Articulatory Variability in Cluttering

from Folia Phoniatrica et Logopaedica

In order to investigate the articulatory processes of the hasty and mumbled speech in cluttering, the kinematic variability was analysed by means of electromagnetic midsagittal articulography. In contrast to persons with stuttering, those with cluttering improve their intelligibility by concentrating on their speech task. Variability has always been an important criterion in comparable studies of stuttering and is discussed in terms of the stability of the speech motor system. The aim of the current study was to analyse the spatial and temporal variability in the speech of three persons with cluttering (PWC) and three control speakers. All participants were native speakers of German. The speech material consisted of repetitive CV syllables and loan words such as ‘emotionalisieren’, because PWC have the severest problems with long words with a complex syllable structure. The results showed a significantly higher coefficient of variation for PWC in loan word production, both in the temporal and in the spatial domain, whereas the means of displacements and durations did not differ between groups. These findings were discussed in terms of the effects of the linguistic complexity, since for the syllable repetition task, no significant differences between PWC and controls were found.

Clinical Intervention for Bilingual Children: An International Survey

from Folia Phoniatrica et Logopaedica

This paper reports on the results of an international survey undertaken by the Multilingual Affairs Committee of the IALP, to investigate the intervention provided to bilingual children. Information pertaining to 157 children was obtained from 99 speech-language therapists in 13 countries. The survey addressed biographical details and language background of the children, the diagnosed communication disorder, language competence of the therapists, issues pertaining to the language of intervention, use of interpreters, advice given to parents regarding the use of each language, and possible results of intervention. The findings are specific to each country and related to the sociolinguistic context. Very few therapists provide bilingual intervention, although many have strategies for ensuring the development of both languages, such as advising parents to speak only the home language. Therapists were generally unable to provide quantifiable intervention results due to a paucity of assessment materials for bilinguals. The IALP Multilingual Affairs Committee used the results of this survey to develop guidelines for working with multilingual populations with communication disorders.

Is a Specialised Training of Phonological Awareness Indicated in Every Preschool Child?

from Folia Phoniatrica et Logopaedica

Objective and Methods: In a prospective study 218 preschool children were enrolled (stratified in 2 training programs, one specialized for phonologic awareness in order to prevent dyslexia, the other consisting in training of general perception) during the last year of kindergarten. After finishing the first grade 131 children were compared in their reading and writing abilities. Results: In the whole group only a slight difference was found between both training modalities concerning their writing abilities. However, children with a history of hearing loss, actual hearing loss or pathologic middle ear findings profited most from the specialized training program compared to the control in their reading abilities. Conclusion: A specialized training program to improve phonologic awareness as a basis for reading and writing in every kindergarten and preschool child seems to be unnecessary. However, children with temporary hearing deficits benefit from such a program. For all other children general perception training may be sufficient.

Medialization Thyroplasty with a Customized Silicone Implant: Clinical Experience

from Folia Phoniatrica et Logopaedica

The authors implemented medialization thyroplasty with a customized silicone implant in a total of 43 operations (36 patients) in 1999-2003. In 5 of these patients, the medialization thyroplasty was combined with cricothyroid subluxation (3 cases) or adduction of arytenoid cartilage (3 cases). One patient received medialization thyroplasty, cricothyroid subluxation and adduction of arytenoid cartilage. Postoperatively 36 patients reported substantial reduction of their complaints, 5 patients found their voice improved and only 2 patients (5.6%) stated that their voice had not changed. The subjective evaluation was consistent with the findings of laryngoscopy and the preoperative and postoperative phonation parameters (maximum phonation time, maximum sound pressure level, jitter and shimmer). Average maximum phonation time was 6.5 s before surgery and 12.5 s after surgery. Maximum vocal sound pressure level was, on average, about 4 dB higher after surgery. Jitter was reduced from 5.3 to 3.7% and shimmer from 32.3 to 18.6%. The differences between presurgical and postsurgical parameters in our study were all statistically significant, indicating voice improvement. Medialization thyroplasty with a silicone implant was proven to be a successful and safe surgical method for the treatment of vocal fold paralysis.

