We integrated data from a newborn hearing screening database and a preschool disability database to examine the relationship between newborn click evoked auditory brainstem responses (ABRs) and ...developmental disabilities. This sample included children with developmental delay (
n
= 2992), speech impairment (SI,
n
= 905), language impairment (
n
= 566), autism spectrum disorder (ASD,
n
= 370), and comparison children (
n
= 128,181). We compared the phase of the ABR waveform, a measure of sound processing latency, across groups. Children with SI and children with ASD had greater newborn ABR phase values than both the comparison group and the developmental delay group. Newborns later diagnosed with SI or ASD have slower neurological responses to auditory stimuli, suggesting sensory differences at birth.
Purpose The goal of this study was to employ frequently used analysis methods and tasks to identify values for cepstral peak prominence (CPP) that can aid clinical voice evaluation. Experiment 1 ...identified CPP values to distinguish speakers with and without voice disorders. Experiment 2 was an initial attempt to estimate auditory-perceptual ratings of overall dysphonia severity using CPP values. Method CPP was computed using the Analysis of Dysphonia in Speech and Voice (ADSV) program and Praat. Experiment 1 included recordings from 295 patients with medically diagnosed voice disorders and 50 vocally healthy control speakers. Speakers produced sustained /a/ vowels and the English language Rainbow Passage. CPP cutoff values that best distinguished patient and control speakers were identified. Experiment 2 analyzed recordings from 32 English speakers with varying dysphonia severity and provided preliminary validation of the Experiment 1 cutoffs. Speakers sustained the /a/ vowel and read four sentences from the Consensus Auditory-Perceptual Evaluation of Voice protocol. Trained listeners provided auditory-perceptual ratings of overall dysphonia for the recordings, which were estimated using CPP values in a linear regression model whose performance was evaluated using the coefficient of determination (
). Results Experiment 1 identified CPP cutoff values of 11.46 dB (ADSV) and 14.45 dB (Praat) for the sustained /a/ vowels and 6.11 dB (ADSV) and 9.33 dB (Praat) for the Rainbow Passage. CPP values below those thresholds indicated the presence of a voice disorder with up to 94.5% accuracy. In Experiment 2, CPP values estimated ratings of overall dysphonia with
values up to .74. Conclusions The CPP cutoff values identified in Experiment 1 provide normative reference points for clinical voice evaluation based on sustained /a/ vowels and the Rainbow Passage. Experiment 2 provides an initial predictive framework that can be used to relate CPP values to the auditory perception of overall dysphonia severity based on sustained /a/ vowels and Consensus Auditory-Perceptual Evaluation of Voice sentences.
There has been an increased interest in speech pattern analysis applications of Parkinsonism for building predictive telediagnosis and telemonitoring models. For this purpose, we have collected a ...wide variety of voice samples, including sustained vowels, words, and sentences compiled from a set of speaking exercises for people with Parkinson's disease. There are two main issues in learning from such a dataset that consists of multiple speech recordings per subject: 1) How predictive these various types, e.g., sustained vowels versus words, of voice samples are in Parkinson's disease (PD) diagnosis? 2) How well the central tendency and dispersion metrics serve as representatives of all sample recordings of a subject? In this paper, investigating our Parkinson dataset using well-known machine learning tools, as reported in the literature, sustained vowels are found to carry more PD-discriminative information. We have also found that rather than using each voice recording of each subject as an independent data sample, representing the samples of a subject with central tendency and dispersion metrics improves generalization of the predictive model.
Purpose: Recent studies confirm the utility of speech-language intervention in primary progressive aphasia (PPA); however, long-term outcomes, ideal dosage parameters, and relative benefits of ...intervention across clinical variants warrant additional investigation. The purpose of this study was to determine whether naming treatment affords significant, lasting, and generalized improvement for individuals with semantic and logopenic PPA and whether dosage manipulations significantly affect treatment outcomes. Method: Eighteen individuals with PPA (9 semantic and 9 logopenic variant) underwent lexical retrieval treatment designed to leverage spared cognitive-linguistic domains and develop self-cueing strategies to promote naming. One group (n = 10) underwent once-weekly treatment sessions, and the other group (n = 8) received the same treatment with 2 sessions per week and an additional "booster" treatment phase at 3 months post-treatment. Performance on trained and untrained targets/tasks was measured immediately after treatment and at 3, 6, and 12 months post-treatment. Results: Outcomes from the full cohort of individuals with PPA showed significantly improved naming of trained items immediately post-treatment and at all follow-up assessments through 1 year. Generalized improvement on untrained items was significant up to 6 months post-treatment. The positive response to treatment was comparable regardless of session frequency or inclusion of a booster phase. Outcomes were comparable across PPA subtypes, as was maintenance of gains over the post-treatment period. Conclusion: This study documents positive naming treatment outcomes for a group of individuals with PPA, demonstrating strong direct treatment effects, maintenance of gains up to 1 year post-treatment, and generalization to untrained items. Lexical retrieval treatment, in conjunction with daily home practice, had a strong positive effect that did not require more than 1 clinician-directed treatment session per week. Findings confirm that strategic training designed to capitalize on spared cognitive-linguistic abilities results in significant and lasting improvement, despite ongoing disease progression, in PPA.
