Assistive devices for children with functional impairments: impact on child and caregiver function

from Developmental Medicine and Child Neurology

Functional impairments can limit a child’s ability to participate in the experiences of childhood. This ‘deprivation’ can, in turn, have a negative effect on such children’s development, academic performance, and quality of life, as well as on the lives of their caregivers and families. Many adults use assistive devices to overcome functional impairments and enable them to participate in daily activities; however, such devices may be underutilized by children. Each of the 54 studies reviewed in this report identified one or more functional impairments towards which an assistive device was targeted: accessing a computer (n=3 [studies]), activity assistance (n=2), behaviour changes (n=3), communication (n=30), independent feeding (n=1), living skills (n=1), mobility (n=9), modifying the environment (n=1), nutrition (n=4), and postural stability (n=2). The aim of this review was to determine the impact of assistive devices on the components of functioning defined by the World Health Organization’s International Classification of Functioning, Disability and Health. The impact of these devices was found to be overwhelmingly positive. Study outcomes reported were mainly child-focused and could be classified as influencing activity, participation, and personal contextual factors, with relatively little attention paid to caregiver-focused outcomes. Few studies provided either qualitative evidence or experimentally-based quantitative research evidence using controls.

What’s the best treatment for perforated tympanic membrane -either a a result of ASOM or barotrauma -ie is there a difference?

from the National Health Service (UK)

We searched the NLH ENT and Audiology Specialist Library and the TRIP database for guidelines on the management of perforated tympanic membranes but found none. However, we did find information on this topic from a number of online encyclopaedias and this seems to suggest, in most cases, no treatment is the recommended option regardless of the cause of tympanic perforation.

Emotions in [a]: A perceptual and acoustic study

from Logopedics Phoniatrics Vocology

The aim of this investigation is to study how well voice quality conveys emotional content that can be discriminated by human listeners and the computer. The speech data were produced by nine professional actors (four women, five men). The speakers simulated the following basic emotions in a unit consisting of a vowel extracted from running Finnish speech: neutral, sadness, joy, anger, and tenderness. The automatic discrimination was clearly more successful than human emotion recognition. Human listeners thus apparently need longer speech samples than vowel-length units for reliable emotion discrimination than the machine, which utilizes quantitative parameters effectively for short speech samples.

The impact of dysarthria on everyday communication after traumatic brain injury: A pilot study

from Brain Injury

Primary objective: To compare the everyday communication of individuals with mild and moderate dysarthria and concomitant cognitive-communication impairments following traumatic brain injury (TBI).

Methods and procedures: Five participants with mild dysarthria and five with moderate dysarthria following TBI were recorded during telephone service enquiries with bus timetable call centre operators. Transcripts were analysed using exchange structure analysis derived from systemic functional linguistics. Listener comfort ratings were collected using a novel equal appearing interval scale to measure how comfortable people would feel interacting with the participants.

Main outcomes and results: Participants with moderate dysarthria were not necessarily penalized for having poorer intelligibility during bus timetable service encounters. While participants with moderate dysarthria were given poorer listener comfort ratings, this did not affect the way information was exchanged with bus timetable call centre operators. These findings were attributed to the powerful interactional role of TBI participants as customers, the amount of disability awareness training and experience held by call centre operators and the highly structured nature of bus timetable service enquiries. Listener comfort ratings could be predicted with moderate accuracy from intelligibility scores.

Conclusions: Service encounters where individuals with TBI are placed in a powerful interactional role of customer may be functional generalization tasks for people with moderate dysartrhia. Training and education of service providers may also impact on the communicative effectiveness of individuals with TBI.

Evoked potential testing in neuro-otology

from Current Opinion in Neurology

Purpose of review: To outline clinically applicable and evolving evoked potential techniques in neuro-otology.

Recent findings: Vestibular evoked potentials can be recorded from the averaged electromyogram of actively contracting sternocleidomastoid muscles (cervical vestibular evoked myogenic potentials) using air-conducted sound, bone-conducted vibration or direct current stimulation of the mastoid. Typical cervical vestibular evoked myogenic potential changes in common peripheral and central vestibulopathies are now known. A sound or vibration evoked vestibulo-ocular response has recently been recorded from averaged extra-ocular muscle electromyograms using surface recordings beneath the eye (ocular vestibular evoked myogenic potentials). Both techniques enable assessment of otolith function, and are sensitive screening tests for the superior canal dehiscence syndrome presenting with sound and pressure sensitivity. Vestibular evoked potentials recorded from human masseter muscles and from scalp electrodes are new techniques whose characteristics are still being explored.

