Audiology and Speech Pathology - Research Publications
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ItemNo Preview AvailableA Comparative Study of Two Acoustic Measures of Hypernasality(AMER SPEECH-LANGUAGE-HEARING ASSOC, 2009-12-01)PURPOSE: This study aimed to compare 2 quantitative acoustic measures of nasality in children with cleft lip and palate (CLP) and healthy controls using formalized perceptual assessment as a guide. METHOD: Fifty participants (23 children with CLP and 27 age- and gender-matched healthy controls) aged between 4 and 12 years produced a variety of high and low vowels that allowed perceptual ratings of nasal resonance severity as well as acoustic analysis of spectral changes. Two objective measures of nasality were used: 1/3 octave spectra analysis and the voice low tone high tone ratio. Each respective technique has been evaluated in previous research, and their potential as an effective means of detecting changes in nasal resonance has been demonstrated. RESULTS: Only 1/3 octave spectra analysis differentiated between participants with hypernasal speech and those perceived to have normal nasal resonance. Significant differences were also observed between varying levels of perceived severity on vowels within nonnasalized phonemic environments (/pIt/, /tIp/). CONCLUSIONS: Perceptual judgment remains the primary means of evaluating levels of nasality in children with CLP. However, the development and validation of easy-to-use objective techniques remains an important goal for effective clinical and empirical practice.
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ItemNo Preview AvailableFactors affecting the quality of sound recording for speech and voice analysis(INFORMA HEALTHCARE, 2009-12)The importance and utility of objective evidence-based measurement of the voice is well documented. Therefore, greater consideration needs to be given to the factors that influence the quality of voice and speech recordings. This manuscript aims to bring together the many features that affect acoustically acquired voice and speech. Specifically, the paper considers the practical requirements of individual speech acquisition configurations through examining issues relating to hardware, software and microphone selection, the impact of environmental noise, analogue to digital conversion and file format as well as the acoustic measures resulting from varying levels of signal integrity. The type of recording environment required by a user is often dictated by a variety of clinical and experimental needs, including: the acoustic measures being investigated; portability of equipment; an individual's budget; and the expertise of the user. As the quality of recorded signals is influenced by many factors, awareness of these issues is essential. This paper aims to highlight the importance of these methodological considerations to those previously uninitiated with voice and speech acoustics. With current technology, the highest quality recording would be made using a stand-alone hard disc recorder, an independent mixer to attenuate the incoming signal, and insulated wiring combined with a high quality microphone in an anechoic chamber or sound treated room.
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ItemNo Preview AvailableVerbal Fluency, Semantics, Context and Symptom Complexes in Schizophrenia(SPRINGER/PLENUM PUBLISHERS, 2009-10)Lexical-semantic access and retrieval was examined in 15 adults diagnosed with schizophrenia and matched controls. This study extends the literature through the inclusion of multiple examinations of lexical-semantic production within the same patient group and through correlating performance on these tasks with various positive and negative clinical symptoms. On tasks of verbal fluency, meaning generation, sentence production using contextual information and confrontation naming, participants with schizophrenia made significantly more semantic errors on naming tasks; produced fewer meanings for homophones; produced fewer items on semantic, phonological, cued and switching fluency tasks; and produced more errors on sentence production tasks when compared to healthy controls. Significant correlations were also observed between ratings of psychomotor poverty and measures of semantic production and mental inflexibility. This study has provided additional evidence for deficits in lexical-semantic retrieval which are not due to underlying semantic store degradation, do not involve phonological based retrieval, and at the level of sentence generation appear to vary as a function of the contextual constraints provided.
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ItemNo Preview AvailableA Cochrane review of treatment for childhood apraxia of speech (Reprinted from Cochrane Database of Systematic Reviews, 2008)(EDIZIONI MINERVA MEDICA, 2009-03)BACKGROUND: The diagnosis of Childhood Apraxia of Speech (CAS) remains heavily debated, and there is no agreement upon the etiology for the disorder. Whilst there is some consensus on the potential broad array of presenting features of children with CAS, only three key features are recognised as ubiquitous for diagnosis: 1) inconsistent error production on both consonants and vowels across repeated productions of syllables or words; 2) lengthened and impaired coarticulatory transitions between sounds and syllables; and 3) inappropriate prosody. Despite the typically severe and complex presentation of CAS, there is little evidence reported on intervention approaches for the disorder, perhaps as a result of the ongoing deliberation over etiology and diagnosis. OBJECTIVES: The aim of this paper was to assess the efficacy of intervention delivered by Speech and Language Pathologists(s)/Speech and Language Therapists targeting CAS in children and adolescents. METHOD: Several electronic databases were searched up to January 2007. The review considered randomised controlled trials (RCTs) and quasi-randomised studies of children aged 3 to 16 years with CAS, grouped by treatment types (e.g., perceptual and instrumentally-based biofeedback treatment techniques). Two authors independently assessed references identified from the searches and obtained full text versions of all potentially relevant articles. RESULTS: Of 825 titles and abstracts searched, only 31 abstracts appeared to meet inclusion criteria. The remaining 794 papers were excluded predominantly on the basis of not including participants with CAS (e.g., focused on other developmental speech disorders or adult acquired apraxia of speech), or for not being intervention studies (i.e. being diagnostic or descriptive). All 31 full text articles obtained were excluded following evaluation as they did not meet inclusion criteria on design. CONCLUSION: The review demonstrates a critical lack of well controlled treatment studies addressing treatment efficacy for CAS, making it impossible for conclusions to be drawn about which interventions are most effective for treating CAS in children or adolescents.