Purpose: Parents, professionals, and policy makers need information on the long-term prognosis for children with communication disorders. Our primary purpose in this report was to help fill this gap ...by profiling the family, educational, occupational, and quality of life outcomes of young adults at 25 years of age (N = 244) from the Ottawa Language Study, a 20-year, prospective, longitudinal study of a community sample of individuals with (n = 112) and without (n = 132) a history of early speech and/or language impairments. A secondary purpose of this report was to use data from earlier phases of the study to predict important, real-life outcomes at age 25. Method: Participants were initially identified at age 5 and subsequently followed at 12, 19, and 25 years of age. Direct assessments were conducted at all 4 time periods in multiple domains (demographic, communicative, cognitive, academic, behavioral, and psychosocial). Results: At age 25, young adults with a history of language impairments showed poorer outcomes in multiple objective domains (communication, cognitive/academic, educational attainment, and occupational status) than their peers without early communication impairments and those with early speech-only impairments. However, those with language impairments did not differ in subjective perceptions of their quality of life from those in the other 2 groups. Objective outcomes at age 25 were predicted differentially by various combinations of multiple, interrelated risk factors, including poor language and reading skills, low family socioeconomic status, low performance IQ, and child behavior problems. Subjective well-being, however, was primarily associated with strong social networks of family, friends, and others. Conclusion: This information on the natural history of communication disorders may be useful in answering parents' questions, anticipating challenges that children with language disorders might encounter, and planning services to address those issues. (Contains 4 tables and 1 figure.)
Purpose: This study collected measures of auditory-perceptual and oral somatosensory acuity in typically developing children and adolescents aged 9-15 years. We aimed to establish reference data that ...can be used as a point of comparison for individuals with residual speech sound disorder (RSSD), especially for RSSD affecting American English rhotics. We examined concurrent validity between tasks and hypothesized that performance on at least some tasks would show a significant association with age, reflecting ongoing refinement of sensory function in later childhood. We also tested for an inverse relationship between performance on auditory and somatosensory tasks, which would support the hypothesis of a trade-off between sensory domains. Method: Ninety-eight children completed three auditory-perceptual tasks (identification and discrimination of stimuli from a "rake"-"wake" continuum and category goodness judgment for naturally produced words containing rhotics) and three oral somatosensory tasks (bite block with auditory masking, oral stereognosis, and articulatory awareness, which involved explicit judgments of relative tongue position for different speech sounds). Pairwise associations were examined between tasks within each domain and between task performance and age. Composite measures of auditory-perceptual and somatosensory functions were used to investigate the possibility of a sensory trade-off. Results: Statistically significant associations were observed between the identification and discrimination tasks and the bite block and articulatory awareness tasks. In addition, significant associations with age were found for the category goodness and bite block tasks. There was no statistically significant evidence of a trade-off between auditory-perceptual and somatosensory domains. Conclusions: This study provided a multidimensional characterization of speech-related sensory function in older children/adolescents. Complete materials to administer all experimental tasks have been shared, along with measures of central tendency and dispersion for scores in two subgroups of age. Ultimately, we hope to apply this information to make customized treatment recommendations for children with RSSD based on sensory profiles.
Purpose: Voice disorders are best assessed by examining vocal fold dynamics in connected speech. This can be achieved using flexible laryngeal high-speed videoendoscopy (HSV), which enables us to ...study vocal fold mechanics with high temporal details. Analysis of vocal fold vibration using HSV requires accurate segmentation of the vocal fold edges. This article presents an automated deep-learning scheme to segment the glottal area in HSV from which the glottal edges are derived during connected speech. Method: Using a custom-built HSV system, data were obtained from a vocally healthy participant reciting the "Rainbow Passage." A deep neural network was designed for glottal area segmentation in the HSV data. A recently introduced hybrid approach by the authors was utilized as an automated labeling tool to train the network on a set of HSV frames, where the glottis region was automatically annotated during vocal fold vibrations. The network was then tested against manually segmented frames using different metrics, intersection over union (IoU), and Boundary F1 (BF) score, and its performance was assessed on various phonatory events on the HSV sequence. Results: The designed network was successfully trained using the hybrid approach, without the need for manual labeling, and tested on the manually labeled data. The performance metrics showed a mean IoU of 0.82 and a mean BF score of 0.96. In addition, the evaluation assessment of the network's performance demonstrated an accurate segmentation of the glottal edges/area even during complex nonstationary phonatory events and when vocal folds were not vibrating, thus overcoming the limitations of the previous hybrid approach that could only be applied to the vibrating vocal folds. Conclusions: The introduced automated scheme guarantees accurate glottis representation in challenging color HSV data with lower image quality and excessive laryngeal maneuvers during all instances of connected speech. This facilitates the future development of HSV-based measures to assess the running vibratory characteristics of the vocal folds in speakers with and without voice disorder.