Summary: Vestibular evoked potentials to nonphysiological stimuli can be recorded from cervical and extra-ocular muscles. They enable assessment of otolith organs, complement conventional tests of semicircular canal function and can be easily established in a neurology or otology practice.

Hearing Improvement after Resection of a Large Jugular Foramen Schwannoma: Case Report

from Skull Base

Although hearing improvement after surgery for small tumors of the cerebellopontine angle has been reported, the mechanism by which surgery leads to the improvement in hearing remains controversial. We report a patient who sought treatment for progressive tinnitus and hearing loss. Magnetic resonance imaging showed a large (5-cm) schwannoma in the cerebellopontine angle. At surgery the lesion was found to originate from rootlets of cranial nerve X at the jugular foramen. The patient underwent gross total resection of the tumor. Immediately after surgery, his hearing improved dramatically. We believe that our patient represents an example of hearing impairment at least in part referable to direct compression of the brainstem. Importantly, the patient’s hearing deficit was completely reversible. Some authors claim that surgery to preserve hearing may be contraindicated in patients with speech discrimination scores below 50%. However, when extrinsic brainstem compression may contribute to the cause of such a hearing decrement, postoperative improvement in hearing may be a reasonable expectation.

Decline in verbal memory in non-demented older adults

from the Journal of Clinical and Experimental Neuropsychology

Decline in memory function was detected in 30% of healthy community-dwelling elderly over 6 years using a task assessing delayed word list recall. Individuals with memory decline over time also demonstrated relative deficits on additional tasks of memory and learning, a task of working memory and executive function, and on a verbal (category) fluency task at their most recent assessment. These relative deficits in the performance of individuals with memory decline cannot be explained by age-related changes, education, intelligence, mood, health-related factors, or the individuals’ APOE ε 4 status. Decline in memory performance did not result in greater complaints of cognitive difficulties when compared with normal elderly, nor did it limit overall participation in life activities. Although the significance of memory decline in the current study was not determined quantitatively, memory decline is consistent with the early deterioration characteristic of mild cognitive impairment and preclinical Alzheimer’s disease and confirms the need to monitor individuals with objective memory decline, even when these individuals fall within normal limits for a given neuropsychological task.

Immediacy of integration in discourse comprehension: Evidence from Chinese readers’ eye movements

from Language and Cognitive Processes

An eye-movement study was conducted to examine whether Chinese readers immediately activate and integrate related background information during discourse comprehension. Participants were asked to read short passages, each containing a critical word that fitted well within the local context but was inconsistent or neutral with background information from the early part of the passage. This manipulation of textual consistency produced reliable effects on both first-pass reading fixations in the target region and second-pass reading times in the pre-target and target regions. These results indicate that integration processes start very rapidly in reading text in a writing system with properties that encourage delayed processing, suggesting that immediate processing is likely a universal principle in discourse comprehension.

Multiple meanings are not necessarily a disadvantage in semantic processing: Evidence from homophone effects in semantic categorisation

from Language and Cognitive Processes

The ambiguity disadvantage (slower processing of ambiguous words relative to unambiguous words) has been taken as evidence for a distributed semantic representational system like that embodied in parallel distributed processing (PDP) models. In the present study, we investigated whether semantic ambiguity slows meaning activation, as PDP models would predict, by examining homophone effects in semantic categorisation tasks. We observed a homophone effect in a go/no-go semantic categorisation task, but not in a yes/no semantic categorisation task. Our results suggest that previously reported ambiguity effects may have been due to the decision phase of the semantic categorisation task and not to the semantic processing phase, in which case the interpretation of the ambiguity disadvantage will need to be reconsidered.

