Voice focus is a term that describes the perceived brightness or throatiness of the voice. In previous research, forward voice focus resulted in higher and backward focus in lower nasalance scores. ...This study explored whether electronically altered auditory voice focus feedback prompts speakers to adjust their voice focus and whether this affects nasalance scores. Twenty females with normal speech wore a Nasometer headset and headphones. They repeated a single sentence with oral and nasal sounds. Their auditory feedback was gradually changed with a voice transformer, so the speakers heard themselves with a more forward or backward voice focus, respectively. Oral-nasal balance was quantified as a nasalance score. Analysis of variance results of the averaged first and second vowel formants of three repetitions of the stimulus at the different baselines and maximum forward and maximum backward voice focus feedback conditions demonstrated significant effects of the voice shift condition. Analysis of variance for the nasalance scores demonstrated a significant effect of feedback condition. From the initial mean nasalance scores of 29.5%, the mean nasalance dropped to 27.5% in the backward and to 25.7% in the forward focus feedback condition. The altered auditory feedback induced voice focus adjustments that resulted in lower nasalance scores. The use of altered auditory feedback in speech therapy of hypernasality needs to be investigated in future research. KEYWORDS ACOUSTIC ANALYSIS ACOUSTIC MEASUREMENTS NASALITY RESONANCE SPEECH MOTOR COORDINATION SPEECH PRODUCTION VELOPHARYNGEAL FUNCTION VOICE La resonance vocale (voice focus') est un terme qui decrit la brillance (brightness) ou la sombreur ((throatiness) percues de la voix. Les resultats d'etudes precedemment publiees ont montre qu'une resonance vocale anterieure generait des scores de nasalance plus eleves, tandis qu'une resonance vocale posterieure generait des scores de nasalance plus bas. La presente etude avait pour objectif d'explorer si une retroaction auditive dans laquelle la resonance vocale est alteree de facon electronique incitait des locutrices a modifier leur resonance vocale et si cet ajustement avait pour effet de modifier leurs scores de nasalance. Vingt femmes ayant une parole normale ont ete equipees d'un casque d'un nasometre et d'ecouteurs. Elles ont repete une meme phrase contenant des sons oraux et nasaux. La retroaction auditive a ete graduellement alteree a l'aide d'un appareil de transformation de la voix, de sorte que les locutrices s'entendaient avec une resonance vocale anterieure ou posterieure. Le ratio de l'energie acoustique nasale et de la somme de l'energie acoustique orale et nasale a ete quantifie grace aux scores de nasalance. Des analyses de variance de la moyenne des premiers et deuxiemes formants des voyelles et des scores de nasalance ont ete realisees avec trois repetitions de stimuli recueillis dans differentes conditions experimentales : conditions de reference, condition oU la resonance vocale a une mise au point maximale vers l'avant et condition oU la resonance vocale a une mise au point maximale vers l'arriere. Les resultats montrent un effet significatif du changement de la mise au point de la resonance vocale sur les formants et sur les scores de nasalance. Lorsque comparees a la moyenne initiale des scores de nasalance (c.-a-d. 29,5 %), les moyennes des scores de nasalance ont diminue a 27,5 % et 25,7 % dans les conditions oU la retroaction auditive alterait la resonance vocale vers l'arriere et l'avant respectivement. L'alteration de la retroaction auditive a ainsi entraine des mises au point de la resonance vocale qui se sont traduites par une diminution des scores de nasalance. Le recours a l'alteration de la retroaction auditive dans le cadre de traitements orthophoniques de l'hypernasalite doit etre davantage etudie dans de futures recherches.
This practical workbook is useful for speech-language pathologists who work with children with speech sound disorders in schools, private practices, or clinics. It can also be used as a supplementary ...text for a clinical methods course or within a speech sound disorders clinical practicum. This workbook is an easy-to-follow guide that allows clinicians to move from assessment results to treatment planning and execution.
Artificial language learning studies have demonstrated that learners exposed to many different nonword combinations representing a grammatical form demonstrate rapid learning of that form without ...explicit instruction. However, learners presented with few exemplars, even when they are repeated frequently, fail to learn the underlying grammar. This study translated this experimental finding in a therapeutic context.
Eighteen preschool children with language impairment received conversational recast treatment for morpheme errors. Over a 6-week period, half heard 12 unique verbs twice each during recasts (low-variability condition), and half heard 24 unique verbs (high-variability condition). Children's use of trained and untrained morphemes on generalization probes as well as spontaneous use of trained morphemes was tracked throughout treatment.
The high-variability condition only produced significant change in children's use of trained morphemes, but not untrained morphemes. Data from individual children confirmed that more children in the high- than the low-variability condition showed a strong treatment effect. Children in the high-variability condition also produced significantly more unique utterances containing their trained morpheme than children in the low-variability condition.
The results support the use of highly variable input in a therapeutic context to facilitate grammatical morpheme learning.