Postural Dynamics and Vocal Effort: Preliminary Experimental Analysis

from Folia Phoniatrica et Logopaedica

Objectives: One postural characteristic of increased vocal effort is stiffening of the whole body, which in turn induces some postural instability. The study of postural instability can shed some insight into behavior or causes associated with vocal hyperfunction. Patients and Methods: A posturography platform was used to measure the root mean square of the velocity of variation of the center of pressure (VCOP rms) of control subjects standing upright on the platform. Four conditions were analyzed: (1) standing with eyes open versus eyes closed (n: 9); (2) standing at rest versus holding a 3-kg weight (n: 15); (3) standing while reading a dialogue at normal voice level versus loud voice (n: 17), and (4) standing while reading a dialogue in a calm versus noisy (Lombard effect) ambiance (n: 19). Results: Conditions leading to a stiffening of the body (eyes closed and weight holding) were associated with an increased instability assessed by the VCOP rms. In phonatory conditions leading to vocal effort, the mean VCOP rms was significantly increased: in 19 subjects reading a dialogue in a calm ambiance the mean VCOP rms was at 11.19 mm/s, and the VCOP rms raised 16.69 mm/s with surrounding noise at 82 db (Lombard effect). Conclusion: Increased vocal effort is associated with increased VCOP rms in most subjects studied. The effects of VCOP rms as a postural index allowing noninvasive assessment of the voice in pathology warrants further study.

Public Health Impact of Hearing Impairment and Disability

from Folia Phoniatrica et Logopaedica

This presentation of the public health impact of hearing impairment highlights the important elements of interaction between the disability and community. Objectives: Retrospective study to identify the size of the problem of hearing loss, illustrating not only the magnitude but also the serious effect of the lack of reliable data concerning this matter. It highlights the challenges met within a mid-economy community regarding the handling of the impact of the disability. The Egyptian data is given as an example of the situation in a mid-economy community. Study Design: A brief introduction of some epidemiological factors of hearing impairment is presented including the size of the problem in Egypt. Data of the neonatal hearing screening program of the Audiology Unit, Ain Shams University, is presented. The impact of the disability is then discussed in relation to the age of onset and the degree and type of hearing loss. This is followed by the description of the nature and effect of the disability in the different age groups. A discussion of the various factors that may modify the capability of the community to deal with such disability follows. This includes various economic indices with their possible limitations on the part of the community. Such a briefing illustrates the challenges met in the rehabilitation of the deaf and the hearing-impaired in a developing mid-economy country. The broad lines of the management of the problem both at the prophylactic as well as the rehabilitative levels are discussed. A final remark on recommendations and possible future development in a developing country is presented.

The Interobserver and Test-Retest Variability of the Dysphonia Severity Index

from Folia Phoniatrica et Logopaedica

Objective: The purpose of this study was to investigate the interobserver variability and the test-retest variability of the Dysphonia Severity Index (DSI), a multiparametric instrument to assess voice quality. Methods: The DSI was measured in 30 nonsmoking volunteers without voice complaints or voice disorders by two speech pathologists. The subjects were measured on 3 different days, with an interval of 1 week. Results: The difference in DSI between two observers (interobserver difference) was not significant. The intraclass correlation coefficient for the DSI was 0.79. The standard deviation of the difference between two duplicate measurements by different observers was 1.27. Conclusion: Differences in measurements between different observers were not significant. The intraclass correlation coefficient of the DSI was 0.79, which is to be considered good. Differences in DSI within one patient need to be larger than 2.49 to be significant.