Paradigmatic effects in auditory word recognition: The case of alternating voice in Dutch

from Language and Cognitive Processes

Two lexical decision experiments addressed the role of paradigmatic effects in auditory word recognition. Experiment 1 showed that listeners classified a form with an incorrectly voiced final obstruent more readily as a word if the obstruent is realised as voiced in other forms of that word’s morphological paradigm. Moreover, if such was the case, the exact probability of paradigmatic voicing emerged as a significant predictor of the response latencies. A greater probability of voicing correlated with longer response latencies for words correctly realised with voiceless final obstruents. A similar effect of this probability was observed in Experiment 2 for words with completely voiceless or weakly voiced (incompletely neutralised) final obstruents. These data demonstrate the relevance of paradigmatically related complex words for the processing of morphologically simple words in auditory word recognition.

Shallow semantic processing of text: Evidence from eye movements

from Language and Cognitive Processes

Evidence for shallow semantic processing has depended on paradigms that required readers to explicitly report whether they noticed an anomalous noun phrase (NP) after reading text such as ‘Amanda was bouncing all over because she had taken too many tranquillizing sedatives in one day’. We replicated previous research by showing that readers frequently fail to report the anomaly, and that less-skilled readers have particular difficulty reporting locally anomalous NPs such as tranquillizing stimulants. In addition, we examined the time course of anomaly detection by monitoring readers’ eye movements for spontaneous disruptions when encountering the anomalous NPs. The eye fixation data provided evidence for on-line detection of anomalies; however, the detection was delayed. Readers who later reported the anomaly did not spend longer processing the anomalous NP when first encountering it; however, they did spend longer refixating it. Our results challenge orthodox models of comprehension that assume that semantic analysis is exhaustive and complete.

The role of phonological awareness in mediating between reading and listening to speech

from Language and Cognitive Processes

Previous studies have shown that phonological awareness correlates with children’s reading aloud and also adults’ literacy experience. More recent research has further suggested that phonological awareness is associated with the processing of spoken language, which is a correlate of reading comprehension. In this paper, I argue that phonological awareness, reading, and spoken language are intercorrelated because phonological awareness mediates between the processing of written and spoken language, so far as the derivation of phonological information from print and speech is concerned. For meaning activation, phonological awareness may not have a role to play in linking reading to spoken language. In native and non-native adult speakers of English, I demonstrated: (1) a correlation between processing speech for meaning (i.e., listening comprehension) and reading comprehension, but not reading aloud; (2) a correlation between processing speech for phonological information (i.e., auditory phonological priming and phoneme discrimination) and reading aloud, but not reading comprehension; and (3) that phonological awareness mediated (2) but not (1). The implication is that phonological awareness binds reading and listening to speech only at the level of deriving a phonological code.

New Cochlear Implant Technology Possible

from Ivanhoe.com

How well today’s cochlear implants work varies in patients. Some may be able to hear sounds such as thunder. Others can understand speech but are not able to appreciate music. But new research could make it all possible.

Use of Ear Tubes for Ear Infections Not Consistent with Expert Guidelines

from Newswise.com

A new study suggests that children who typically receive an operation to insert ear tubes because of ear infections or fluid in the ear may not need it, according to clinical practice guidelines.

Learning and generalization on asynchrony and order tasks at sound offset: Implications for underlying neural circuitry

from Learning & Memory

Normal auditory perception relies on accurate judgments about the temporal relationships between sounds. Previously, we used a perceptual-learning paradigm to investigate the neural substrates of two such relative-timing judgments made at sound onset: detecting stimulus asynchrony and discriminating stimulus order. Here, we conducted parallel experiments at sound offset. Human adults practiced 1 h/d for 6–8 d on either asynchrony detection or order discrimination at sound offset with tones at 0.25 and 4.0 kHz. As at sound onset, learning on order-offset discrimination did not generalize to the other task (asynchrony), an untrained temporal position (onset), or untrained frequency pairs, indicating that this training affected a quite specialized neural circuit. In contrast, learning on asynchrony-offset detection generalized to the other task (order) and temporal position (onset), though not to untrained frequency pairs, implying that the training on this condition influenced a less specialized, or more interdependent, circuit. Finally, the learning patterns induced by single-session exposure to asynchrony and order tasks differed depending on whether these tasks were performed primarily at sound onset or offset, suggesting that this exposure modified circuitry specialized to separately process relative-timing tasks at these two temporal positions. Overall, it appears that the neural processes underlying relative-timing judgments are malleable, and that the nature of the affected circuitry depends on the duration of exposure (multihour or single-session) and the parameters of the judgment(s) made during that exposure.