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The latest medical research on Speech Pathologist

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Social-Emotional Functioning of Children With Different Hearing Status and Diverse Cultural Background.

Language, Speech, and Hearing Services

The study investigated the social-emotional functioning of children with typical hearing and deaf and hard of hearing (D/HH) children from diverse cultural backgrounds in Israel through parental reports.

A total of 242 parents from both Arabic and Jewish communities participated: 130 were parents of D/HH children and 112 were parents of children with typical hearing. The Strengths and Difficulties Questionnaire and a background questionnaire were used.

Results revealed increased total difficulties, emotional symptoms, and peer problems as reported by parents of D/HH children. Jewish parents of D/HH children reported greater total difficulties, conduct problems, and peer problems than Arab parents. Significant gender differences were found, with parents of boys reporting higher levels of hyperactivity/inattention and lower prosocial behavior. Among D/HH children, Arab parents reported higher peer problems among hearing aid users compared to cochlear implant users, whereas Jewish parents reported the opposite trend.

These findings highlight the significant social-emotional challenges faced by D/HH children, particularly in peer interactions, and underscore the need for tailored interventions that consider cultural differences.

Applied deaf aesthetics toward transforming deaf higher education.

Journal of Deaf Studies and

Deaf aesthetics is a theoretical framework we actualized to enhance interactions in deaf education, particularly via multimodal pedagogy and curric...

Incorporating Virtual Reality Agents During a Dichotic Speech Reception Task: Insights From the Heart.

Ear and Hearing

Listening effort is moderated by not only task difficulty, but also success importance. In real communication scenarios, success importance varies based upon the social context. However, in the laboratory, it can be challenging to manipulate social context without compromising experimental control. Outside of hearing sciences, studies have applied virtual reality (VR) to incorporate social context in a controlled and repeatable manner. Several of these studies have demonstrated that social manipulations in VR can reliably elicit changes in cardiovascular measures. Here, we investigated the effect of adding VR agents to a speech reception task, while measuring from the cardiovascular system.

Twenty-eight, normally hearing participants undertook a dichotic speech reception task. Sentences in stationary noise were presented dichotically, that is, different sentences presented simultaneously to each ear. Participants were tasked to either repeat one of the sentences (single-sentence condition) or both of the sentences (dual-sentence condition). The task was conducted under two VR conditions: (1) in the presence of agents, who provided sporadic performance feedback and (2) in the presence of nonagent controls, without any feedback given. Alongside task performance, we quantified changes in cardiovascular measures, relative to pretask baselines: heart rate variability, pre-ejection period, heart rate, and blood pressure. After each condition, participants rated their subjective effort, difficulty, performance, and engagement.

Performance and the subjective perception of performance were lower, while subjective effort and difficulty were higher, in the dual-sentence condition, compared with the single-sentence condition. Heart rate was the only cardiovascular measure that was sensitive to the experimental manipulations. Contrary to our expectations, heart rate increased in the nonagent control conditions, compared with the agent conditions. An exploratory analysis revealed heart rate fluctuations within a trial: heart rate was higher during the first 6 sec of the trial (reflecting the presentence masking noise and the sentence presentation) in the dual-sentence condition, compared with the single-sentence condition.

This study was the first to incorporate VR agents who provided performance feedback during a dichotic speech reception task. Our results suggest that the VR agents did not increase success importance, which could be attributed to a lack of realism of the agents. We also demonstrated that the cardiovascular response to experimental manipulations may differ depending on the data window selected for analysis.

Acoustic- Versus Intelligibility-Based Assessment of Subjective Listening Difficulty Measured With the Repeat-Recall Test.

Ear and Hearing

To contrast interpretations of listening effort ratings when judged against acoustic- versus intelligibility-based normative references.

Existing data collected from 66 normal-hearing adult listeners, comprising 2730 trials of the Repeat-Recall Test, were used to establish norms of subjective listening effort ratings for six ranges of intelligibility. Data from 21 aided hearing-impaired listeners were then used to contrast intelligibility-based norms against acoustic-based norms when interpreting listening effort ratings measured in omnidirectional and directional microphone conditions.

Whereas acoustic-based norms effectively demonstrated reduced effort for directional versus omnidirectional microphone modes, intelligibility-based references controlled for listeners' performance biases and improved the consistency with which subjective ratings were ranked across the two microphone conditions.

The choice of normative reference should be carefully considered when judging listening effort ratings from hearing-impaired individuals against those of their normal-hearing peers. Whereas acoustic-based references may be more useful for evaluating the benefits of hearing aid technology, intelligibility-based references may be better suited to identifying listeners with poor subjective experiences for speech-in-noise related to factors beyond intelligibility.

