Using preference-based measures to assess quality of life in stuttering.

PURPOSE: The purpose of this study was to determine whether standard pharmaco-economic preference methods can be used to assess perceived quality of life in stuttering. METHOD: Seventy-five nonstuttering adults completed a standardized face-to-face interview that included a rating scale, standard gamble, and time trade-off preference measures for 4 health states (your health and mild, moderate, and severe stuttering) in the context of 2 anchor states (perfect health and death). RESULTS: Results showed mean utility values between .443 for severe stuttering estimated using the rating scale technique and .982 for respondents' own current health estimated using a standard gamble technique. A two-way repeated measures analysis of variance and post hoc tests showed significant effects for method, health state, and the interaction. CONCLUSIONS: These results confirm that utility estimates can differentiate between stuttering severity levels and that utility scores for stuttering conform to the known properties of data obtained using these standard measurement techniques. These techniques, therefore, can and should be further investigated as potential contributors to complete measurement protocols for the study and treatment of stuttering.     

Communicative and psychological dimensions of the KiddyCAT

PurposeThe purpose of the present study was to investigate the underlying constructs of the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (KiddyCAT; Vanryckeghem &; Brutten, 2007), especially those related to awareness of stuttering and negative speech-associated attitudes.MethodParticipants were 114 preschool-age children who stutter (CWS; n = 52; 15 females) and children who do not stutter (CWNS; n = 62; 31 females). Their scores on the KiddyCAT were assessed to determine whether they differed with respect to talker group (CWS vs. CWNS), chronological age, younger versus older age groups, and gender. A categorical data principal components factor analysis (CATPCA) assessed the quantity and quality of the KiddyCAT dimensions.ResultsFindings indicated that preschool-age CWS scored significantly higher than CWNS on the KiddyCAT, regardless of age or gender. Additionally, the extraction of a single factor from the CATPCA indicated that one dimension—speech difficulty—appears to underlie the KiddyCAT items.ConclusionsAs reported by its test developers, the KiddyCAT differentiates between CWS and CWNS. Furthermore, one factor, which appears related to participants’ attitudes towards speech difficulty, underlies the questionnaire. Findings were taken to suggest that children's responses to the KiddyCAT are related to their perception that speech is difficult, which, for CWS, may be associated with relatively frequent experiences with their speaking difficulties (i.e., stuttering).Learning outcomes: After reading this article, the reader will be able to: (1) Better understand the concepts of attitude and awareness; (2) compare historical views with more recent empirical findings regarding preschool-age CWS’ attitudes/awareness towards their stuttering; (3) describe the underlying dimension of the KiddyCAT questionnaire; (4) interpret KiddyCAT results and describe implications of those results.     

Influence of gender on the sensory organisation test and the limits of stability in healthy subjects

IntroductionThe sensory organization test and the limits of stability are the gold standard for dynamic posturography. It is postulated that these measurements vary depending on age, activity of the subject and musculoskeletal system, emotional condition or other factors. The aim of this study was to determine the influence of gender on the above-mentioned analyses.Material and methods70 healthy subjects (35 males and 35 females); mean age: 44.9 years. A clinical history was taken and a physical and otoneurological exploration was performed for each subject, along with a posturography study using the Neurocom SMART Balance Master platform model. The statistical study was carried out with the ANOVA test (p < 0.05).ResultsCondition 5 presented the lowest percentage of balance in both sexes (64.36%). The highest percentage of balance in males was in Condition 1 (p < 0.001) and the lowest in 3 (p = 0.030). There were no differences in the sensory analysis. The lowest employment of ankle strategy was in Condition 5 for both sexes (88.61%); women used the ankle strategy in Condition 4 more efficiently (p = 0.0129). There were also differences in the time of reaction towards the right (p = 0.022) and the mean (p = 0.011) (higher in females), and in the speed of movement backwards (p = 0.001) and towards the right (p = 0.04) (higher in males). In path length and directional control, there were no differences.ConclusionsGender differences should be taken into consideration for vestibular rehabilitation. Greater speed in conducting the tests does not lead to better balance control.     