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ItemNo Preview AvailableArticulatory disturbance in Friedreich’s ataxia: An electropalatographic study(Wiley, 2009)Objective: To use the instrumentation of electropalatography (EPG) to investigate the spatial and temporal aspects of linguopalatal contact during consonant production in a group of individuals with Friedreich’s Ataxia (FRDA). Background: FRDA is an autosomal neurodegenerative disease primarily affecting the spinocerebellar tracts, the corticospinal path- ways and the dorsal columns. Clinical manifestation generally begins in childhood, with the individual becoming wheelchair bound in early adulthood and life expectancy being markedly reduced. Dysarthria constitutes a core symptom of FRDA, presenting between 5 and 19 years post onset of disease. Perceptual and acoustic studies have revealed an articulatory disturbance to be prominent in the dysarthria associated with FRDA. Methods: The subject group consisted of seven individuals, four females and three males, with confirmation of FRDA. The mean age of the group was 41.71 years (SD 5 8.3) with an age range of 35 to 56 years. A group of 14 non-neurologically impaired adults served as controls. The Reading EPG3 system was used to measure the amount and pattern of linguopalatal contact at the point of maximum contact and the consonant phase durations for an array of consonants, /t/, /l/, /s/, /k/. All consonants were word initial position, within words of CV and CVC construction, embedded into short sentences and repeated aloud five times by each subjects while wearing an EPG palate. Results: The FRDA group exhibited normal spatial configurations of linguopalatal contact. Temporal measures revealed significantly prolonged closure phase durations for each consonant singleton, con- tributing to longer consonant phase durations compared to the control group. Conclusions: The FRDA group demonstrated disturbances in artic- ulatory timing while maintaining normal linguopalatal contact pat- terns. The results are discussed in relation to the neuropathophysio- logical effects of spinocerebellar degeneration on speech motor control systems.
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ItemNo Preview AvailableStandardization of pitch-range settings in voice acoustic analysis(PSYCHONOMIC SOC INC, 2009-05)Voice acoustic analysis is typically a labor-intensive, time-consuming process that requires the application of idiosyncratic parameters tailored to individual aspects of the speech signal. Such processes limit the efficiency and utility of voice analysis in clinical practice as well as in applied research and development. In the present study, we analyzed 1,120 voice files, using standard techniques (case-by-case hand analysis), taking roughly 10 work weeks of personnel time to complete. The results were compared with the analytic output of several automated analysis scripts that made use of preset pitch-range parameters. After pitch windows were selected to appropriately account for sex differences, the automated analysis scripts reduced processing time of the 1,120 speech samples to less than 2.5 h and produced results comparable to those obtained with hand analysis. However, caution should be exercised when applying the suggested preset values to pathological voice populations.
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ItemNo Preview AvailableA Cochrane review of treatment for dysarthria following acquired brain injury in children and adolescents(EDIZIONI MINERVA MEDICA, 2009-06)BACKGROUND: The expression ''acquired brain injury'' (ABI) incorporates a range of etiologies including cerebrovascular accident, brain tumour and traumatic brain injury. ABI is a common cause of disability in the pediatric population, and dysarthria is a common and often persistent sequelae associated with ABI in children. OBJECTIVES: The aim of this study was to assess the efficacy of intervention delivered by Speech and Language Pathologists/Therapists targeting dysarthric speech in children resulting from acquired brain injury. METHODS: Several electronic databases were searched up to January 2007. The review considered randomised controlled trials (RCTs) and quasi-randomised studies of children aged 3 to 16 years with acquired dysarthria grouped by aetiology (e.g., brain tumour, traumatic brain injury, cerebrovascular accident). Both authors independently assessed the titles and abstracts for relevance (100% inter-rater reliability) and the full text version of all potentially relevant articles was obtained. No studies met inclusion criteria. RESULTS: Of 2091 titles and abstracts identified, full text versions of only three were obtained. The remaining 2 088 were excluded, largely on the basis of not including dysarthria, being diagnostic or descriptive papers, and for concerning adults rather than children. All obtained articles were excluded due to including populations without ABI, adults with dysarthria, or inappropriate design. Thus, no studies met inclusion criteria. CONCLUSIONS: The review demonstrates a critical lack of studies, let alone RCTs, addressing treatment efficacy for dysarthria in children with ABI. Possible reasons to explain this lack of data include 1) a lack of understanding of the characteristics or natural history of dysarthria associated with this population; 2) the lack of a diagnostic classification system for children precluding the development of well targeted intervention programs; and 3) the heterogeneity of both the etiologies and resultant possible dysarthria types of pediatric ABI. Efforts should first be directed at modest well-controlled studies to identify likely efficacious treatments that may then be trialled in multicentre collaborations using quasi-randomised or RCT methodology.
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ItemHow we do it: clinical management of the child receiving a second, bilateral cochlear implant.(Informa UK Limited, 2009-06)For children to gain maximum benefit from a second, bilateral cochlear implant clinicians need to be aware of the special needs of the family and child, and to adapt their clinical management appropriately. This article describes how the situation of the family considering a second implant is different, and how the decision to be made differs from that for a first implant. The information specific to sequential implants that should be provided so families can make an informed decision is reviewed. Programming issues unique to sequential bilateral cochlear implants are discussed. Finally, information is provided on how children may respond post-operatively, and what can be done to promote bilateral device use and the development of listening skills with the new implant.