Assessing vocabulary acquisition using a fast-mapping task in an Android application: A pilot study.

International Journal of Epidemiology

The aim of this study was to explore whether a fast mapping task embedded in an Android application (FastMApp) is a valid tool to assess referent selection abilities in Spanish-speaking children aged between 18 and 30 months. Traditional assessment tools for lexical development use static quantitative methods that assign children a final score to represent their overall vocabulary level. These methods fail to provide insights into the learning process, despite their potential relevance for clinical and educational purposes.

Sixty Spanish-speaking children participated in this study. They completed the FastMApp (a 22-trials' fast mapping noun task including 4- and 5-item trials, with one unknown object), and their caregivers rated their child's vocabulary on a parent-rated vocabulary inventory measure.

The data show a high percentage of responses to the task, indicating that the children were actively complied with the task. The scores for known labels are significantly higher compared to unknown labels, and the scores for 4-item trials are significantly higher compared to 5-item trials. We observed a strong and significant relationship between the scores in this task and the scores on the parent-rated vocabulary inventory measure.

The results suggest that FastMApp is suitable for assessing early vocabulary acquisition in Spanish-speaking children.

Cochlear Implant Sound Quality.

Journal of Speech, Language, and

The aims of this exploratory study were (a) to assess common terms used to describe cochlear implant (CI) sound quality by patients fit with conventional CIs and (b) to compare those descriptors to previously obtained acoustic matches to CI sound quality created by single-sided deaf (SSD) patients for their normal-hearing ear.

CI patients fit with Advanced Bionics (AB; n = 89), Cochlear Corporation (n = 86), and MED-EL (n = 80) implants were the participants. The patients filled out a questionnaire about CI sound quality for two time points: For the time near activation (T1) from memory and at the time of filling out the questionnaire (T2). The mean CI experience at T2 for the three groups ranged from 4 to 8 years. The questionnaire was composed of 25 adjectives describing sound quality.

For T1, the most commonly used descriptors were Computer-like, Treble-y, Metallic, and Mickey Mouse-like. A superordinate category of HiPitched (High Pitched) gathered significantly more responses from patients with shorter electrode arrays (AB and Cochlear) than patients with longer arrays (MED-EL). At T2, the most common descriptor was Clear and was chosen by approximately two thirds of the patients. The between-group differences in responses to items in the HiPitched category, present at T1, were absent at T2.

The questionnaire data from conventional CI patients differs from previous sound matching data collected from SSD-CI patients. Alterations to the spectral composition of the signal are less salient to experienced conventional patients than to experienced SSD-CI patients. This is likely due to the absence, for conventional patients, of an exemplar in an NH ear against which to judge CI sound quality.

A Methodological Review of Stimuli Used for Classroom Speech-in-Noise Tests.

Journal of Speech, Language, and

Listening is the gateway to learning in the mainstream classroom; however, classrooms are noisy environments, making listening challenging. Therefore, speech-in-noise tests that realistically incorporate the complexity of the classroom listening environment are needed. The aim of this article was to review the speech stimuli, noise stimuli, presentation mode, and presentation levels of current classroom speech-in-noise tests to determine how representative they are of real-world classroom listening.

A comprehensive search of Scopus database following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines was conducted to identify classroom speech-in-noise tests used in the research literature. The search term was classroom AND (listening OR (speech AND (perception OR intelligibility OR recognition OR discrimination) AND noise) OR speech-in-noise) AND (test OR task OR measure OR assessment) AND children in the article title, abstract, and key word fields.

A total of 97 papers met the criteria to be included in the review. While the speech and noise stimuli were generally presented at realistic speech and noise levels, the speech materials were not representative of real-world classroom listening. Additionally, unrealistic noise and presentation modes were used in several studies.

This review will help researchers choose appropriate speech-in-noise test stimuli in future research and also help researchers understand what to consider when creating new speech-in-noise tests for classroom listening.

https://doi.org/10.23641/asha.27659619.

Barriers and Facilitators in Using Surface Electromyography in Swallowing Management: An Implementation Science Study.

Speech Language Path

This study aimed to identify clinician-perceived barriers and facilitators before the implementation of surface electromyography (sEMG) for swallowing management, implement sEMG biofeedback in swallowing rehabilitation sessions using implementation strategies, and investigate the perceived benefits and drawbacks after the implementation of the sEMG device from the perspectives of speech-language pathologists (SLPs).