Indirect laryngoscopy with rigid 70-degree laryngoscope as a predictor of difficult direct laryngoscopy

Introduction and objectivesThe commonly-used predictors for difficult airway management are not very accurate. We investigate the power of indirect laryngoscopy with the rigid 70-degree laryngoscope as a predictor of difficult visualisation of the larynx with direct laryngoscopy.MethodsWe performed preoperative indirect laryngoscopy with the rigid laryngoscope on 300 patients. The vision obtained was classified into four grades: 1 (vocal cords visible), 2 (posterior commissure visible), 3 (epiglottis visible) and 4 (no glottic structure visible). Grades 3 and 4 were considered predictors of difficult larynx visualisation. Next, direct laryngoscopy with the Macintosh laryngoscope was carried out on the patients under general anaesthesia. Positive value was defined as a Cormack and Lehane III and IV. Other common clinical predictors were also analysed. A logistic regression model using the relevant variables was elaborated. We also investigated predictors of difficult visualisation of the larynx with indirect laryngoscopy.ResultsThe model found and the coefficients for preparing it were: f(x)= -10.097 + 5.145 indirect laryngoscopy (3-4) + 3.489 retrognathia +2.548 mouth opening <3.5 cm +1.911 thyromental distance <6.5 cm +1.352 snorer + (0.151 * cm neck thickness). This model provided a correct result in 94.3% of cases. In the case of indirect laryngoscopy, the model found was: f (x) = -2.641 + 0.920 snorer + 0.875 cervical mobility.ConclusionsIndirect laryngoscopy was the independent variable with the greatest predictive power. Snoring is a common predictor in both laryngoscopy models.     

Effects of vibrotactile vestibular substitution on vestibular rehabilitation – preliminary study

IntroductionSome patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR).ObjectiveTo evaluate the effectiveness of Vertiguard™ biofeedback equipment as a sensory substitution (SS) of the vestibular system in patients who did not obtain sufficient improvement from VR.MethodsThis was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG), which received the vibrotactile stimulus from Vertiguard™ for ten days, and a control group (CG), which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT) protocol of the Computerized Dynamic Posturography (CDP) and two scales of balance self-perception, Activities-specific Balance Confidence (ABC) and Dizziness Handicap Inventory (DHI), were used.ResultsAfter treatment, only the SG showed statistically significant improvement in C5 (p = 0.007) and C6 (p = 0.01). On the ABC scale, there was a significant difference in the SG (p = 0.04). The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p = 0.04).ConclusionThe present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard™ system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance.     

Newborn hearing screening test with multiple auditory steady-state responses

IntroductionThe techniques most frequently used within a screening context (otoacoustic emissions and click auditory brainstem response) have well-known limitations in hearing loss detection.ObjectiveThis study examines the feasibility of a semi-automated multiple auditory steady-state responses (MSSR) system designed for neonatal hearing screening.MethodsA sample of 50 newborns without risk factors (well-babies) was tested within two weeks of birth. All had detectable auditory brainstem responses to clicks down to 40 dB nHL in both ears. Two amplitude modulated carrier tones of 500 and 2,000 Hz were mixed together and presented simultaneously. Each infant (and ear) was screened with the MSSR system; to simulate a hearing loss, a recording without stimulation was also obtained.ResultsMean auditory thresholds were 42.5 ± 7 dB HL at 500 Hz and 35.5 ± 6 dB HL at 2,000 Hz. The average duration of the MSSR recording was 2.6 ± 1.6 minutes for each tested ear and the overall duration of the screening procedure (including electrode fitting and infant preparation) was 17.8 ± 3.7 minutes. The diagnostic sensibility and the positive predictive values of the MSSR semi-automatic screening system was 100% and 96% respectively, with specificity of 96% and negative predictive values of 100%.ConclusionsAlthough the diagnostic efficiency of the semi-automated MSSR system was found adequate, further technological improvements are still necessary to facilitate its use in the context of universal newborn hearing screening program.     