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Inroduction. Pathological characteristics of voice and speech in persons with benign and malignant vocal fold tumors present as different variations in the voice pitch, intensity and quality. The aim ...of the study was to determine the speech capacity of persons with malignant and benign vocal fold tumors before and after surgical treatment and to establish if there are differences in the speech capacity in relation to the type of tumor. Material and Methods. The sample included 67 subjects who were divided into two groups: group I - subjects with benign tumors, vocal cord lesions (polyps, cysts) and Reinke's edema and group II - subjects with malignant tumors, aged 23 to 74 years (mean age 55.43; standard deviation 11.95). Acoustic voice analysis, maximum phonation time of the vowel /a/, analysis of temporal speech organization, and sentence melody analysis were used for measuring the speech capacity. Results. Before surgery, the speech capacity in both groups of patients was almost equal, without statistical significance between the compared groups. After surgery, there was a statistically significant difference between the speech capacity in the examined groups, with better speech capacity observed in group I (t = -3.807, p < 0.001). The study did not show an isolated effect of time or tumor type on the speech capacity, but showed a combined effect (F = 10.079, p = 0.002). Conclusion. The proposed method for the assessment of the speech capacity before and after surgical treatment of vocal fold tumors is a useful tool for the prediction of the voice outcome and in planning rehabilitation procedures. Key words: Larynx; Neoplasms; Vocal Cords; Vocal Cord Dysfunction; Voice; Speech-Language Pathology; Speech Acoustics; Speech Production Measurement Uvod. Patoloske karakteristike glasa i govora kod osoba sa benignim i malignim tumorima na glasnicama sagledavaju se kao razlicite varijacije visine, intenziteta i kvaliteta govornog glasa. Cilj rada bio je utvrdivanje govornog kapaciteta osoba sa malignim i benignim tumorima na glasnicama, pre i posle hirurskog lecenja i konstatovanje da li postoje razlike u govornom kapacitetu u odnosu na vrstu tumora. Materijal i metode. Uzorak je cinilo 67 ispitanika podeljenih u dve grupe: I grupa - benigni tumori (polipi, ciste) i Rajnkeovi edemi i II grupa - ispitanici sa malignim tumorima, starosti od 23 do 74 godine (prosecna starost 55,43 godine; standardna devijacija 11,95 godina). Kao mera kapaciteta govora u istrazivanju je koriscena akusticka analiza glasa, maksimalno vreme fonacije samoglasnika /a/, analiza vremenske organizacije govora i analiza melodije recenice. Rezultati. Pre operacije govorni kapacitet u obe grupe ispitanika bio je skoro jednak, bez statisticke znacajnosti izmedu uporedenih grupa. Nakon operacije uocena je statisticki znacajna razlika izmedu govornog kapaciteta ispitivanih grupa, pri cemu je bolji govorni kapacitet uocen u I grupi (t = -3,807, p < 0,001). Studija nije pokazala izolovani efekat vremena ili vrste tumora na kapacitet govora, ali je pokazala kombinovani efekat (F = 10,079, p = 0,002). Zakljucak. Predlozeni nacin procene govornog kapaciteta pre i posle operativnog lecenja tumora glasnica predstavlja koristan alat kojim bi se moglo predvideti ocekivano stanje glasa i planirati rehabilitacioni postupak. Kljucne reci: larinks; neoplazme; glasne zice; disfunkcija glasnih zica; glas; govorno jezicka patologija; govorna akustika; merenje govornog kapaciteta
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Background: A 2009 survey of ENT, audiology, and speech therapy services and training opportunities in 18 Sub-Saharan African countries reported that the availability of services was extremely poor, ...the distribution of services was very inequitable, and training opportunities were limited.
Objective: We conducted a new survey to determine the current status of ear, nose, and throat (ENT), audiology, and speech therapy services in sub-Saharan Africa.
Method: This study is a cross-sectional study. A questionnaire was distributed by email to an ad hoc group of ENT surgeons and audiologists in 30 sub-Saharan African countries. Data from the current survey were compared to those of a 2009 survey. The numbers of ENT surgeons, audiologists, and speech therapists/100,000 people were compared to the ratios in the United Kingdom.
Results: A total of 22 countries responded to the questionnaire. When data of the 15 countries that responded in both 2009 and 2015 are compared, the number of ENT surgeons had increased by 43%, audiologists had increased by 2.5%, and speech therapists by 30%. When the 23% population growth is taken into account, the numbers of ENT surgeons, audiologists, and speech therapists per 100,000 people had declined in four countries, and there remains a severe shortfall of ENT surgeons, audiologists, and speech therapists when compared to the UK Respondents cited lack of availability of basic equipment as the most frequent limitation in providing ENT services. Other important factors causing limitations in daily practice were: lack of ENT training facilities and audiological rehabilitation, low awareness of the burden of ENT pathology, as well as poor human resources management.