An initial pre-implementation survey characterized the SLPs' practices in swallowing management regarding the use of biofeedback modalities as well as facilitators and barriers to the implementation of sEMG. In the implementation phase, six SLPs attended educational and training meetings, tested, and used sEMG with patients during their swallowing sessions. Finally, a postimplementation survey and focus group assessed the six SLPs' perceptions and experiences using sEMG and identified areas for improvement in the implementation process.

The majority of the 44 SLPs who answered the pre-implementation survey did not use sEMG in swallowing therapy. The most frequently reported barriers to implementation were reduced sEMG knowledge and lack of training (86.4%), lack of equipment access or availability (68.2%), and patient-related barriers (36.6%). The six SLPs who participated in the implementation phase used sEMG with 30 different patients, conducting a total of 105 sessions. They reported that it was easy to use sEMG during sessions and that sEMG helped them to teach swallowing maneuvers. Additionally, they stated that patients were motivated during sEMG sessions. Ongoing training and mentoring were some of the suggestions for implementation improvements.

This study exemplifies the collaborative work between researchers and clinicians to facilitate the translation of technologies into clinical practice. Identifying determinants of sEMG implementation and strategies to address barriers was critical to its acceptability and adoption into clinical practice.

How speech and language therapists and parents work together in the therapeutic process for children with speech sound disorder: A scoping review.

Int J Lang

Speech sound disorders (SSDs) are broadly defined as difficulty producing speech sounds in childhood. Reported prevalence of SSD varies from 2.3% to 24.6%, depending on how SSD is defined and the included age range. SSDs that do not resolve before age 8 can have a lasting impact on a child's academic achievements. The intensity of intervention for SSD is important to ensure effectiveness. However, there is a gap between the evidence base for intensity and speech and language therapists' (SLTs) clinical practice. One way that SLTs try to bridge this gap is by working with parents. SLTs believe that working with parents/caregivers is vital for a child with SSD to make progress.

To conduct a scoping review of the literature to provide a comprehensive picture of the perceptions, experiences and strategies underpinning collaborative working between SLTs and parents/caregivers of children (aged ≤ 5 years 11 months) with SSD to increase intervention intensity at home.

This scoping review was completed in accordance with PRISMA-ScR guidelines. A systematic search of PubMed, PsycInfo, CINHAL, Web of Science, EBSCOhost and EThOS was conducted using synonyms of three key terms: SSD, Therapy, Parents. Key journals and papers were hand searched for unique papers. A total of 29 papers were included for review. Data were analysed using thematic synthesis to develop themes. These themes are discussed using the PAGER framework to identify advances, gaps, evidence for practice and areas for future research.

Seven key themes were identified: individualization, setting expectations, daily life, parental knowledge, parental involvement, therapeutic relationships and supporting parents to deliver home practice. There has been an acceleration of research around working with parents of children with SSD, with increased consideration of effective adult coaching techniques. Parents value the parental and child relationship with the SLT and feel this supports the success of home practice. There is a need for further research, and guidance for SLTs working with parents of children with SSD to enable them to support parents to deliver home practice effectively.

What is already known on the subject There is a gap between what is recommended in the evidence base for intervention intensity for children with SSD and current clinical practice worldwide. SLTs try to bridge this gap through home practice and believe that working with parents/caregivers is vital for children with SSD to make progress. However, little is known about the best ways for SLTs to work with parents for this population. What this paper adds to the existing knowledge Training parents to be implementers of intervention in a personalized and flexible way is important and valued by parents and SLTs. Parents value understanding the clinical rationale behind the intervention approach and benefit from explicit instructions for home practice, including discussion, written information, observation and feedback. Therapeutic relationships take time to develop and impact parental engagement in home practice. What are the potential or actual clinical implications of this work? The findings of this study highlight existing knowledge which will support SLTs to work optimally with parents to implement home practice for their child with SSD. It highlights the importance of taking time to foster working relationships with parents to support effective home practice. The review identifies gaps in the current skills and knowledge of SLTs, highlighting the need for further research, support and guidance for SLTs in their work with parents, as well as implications for the development of the SLT pre-registration curriculum.

Characterizing Physiologic Swallowing Impairment Profiles: A Large-Scale Exploratory Study of Head and Neck Cancer, Stroke, Chronic Obstructive Pulmonary Disease, Dementia, and Parkinson's Disease.

Journal of Speech, Language, and

The purpose of the present study was to use a large swallowing database to explore and compare the swallow-physiology impairment profiles of five dysphagia-associated diagnoses: chronic obstructive pulmonary disease (COPD), dementia, head and neck cancer (HNC), Parkinson's disease (PD), and stroke.