Influence of stuttering variation on talker group classification in preschool children: Preliminary findings

The purpose of this study was to investigate whether variations in disfluencies of young children who do (CWS) and do not stutter (CWNS) significantly change their talker group classification or diagnosis from stutterer to nonstutterer, and vice versa. Participants consisted of seventeen 3- to 5-year-old CWS and nine 3- to 5-year-old CWNS, with no statistically significant between-group difference in chronological age (CWS: M = 45.53 months, S.D. = 8.32; CWNS: M = 47.67 months, S.D. = 6.69). All participants had speech, language, and hearing development within normal limits, with the exception of stuttering for CWS. Both talker groups participated in a series of speaking samples that varied by: (a) conversational partner [parent and clinician], (b) location [home and clinic], and (c) context [conversation and narrative]. The primary dependent measures for this study were the number of stuttering-like disfluencies (SLD) per total number of spoken words [%SLD] and the ratio of SLD to total disfluencies (TD) [SLD/TD]. The results indicated that significant variability of stuttering did not exist as a result of conversational partner or location. Changes in context, however, did impact the CWS, who demonstrated higher SLD/TD in the conversation sample versus a narrative sample. Consistent with hypotheses, CWS and CWNS were accurately identified as stutterers and nonstutterers, respectively, regardless of changes to conversational partner, location or context for the overall participant sample. Present findings were taken to suggest that during assessment, variations in stuttering frequency resulting from changes in conversational partner, location or context do not significantly influence the diagnosis of stuttering, especially for children not on the talker group classification borderline between CWS and CWNS.Learning outcomes: Readers will be able to: (1) Describe the role of variability in stuttering frequency for young children who stutter; (2) Identify three fundamental measurements of the frequency of stuttering-like and nonstuttering-like disfluencies; (3) Describe the effects of stuttering variation on talker group classification of stuttering or nonstuttering.     

ENDOCOCHLEAR POTENTIAL AND POTASSIUM CONCENTRATION RECORDING IN MINIPIG COCHLEA

Objective To record the endocochlear potential (EP) and calculate potassium concentration [K+] in Minipig cochleae. Methods We used multi-barreled electrodes to measure the EP and the potential, [K+].EP and potassium electrode recording were made in 9 cochleae from 5 minipigs to get normal EP values.Results The average EP value in the cochlea from the minipigs was 77.3 ± 14 mV. The average [K+] for the minipigs was 147.1 ± 13 mM. Conclusions The EP and potential, [K+] in minipigs are lower than in the human and rodents. This may be the reason why porcine ABR thresholds are slightly higher than humans and rodents.     

Evaluation of Eye Movement Desensitization and Reprocessing in the management of tinnitus. An observational study

ObjectivesTinnitus can induce disabling psychological suffering, requiring an integrative multimodal approach, combining neuromodulation and psychotherapeutic methods. We sought to evaluate the therapeutic efficacy and acceptability of Eye Movement Desensitization and Reprocessing (EMDR) in tinnitus.Materials and methodsThis was a single-center prospective non-comparative study. Inclusion criteria comprised: adult patient, with chronic tinnitus, Tinnitus Handicap Inventory (THI) score > 17, causing psychological distress motivating active treatment after ineffective “classic” treatment (combining advice, sound therapy and first-line drug treatment), and agreement to EMDR therapy. Therapeutic efficacy was defined by a decrease in THI or Visual Analog Scale (VAS) scores. Treatment acceptability was defined by the rate of included patients who completed therapy.ResultsThirty-eight patients were included. There was a significant reduction of 53.5% in THI score in 78.9% of patients (P < 0.0001; 64.8 ± 20.8 before versus 31.8 ± 24.7 after treatment), and of 51% in VAS score in 76.3% of patients (P < 0.0001; 7.24 ± 2.12 before versus 3.58 ± 2.03 after treatment). The treatment acceptability was 86.8%.ConclusionEMDR appeared to be an effective alternative that was acceptable to the majority of patients, after failure of “classic” first-line treatment, improving quality of life in tinnitus patients and thus relieving disability.     

