniques employed and the results obtained.     

Effects of synthetic speech output in the learning of graphic symbols of varied iconicity

Purpose: To examine the effects of additional auditory feedback from synthetic speech on the learning of high translucent symbols versus low translucent symbols. Method: Two adults with little or no functional speech and severe intellectual disabilities served as participants. A single-subject ABACA/ACABA design was used to study the relative effects of two treatments: symbol training in the presence and absence of synthetic speech output. Results: The results clearly indicated that the two treatments, rather than extraneous variables were responsible for gains in the symbol learning. Both participants learned either more low translucent symbols or reached their maximum learning of low translucent symbols in the speech output condition. Conclusions: The results of this preliminary study replicate and extend the iconicity hypothesis to a new set of learning conditions involving speech output, and suggest that feedback from speech output may assist adults with profound intellectual disabilities in coding particularly those symbols whose association with their referent cannot be coded via their visual resemblance with the referent.     

Examining a premise underlying self-instructional techniques

Twenty learning-disabled (LD) children were administered the Matching Familiar Figures Test before they played alone in a room while their behavior and private speech were videotaped. Tapes were transcribed and coded according to activity level and the types and amounts of private speech used during play. Children used more Fantasy/Role-Playing speech than Regulatory or Affective speech. The speech of 10 of the children who had been diagnosed hyperactive was generally similar to that of the nonhyperactive children, although high activity level during play was accompanied by more private speech. Reflective children used Fantasy/Role-Playing speech more than did impulsive children. The premise that highly active or impulsive LD children show differences in their use of private speech as compared to less active and more reflective children, and that they thus could profit from techniques that try to modify self-directed speech, was supported.The authors wish to thank Barbara Alexander Pan and Karen Kudenchak-Kugel for their assistance in this project, and two anonymous reviewers for their helpful suggestions. A version of this paper was presented at the 1981 meeting of the American Psychological Association.     

功能性构音障碍语言评价及训练效果的分析

目的　探讨功能性构音障碍的临床特点及康复治疗。方法　对功能性构音障碍儿童 12例及功能性构音障碍成人 5例进行语言评价及语言训练 ,比较并分析儿童及成人功能性构音障碍患者的特点及疗效。结果　构音检查方面 ,儿童与成人的主要错误方式为歪曲、置换 ,主要的错误音为舌尖前音、舌尖后音、舌根音、舌面音和舌尖音。儿童与成人平均错误音差异无显著性 (P >0 .0 5 )。训练时 ,引出每个目标音正确发音平均需时儿童较成人长 (P <0 .0 0 1) ,而每个目标音较熟练应用所需时间儿童较成人短 (P <0 .0 0 1)。经训练后 ,12例儿童患者中有 10例完全纠正 ,2例部分纠正 ,治愈率为 83.33 % ,有效率为 10 0 .0 0 % ;5例成人患者全部纠正 ,治愈率为 10 0 .0 0 % ;总治愈率为 88.2 4% ,总有效率为 10 0 .0 0 %。结论　儿童与成人功能性构音障碍的临床特点差别不大 ,均以歪曲、置换的错误方式为主 ;语言训练效果好 ,但开始训练的时机应该适当 ,并非越早训练效果越好。     

Factors That Influence the Performance of Experienced Speech Recognition Users

Performance on automatic speech recognition (ASR) systems for users with physical disabilities varies widely between individuals. The goal of this study was to discover some key factors that account for that variation. Using data from 23 experienced ASR users with physical disabilities, the effect of 20 different independent variables on recognition accuracy and text entry rate with ASR was measured using bivariate and multivariate analyses. The results show that use of appropriate correction strategies had the strongest influence on user performance with ASR. The amount of time the user spent on his or her computer, the user's manual typing speed, and the speed with which the ASR system recognized speech were all positively associated with better performance. The amount or perceived adequacy of ASR training did not have a significant impact on performance for this user group.