Conclusions: There has been a lack of progress in ENT, audiology, and speech therapy services and training opportunities in sub-Saharan Africa between 2009 and 2015. There is a need to look at increased collaboration with developed countries and non-governmental organisations, establishing new and improving existing training centres in Africa, and task-shifting of some ENT services to primary health workers.
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PURPOSE: Nearly 800,000 individuals in the U.S. experience a stroke each year, with at least 15% acquiring subsequent aphasia (Centers for Disease Control & Prevention, 2019; Hilari, 2011 as cited in ...Escher, Amlani, Viani & Berger, 2018). One therapeutic approach that has been found to improve participation and quality of life for persons with aphasia (PWA) is that of an intensive comprehensive aphasia program (ICAP) (Escher et al., 2018; Hoover, Waters, Caplan, & Carney, 2013). Escher and colleagues (2018) describe an ICAP as interdisciplinary in nature, incorporating speech and occupational therapists in a community-based, group therapy setting to target participation and communication across many areas of occupation. One such program is executed at a graduate school for health professions and involves students from the occupational therapy (OT) and communication sciences and disorders (CSD) departments in leading group therapy for PWA over a six-week duration. The creators of this program have well established means to assess participation for PWA across both disciplines, but experiences of the student clinicians have not yet been explored (Nicholas, Connor, & Jennelle, 2013). This study seeks to explain students' experiences in the ICAP as they relate to promoting interdisciplinary foundations for entry-level clinical practice. The findings will inform clinical educators about how to promote interprofessional practice within an ICAP. DESIGN: A phenomenological, qualitative research design was utilized to describe OT students' experiences in an ICAP. METHOD: Qualitative data was collected via online discussion boards from OT students who participated in three instances of a six-week long ICAP at a graduate school for health professions. Data was collected as part of a reflection assignment for a three-credit academic elective centered around leading group therapy within the ICAP. Discussion board prompts asked students their reactions to and appraisal of interprofessional collaboration with CSD students as part of the program. They were also asked about their overall opinions related to the program and how it has prepared them for their careers. RESULTS: The discussion board responses over the course of the three ICAPs revealed overarching experiences about OT students' participation in the program. The two main themes identified are as follows: (1) desire for more consistent and formal interaction with CSD students throughout program duration, (2) appreciation of hands-on experience that prepared students for practice with PWA and beyond. While additions were made to the program over the years to facilitate further interprofessional collaboration, such as an online discussion board for communicating weekly plans, students continued to identify a need for in-person interactions on a weekly basis. OT and CSD students work together to perform an interprofessional evaluation and can assist in one another's group therapy sessions. However, OT students expressed a desire to observe individualized speech therapy sessions. They also suggested a comprehensive introduction of each disciplines' areas of expertise at the program's start. Many sentiments expressed by students in the first ICAP continued to emerge in following years. CONCLUSION: OT students involved in this six-week ICAP greatly appreciated the hands-on learning experiences that it provided. They expressed an increased ability and confidence in working with PWA, as well as in clinical documentation and treatment planning overall. Student reflections suggest that future ICAPs may benefit from the inclusion of weekly interdisciplinary meetings surrounding planning and client progress as well as conversations that facilitate a deeper understanding of disciplines' unique roles.
This text provides a foundation for understanding where speech-language pathology (SLP) programs fit within the school organization. SLPs will be motivated to collaborate with colleagues, lead ...discussions about the link between communication and learning, and introduce innovative models for delivering services. School Programs encourages SLPs to embrace their positions on school teams, share knowledge to make services educationally relevant and help children reach their highest potential.
•The Viking Speech Scale classifies the speech of children with cerebral palsy.•Parents and health professionals judge the Scale as valid and easy to use.•The Scale can be applied from direct ...observation of the child or using case notes.
Surveillance registers monitor the prevalence of cerebral palsy and the severity of resulting impairments across time and place. The motor disorders of cerebral palsy can affect children's speech production and limit their intelligibility. We describe the development of a scale to classify children's speech performance for use in cerebral palsy surveillance registers, and its reliability across raters and across time. Speech and language therapists, other healthcare professionals and parents classified the speech of 139 children with cerebral palsy (85 boys, 54 girls; mean age 6.03 years, SD 1.09) from observation and previous knowledge of the children. Another group of health professionals rated children's speech from information in their medical notes. With the exception of parents, raters reclassified children's speech at least four weeks after their initial classification. Raters were asked to rate how easy the scale was to use and how well the scale described the child's speech production using Likert scales. Inter-rater reliability was moderate to substantial (k>.58 for all comparisons). Test–retest reliability was substantial to almost perfect for all groups (k>.68). Over 74% of raters found the scale easy or very easy to use; 66% of parents and over 70% of health care professionals judged the scale to describe children's speech well or very well. We conclude that the Viking Speech Scale is a reliable tool to describe the speech performance of children with cerebral palsy, which can be applied through direct observation of children or through case note review.
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