Sensitivity to structure in the speech signal by children with speech sound disorder and reading disability

PurposeChildren with speech sound disorder (SSD) and reading disability (RD) have poor phonological awareness, a problem believed to arise largely from deficits in processing the sensory information in speech, specifically individual acoustic cues. However, such cues are details of acoustic structure. Recent theories suggest that listeners also need to be able to integrate those details to perceive linguistically relevant form. This study examined abilities of children with SSD, RD, and SSD + RD not only to process acoustic cues but also to recover linguistically relevant form from the speech signal.MethodTen- to 11-year-olds with SSD (n = 17), RD (n = 16), SSD + RD (n = 17), and Controls (n = 16) were tested to examine their sensitivity to (1) voice onset times (VOT); (2) spectral structure in fricative-vowel syllables; and (3) vocoded sentences.ResultsChildren in all groups performed similarly with VOT stimuli, but children with disorders showed delays on other tasks, although the specifics of their performance varied.ConclusionChildren with poor phonemic awareness not only lack sensitivity to acoustic details, but are also less able to recover linguistically relevant forms. This is contrary to one of the main current theories of the relation between spoken and written language development.Learning outcomes: Readers will be able to (1) understand the role speech perception plays in phonological awareness, (2) distinguish between segmental and global structure analysis of speech perception, (3) describe differences and similarities in speech perception among children with speech sound disorder and/or reading disability, and (4) recognize the importance of broadening clinical interventions to focus on recognizing structure at all levels of speech analysis.     

Speaking rate characteristics of elementary-school-aged children who do and do not stutter

PurposeTo compare articulation and speech rates of school-aged children who do and do not stutter across sentence priming, structured conversation, and narration tasks and to determine factors that predict children's speech and articulation rates.Method34 children who stutter (CWS) and 34 age- and gender-matched children who do not stutter (CWNS) were divided into younger (M age = 6;10) and older (M age = 9;6) subgroups. Speech samples were elicited using the Modeled Sentences, Structured Conversation, and Narration tasks from an experimental version of the Test of Childhood Stuttering (Gillam, Logan, &; Pearson, 2009). Speech rates (based on both fluent and disfluent utterances), articulation rates (based on only fluent utterances), disfluency frequency, and utterance length were compared across groups and tasks.ResultsCWNS had faster speech rates than CWS. Older children had faster speech rates than younger children during Modeled Sentences, and their Modeled Sentences speech rates were faster than their Structured Conversation and Narration speech rates. Disfluency frequency predicted speech rate better than age or utterance length for CWS and CWNS. Speech rate was negatively correlated with stuttering severity for CWS. Articulation rates for CWNS and CWS were not significantly different; however, older children had faster articulation rates than younger children, and articulation rates for both age groups were fastest during Modeled Sentences.ConclusionsResults provide age-based reference data for the speech and articulation rates of school-aged CWS and CWNS on three TOCS tasks and offer insight into the relative contributions of age, disfluency frequency, and utterance length to children's rate performance.Learning outcomesAfter reading this paper readers should be able to: (1) summarize the main findings from past studies of children's speech rate and articulation rate; (2) describe how school-aged children who stutter compare to age-matched children who do not stutter with regard to speech rate and articulation rate; (3) explain the extent to which age, speaking task, disfluency frequency, and utterance length affect children's rate performance; (4) discuss the advantages and disadvantages of various approaches to rate measurement.     