Purpose: Children with cerebral palsy (CP) are at risk for significant communication problems. Reduced speech intelligibility is common, even for those who do not have speech motor deficits. ...Development of intelligibility has not been comprehensively quantified in children with CP; as a result, we are currently unable to predict later speech outcomes. Such information would advance treatment decision making. We sought to examine growth in speech intelligibility among children with CP using a prospective longitudinal design, with a focus on age of crossing target intelligibility thresholds, age of greatest intelligibility growth, and how well intelligibility at 36 months predicted intelligibility at 96 months. Method: Sixty-nine children with CP were followed longitudinally between 24 and 96 months of age. A total of 566 time points were examined across children (M = 8.2 time points per child, SD = 2.6). We fitted a nonlinear random effects model for longitudinal observations and then used the fitted model trajectories to generate descriptive analyses of growth. We used results of the model to generate a set of simulations, which we analyzed to determine how well 36-month intelligibility data predicted 96-month data. Results: Half of children crossed 25% and 50% intelligibility thresholds at 36 and 49 months of age, respectively. Slightly more than half of children did not reach 75% intelligibility by 96 months of age. Age of crossing 25%, 50%, and 75% intelligibility thresholds was highly negatively correlated with intelligibly at 96 months. Children had the steepest intelligibility growth at 36 months, followed by 48 and 60 months. Intelligibility at 36 months was highly predictive of intelligibility at 96 months. Conclusions: The developmental window from 3 to 5 years constitutes a time of rapid growth in speech intelligibility in children with CP. Children who cross intelligibility thresholds of 25%, 50%, and 75% at earlier ages have better outcomes when they are older; early performance is highly predictive of later speech intelligibility outcomes. Children with CP as a group have delayed speech intelligibility development but are still growing through 96 months of age.
Purpose: The purpose of this study was to explore the relationship between speech perception, speech production, and vocabulary abilities in children with and without speech sound disorders (SSDs), ...analyzing the data both by group and continuously. Method: Sixty-one Australian English--speaking children aged 48-69 months participated in this study. Children's speech production abilities ranged along the continuum from SSDs through to typical speech. Their vocabulary abilities ranged along the continuum from typical to above average ("lexically precocious"). Children completed routine speech and language assessments in addition to an experimental Australian English lexical and phonetic judgment task. Results: When analyzing data by group, there was no significant difference between the speech perception ability of children with SSDs and that of children without SSDs. Children with above-average vocabularies had significantly better speech perception ability than children with average vocabularies. When analyzing data continuously, speech production and vocabulary were both significant positive predictors of variance in speech perception ability, both individually in simple linear regression and when combined in multiple linear regression. There was also a significant positive correlation between perception and production of two of the four target phonemes tested (i.e., /k/ and Purpose: The purpose of this study was to explore the relationship between speech perception, speech production, and vocabulary abilities in children with and without speech sound disorders (SSDs), analyzing the data both by group and continuously. Method: Sixty-one Australian English--speaking children aged 48--69 months participated in this study. Children's speech production abilities ranged along the continuum from SSDs through to typical speech. Their vocabulary abilities ranged along the continuum from typical to above average ("lexically precocious"). Children completed routine speech and language assessments in addition to an experimental Australian English lexical and phonetic judgment task. Results: When analyzing data by group, there was no significant difference between the speech perception ability of children with SSDs and that of children without SSDs. Children with above-average vocabularies had significantly better speech perception ability than children with average vocabularies. When analyzing data continuously, speech production and vocabulary were both significant positive predictors of variance in speech perception ability, both individually in simple linear regression and when combined in multiple linear regression. There was also a significant positive correlation between perception and production of two of the four target phonemes tested (i.e., /k/ and voiceless postalveolar fricative) among children in the SSD group. Conclusions: Results from this study provide further insight into the complex relationship between speech perception, speech production, and vocabulary abilities in children. While there is a clinical and important need for categorical distinctions between SSDs and typically developing speech, findings further highlight the value of investigating speech production and vocabulary abilities continuously and categorically. By capturing the heterogeneity among children's speech production and vocabulary abilities, we can advance our understanding of SSDs in children. ) among children in the SSD group. Conclusions: Results from this study provide further insight into the complex relationship between speech perception, speech production, and vocabulary abilities in children. While there is a clinical and important need for categorical distinctions between SSDs and typically developing speech, findings further highlight the value of investigating speech production and vocabulary abilities continuously and categorically. By capturing the heterogeneity among children's speech production and vocabulary abilities, we can advance our understanding of SSDs in children.
PDF