A total of 8,190 patients across five diagnoses were extracted from a de-identified swallowing database, that is, the Modified Barium Swallow Impairment Profile Swallowing Data Registry, for the present exploratory cross-sectional analysis. To identify the impairment profiles of the five diagnoses, we fit 18 partial proportional odds models, one for each of the 17 Modified Barium Swallow Impairment Profile components and the Penetration-Aspiration Scale, with impairment score as the dependent variable and diagnoses, age, sex, and race as the independent variables with interactions between age and diagnoses and between PD and dementia (in effect creating a PD with dementia [PDwDem] group). For components with > 5% missingness, we applied inverse probability weighting to correct for bias.

PD and COPD did not significantly differ on 13 of the 18 outcome variables (all ps > .02). Dementia, stroke, and PDwDem all showed worse impairments than COPD or PD on five of six oral components (all ps < .007). HNC had worse impairment than all diagnoses except PDwDem for nine of 10 pharyngeal components (all ps < .006). Stroke and HNC had worse penetration/aspiration than all other diagnoses (all ps < .003).

The present results show that there are both common and differing impairment profiles among these five diagnoses. These commonalities and differences in profiles provide a basis for the generation of hypotheses about the nature and severity of dysphagia in these populations. These results are also likely highly generalizable given the size and representativeness of the data set.

https://doi.org/10.23641/asha.27478245.

Aerodynamic Threshold Measures for Reflecting Glottal Closure in Voice Disorders.

Journal of Speech, Language, and

Previous work suggested that phonation threshold pressure (PTP), phonation threshold flow (PTF), and phonation threshold power (PTW) could be effective aerodynamic measures for quantifying glottal incompetence. This study examined how these measures could reflect varying extent of incomplete glottal closure in individuals with voice disorders.

Thirty individuals formally diagnosed with glottal incompetence, including 10 with hypofunctional disorders (hypo group) and 20 with hyperfunctional disorders (hyper group), and 30 individuals with normal voice (control group) participated in the study. PTP was measured indirectly by intra-oral pressure during production of bilabial stop consonant-vowel syllables, PTF was measured during the sustained vowel /a/, and PTW was obtained as the product of PTP and PTF. The extent of incomplete glottal closure was quantified by normalized glottal gap (NGG) and normalized glottal gap area (NGGA) based on image analysis of videostroboscopic recordings of sustained /i/.

Significant differences in all threshold measures (p < .05) were found among three participant groups with medium-to-large effect sizes (ηp2 = .128-.220), with significantly higher values for the hypo group than the control group and no significant differences between the hyper and control groups. Receiver operating characteristic (ROC) analysis showed the highest diagnostic or classification accuracy contrasting between the hypo and control groups (area under the ROC curve = .717-.757), with the highest classification accuracy for PTW. There were significant, moderate-to-strong positive correlations with NGG and NGGA for the disorders group (Pearson's r = .4244-.6226) and the hypo group (r = .5689-.8949).

These measures could be effective for identifying glottal incompetence, especially for hypofunctional disorders. PTW could be more sensitive than PTP and PTF in reflecting the extent of incomplete glottal closure, consistent with theoretical predictions. Their relative sensitivities for quantifying distinct incomplete glottal closures specific to different voice disorders should be evaluated in future studies.

The Impact of Clear and Loud Speech Cues on Acoustic and Perceptual Features of Speech Production in Adolescents With Down Syndrome.

Speech Language Path

There are few evidence-based speech interventions designed to alter speech production in a way that ultimately results in increased speech intelligibility in adolescents with Down syndrome (DS). The primary purpose of this study was to examine the impact of clear and loud speech cues on acoustic and perceptual features of speech production in adolescents with DS.

Eight adolescents diagnosed with DS repeated sentences of varying lengths in three conditions: habitual, big mouth (i.e., clear speech), and strong voice (i.e., loud speech). Four hundred eighty adult listeners (20 listeners per adolescent per condition) provided orthographic transcriptions of adolescent's speech, which were used to calculate intelligibility scores. Acoustic measures of speech rate, articulation rate, proportion of time spent pausing, vocal intensity, and fundamental frequency were calculated for each sentence.

The big mouth condition resulted in significantly increased intelligibility, slowed speech and articulation rates, increased pauses, increased vocal intensity, and increased fundamental frequency. The strong voice condition resulted in significantly increased vocal intensity and fundamental frequency, but no other changes. Speech rate was the only variable that explained any of the variance in intelligibility.

Adolescents with DS respond differently to clear and loud speech cues. In particular, clear speech cues resulted in significant increases in intelligibility, but loud speech cues did not. Clear speech cues hold promise as an intervention strategy for adolescents with DS.