Otorhinolaryngologists’ personal treatment preferences (total laryngectomy or laryngeal preservation) when faced with advanced stage laryngeal cancer

ObjectiveTo analyse the treatment options that otorhinolaryngologists would consider if faced with advanced stage laryngeal cancer amenable to total laryngectomy or an organ preservation protocol.Material and methodsProspective study conducted in a French Teaching Hospital based on questionnaires filled in by 163 otorhinolaryngologists in 2012, studying the percentage chance of cure that they would be prepared to trade-off to preserve their larynx, defining the additional information that they would like to receive and identifying any statistical associations between these parameters and various medical and socioeconomic variables.ResultsA total of 42.3% of otorhinolaryngologists would not consider the slightest trade-off to preserve their larynx and preferred to undergo total laryngectomy. In the group of otorhinolaryngologists who would consider a larynx preservation protocol (57.6%), the percentage chance of cure that they would be willing to trade-off to preserve their larynx ranged between 5 to 100% (median: 15%) and 4.2% of them were willing to trade-off all chances of cure (100%) to avoid total laryngectomy. The percentage of otorhinolaryngologists who would not consider trading off the slightest chance of survival to preserve their larynx increased from 29.3 to 49.5% (P = 0.01) when they participated in multidisciplinary consultation meetings. In the group of otorhinolaryngologists who would consider a larynx preservation protocol, the median percentage survival trade-off that they would consider in order to preserve their larynx (i) decreased from 20 to 10% (P = 0.004) when they participated in multidisciplinary consultation meetings and (ii) increased regularly with their number of years of practice (P = 0.03) and their age (P = 0.025). Finally, 25.1% of otorhinolaryngologists wanted to receive additional information, although none of the variables analysed affected this desire for more information.ConclusionTreatment options considered by otorhinolaryngologists faced with advanced stage laryngeal cancer were almost equally divided between total laryngectomy and larynx preservation. Number of years of practice and regular participation in head and neck cancer multidisciplinary consultation meetings were variables that significantly influenced this choice.     

Dentofacial development abnormalities in paediatric sleep-related breathing disorders

IntroductionThe recent interest in sleep-related breathing disorders has re-opened the old debate as to whether there is a causal relationship between upper respiratory obstruction and abnormalities in dentofacial development.ObjectiveTo establish the impact of dentofacial development on sleep-related breathing disorders in children.MethodThis is a prospective study in which the dentofacial studies of 30 children, diagnosed with a sleep-related breathing disorder using polysomnography, were compared with a control group of 30 healthy children. The ages of both groups were between 3 and 13 years.ResultsThe statistical analysis showed significant differences between the groups in the proportion of children with a narrow palate (83% of the problem group and 57% in the control; P = 0.024) and cross bite (40% and 13%; P = 0.020). On comparing the angles measured, the only statistically-significant difference was the skull base-mandibular plane angle: The problem children group had a mean of 37.59 ± 5.56 and the control group, a mean of 34.41 ± 4.62 (P = 0.023).ConclusionChildren with sleep-related breathing disorders have abnormalities in facial and dental development caused by upper respiratory obstruction. These anomalies, vertical growth of the face, narrow palate and dental occlusion changes should be taken into account when assessing the indication for a adenotonsillectomy.     

Objective measurement of motor speech characteristics in the healthy pediatric population

ObjectiveTo obtain objective measurements of motor speech characteristics in normal children, using a computer-based motor speech software program.MethodsCross-sectional, observational design in a university-based ambulatory pediatric otolaryngology clinic. Participants included 112 subjects (54 females and 58 males) aged 4–18 years. Participants with previously diagnosed hearing loss, voice and motor disorders, and children unable to repeat a passage in English were excluded. Voice samples were recorded and analysed using the Motor Speech Profile (MSP) software (KayPENTAX, Lincoln Park, NJ). The MSP produced measures of diadochokinetics, second formant transition, intonation, and syllabic rates.ResultsDemographic data, including sex, age, and cigarette smoke exposure were obtained. Normative data for several motor speech characteristics were derived for children ranging from age 4 to 18 years. A number of age-dependent changes were indentified, including an increase in average diadochokinetic rate (p < 0.001) and standard syllabic duration (p < 0.001) with age. There were no identified differences in motor speech characteristics between males and females across the measured age range. Variations in fundamental frequency (Fo) during speech did not change significantly with age for both males and females.ConclusionsTo our knowledge, this is the first pediatric normative database for the MSP progam. The MSP is suitable for testing children and can be used to study developmental changes in motor speech. The analysis demonstrated that males and females behave similarly and show the same relationship with age for the motor speech characteristics studied. This normative database will provide essential comparative data for future studies exploring alterations in motor speech that may occur with hearing, voice, and motor disorders and to assess the results of targeted therapies.     

The effects of self-generated synchronous and asynchronous visual speech feedback on overt stuttering frequency

PurposeRelatively recent research documents that visual choral speech, which represents an externally generated form of synchronous visual speech feedback, significantly enhanced fluency in those who stutter. As a consequence, it was hypothesized that self-generated synchronous and asynchronous visual speech feedback would likewise enhance fluency. Therefore, the purpose of this study was to investigate the effects of self-generated visual feedback (i.e., synchronous speech feedback with a mirror and asynchronous speech feedback via delayed visual feedback) on overt stuttering frequency in those who stutter.MethodEight people who stutter (4 males, 4 females), ranging from 18 to 42 years of age participated in this study. Due to the nature of visual speech feedback, the speaking task required that participants recite memorized phrases in control and experimental speaking conditions so that visual attention could be focused on the speech feedback, rather than a written passage. During experimental conditions, participants recited memorized phrases while simultaneously focusing on the movement of their lips, mouth, and jaw within their own synchronous (i.e., mirror) and asynchronous (i.e., delayed video signal) visual speech feedback.ResultsResults indicated that the self-generated visual feedback speaking conditions significantly decreased stuttering frequency (Greenhouse–Geisser p = .000); post hoc orthogonal comparisons revealed no significant differences in stuttering frequency reduction between the synchronous and asynchronous visual feedback speaking conditions (p = .2554).ConclusionsThese data suggest that synchronous and asynchronous self-generated visual speech feedback is associated with significant reductions in overt stuttering frequency. Study results were discussed relative to existing theoretical models of fluency-enhancement via speech feedback, such as the engagement of mirror neuron networks, the EXPLAN model, and the Dual Premotor System Hypothesis. Further research in the area of self-generated visual speech feedback, as well as theoretical constructs accounting for how exposure to a multi-sensory speech feedback enhances fluency, is warranted.Learning outcomes: Readers will be able to (1) discuss the multi-sensory nature of fluency-enhancing speech feedback, (2) compare and contrast synchronous and asynchronous self-generated and externally generated visual speech feedback, and (3) compare and contrast self-generated and externally generated visual speech feedback.     

Stopping criteria for averaging the multiple auditory steady-state response

Introduction and objectivesThe aim of this study was to examine the efficiency of the averaging technique for estimating multiple auditory steady state responses in normal hearing subjects and to provide quantifiable stopping criteria at near-threshold intensities.MethodsMultiple amplitude-modulated (89-115 Hz) tones (500, 1,000, 2,000 and 4,000 Hz) were simultaneously presented to both ears at a fixed intensity of 40 dB HL. A total of 128 data epochs were averaged (23.9 minutes).ResultsThe results showed that “classic” ensemble averaging, although accurate and time-efficient in most cases, could not extract all near-threshold MSSR from noise, even after recording a considerable number of sweeps. The present study also proposed a different approach to evaluate the background noise based on evaluating the mean of the variance close to the signal.ConclusionsThe study proposed quantitative parameters to establish stopping criteria during auditory steady-state recordings.     

Low frequency of GJB2 mutations in thirty-five students with hearing loss in Chinese consanguineous families

ObjectiveGJB2 mutation is recognized as the prevalent causes of non-syndromic hearing impairment (NSHI) worldwide. However, the mutation profiles of this gene are unknown in deafness probands in the consanguineous pedigrees in China. Therefore, this study aimed to characterize the forms and frequencies of GJB2 mutations in 35 students with hearing loss in the consanguineous families in Hubei province, Central China.MethodsGenomic DNA was extracted from blood samples of 35 students with hearing loss. The target fragments were amplified by polymerase chain reaction (PCR) and subjected to sequencing to identify sequence variations.ResultsSurprisingly, none of these probands harbored homozygous mutation in GJB2. Three GJB2 heterozygous mutations were identified: a single base pair substitution c.35G > T and c.139G > T, and a 2 bp deletion c.299-300delAT in three probands.ConclusionThe frequency of GJB2 mutation is relatively low in these consanguineous families, most of which were minorities. Our results suggest that screening for responsible genes other than GJB2 may be necessary for NSHI in these minorities.     

A nonverbal phoneme deletion task administered in a dynamic assessment format

PurposeThe purpose of the project was to design a nonverbal dynamic assessment of phoneme deletion that may prove useful with individuals who demonstrate complex communication needs (CCN) and are unable to communicate using natural speech or who present with moderate–severe speech impairments.MethodA nonverbal dynamic assessment of phoneme deletion with a systematic prompting and scoring system was developed and compared to the same measure administered using a traditional “static” format. Both versions were administered to 64 typically developing children ranging in age from 6 to 8;5. The dynamic phoneme deletion task was designed so that no verbal response was required. Children were asked to point to pictures representing each stimulus item. The same stimulus items were administered to children in a traditional static format, without the use of pictures. For example, in the dynamic assessment task, children were asked to point to 1 of 4 pictures (e.g., ice) to indicate their response when asked to delete “m” from “mice.” In the static format, children were asked to “say” the real word left over after deleting “m” from “mice.” Correlations between phoneme deletion tasks and word-level reading tasks were calculated.ResultsInternal reliability for the nonverbal dynamic phoneme deletion task was α = .88 for the total sample. Correlations between the dynamic and static formats were high (r = .84) as were correlations between the deletion tasks and the measure of word-level reading (dynamic; r = .54, static; r = .53).ConclusionsThese preliminary findings suggest that the nonverbal dynamic phoneme deletion task holds promise for use with children for whom speech output is compromised. Implications for use with children who use AAC or who have significant speech impairments and recommendations for future research are discussed.Learning outcomes: Readers will learn about a nonverbal dynamic assessment of phoneme deletion that may prove useful for measuring phoneme awareness for children who are unable to communicate using natural speech or who present with moderate–severe speech impairments. Readers will learn about the importance of accurate measurement of phoneme awareness for children with complex communication needs. Readers will also learn about how to develop and utilize reliable and valid measures of phoneme awareness for this population of children with communication impairments.     

Electrophysiological characterisation of envelope-following responses

IntroductionThe auditory ability to discriminate rapid changes in the envelope of language sounds is essential for speech comprehension. This ability is deteriorated in some neurological diseases such as multiple sclerosis, auditory neuropathy, sensorineural hearing loss, presbycusis and primary developmental language disorder. Envelope-following responses (EFRs) in humans are useful in objective measurement of temporal processing in the auditory nervous system.ObjectivesTo evaluate EFRs in healthy younger subjects and to investigate the effects of subject states on the EFRs recorded.MethodsEleven young subjects were included; six of them were awake and five were asleep. EFRs were evoked by white noise carrier stimuli with a sweep of modulation frequencies from 20 to 200 Hz presented at 50 dB HL.ResultsThe EFRs we recorded were similar in all subjects. There were two principal components. During both subject sleep and wakefulness, the first component (located between 30-50 Hz) was significantly larger than the second component (located between 80-110 Hz). There was also a significant effect of sleep on the EFR amplitude for the modulation frequencies between 88-110, 155-165 and 190-200 Hz. However, there were no significant effects of sleep on the principal EFR components.ConclusionsThese results corroborate the usefulness of the EFR technique for objective measurement of human auditory temporal processing.