Determination of Noise Immission From Sound Sources Close to the Ears

from Acta Acoustica united with Acustica

When a sound exposure stems from a sound source that is close to the ear of the exposed person, the noise is described in terms of the free-field related or diffuse-field related sound pressure level, i.e. the level of a free or a diffuse-sound field that would result in the same exposure of the person’s ear as that stemming from the close sound source. The at-ear sound exposure level is measured either by MIRE technique (microphones in real ears) or by a manikin, and the free-field related or diffuse-field related sound pressure levels are obtained by subtracting the free-field-front or the diffuse-field head-related transfer function (HRTF) expressed in dB. The use of either, the eardrum, the open entrance, or the blocked entrance as measurement point for the MIRE-technique is evaluated. The results are the same, wherever in the ear canal the measurements are made. There is good agreement between human HRTFs measured at different laboratories, and for eardrum, open-entrance and blocked entrance, standard HRTF data have been derived, which may be used instead of HRTFs measured for each subject. The resulting statistical uncertainty depends on the choice of measurement point, and whether individual or standard HRTF data are used. Generally, measurements at the blocked entrance are practical and produce results with low statistical uncertainty. The results from manikin-measurements do not agree well with results from humans (MIRE), when HRTFs from the actual manikin or from the manikin standards (IEC 60959 and ITU-T P.58) are used. A better agreement is obtained with HRTFs constructed by multiplying human blocked-entrance data with the transfer function of the standardized coupler for manikins. This method is therefore described (and data tabled) in ISO 11904-2. A comparison between humans, manikins, and the manikin standards suggest, that standards do not specify an average human and should be revised.

A psychometric analysis of functional category production in English agrammatic narratives

from Brain and Language

Hierarchical models of agrammatism propose that sentence production deficits can be accounted for in terms of clausal syntactic structure [Friedmann, N., & Grodzinsky, Y. (1997). Tense and agreement in agrammatic production: Pruning the syntactic tree. Brain and Language, 56, 397-425; Hagiwara, H. (1995). The breakdown of functional categories and the economy of derivation. Brain and Language, 50, 92-116]. Such theories predict that morpho-syntactic elements associated with higher nodes in the syntactic tree (complementizers and verb inflections) will be more impaired than elements associated with lower structural positions (negation markers and aspectual verb forms). While this hypothesis has been supported by the results of several studies [Benedet, M. J., Christiansen, J. A., & Goodglass, H. (1998). A cross-linguistic study of grammatical morphology in Spanish- and English-speaking agrammatic patients. Cortex, 34, 309-336; Friedmann, N. (2001). Agrammatism and the psychological reality of the syntactic tree. Journal of Psycholinguistic Research, 30, 71-88; Friedmann, N. (2002). Question production in agrammatism: The tree pruning hypothesis. Brain and Language, 80, 160-187], it has also been challenged on several grounds [Burchert, F., Swoboda-Moll, M., & De Bleser, R. (2005a). Tense and agreement dissociations in German agrammatic speakers: Underspecification vs. hierarchy. Brain and Language, 94, 188-199; Lee, M. (2003). Dissociations among functional categories in Korean agrammatism. Brain and Language, 84, 170-188; Lee, J., Milman, L. H., & Thompson, C. K. (2005). Functional category production in agrammatic speech. Brain and Language, 95, 123-124]. In this paper the question of hierarchical structure was re-examined within the framework of Item Response Theory [IRT, Rasch, G. (1980). Probabilistic models for some intelligence and attainment tests (Expanded ed.). Chicago: University of Chicago Press]. IRT is a probabilistic model widely used in the field of psychometrics to model behavioral constructs as numeric variables. In this study we examined production of functional categories (complementizers, verb inflections, negation markers, and aspectual verb forms) in narrative samples elicited from 18 individuals diagnosed with nonfluent aphasia and 18 matched controls. Data from the aphasic participants were entered into an IRT analysis to test (1) whether production of clausal functional categories can be represented as a variable on a numeric scale; and (2) whether production patterns were consistent with hierarchical syntactic structure. Pearson r correlation coefficients were also computed to determine whether there was a relation between functional category production and other indices of language performance. Results indicate that functional category production can be modeled as a numeric variable using IRT. Furthermore, although variability was observed across individuals, consistent patterns were evident when the data were interpreted within a probabilistic framework. Although functional category production was moderately correlated with a second measure of clausal structure (clause length), it was not correlated with more distant language constructs (noun/verb ratio and WAB A.Q.). These results suggest that functional category production is related to some, but not all, measures of agrammatic language performance.

Cognitive supports and cognitive constraints on comprehension of spoken language

from the Journal of the American Academy of Audiology

Although comprehension of spoken language is ordinarily conducted without apparent effort, it is among the most complex of human activities. We illustrate this complexity by outlining the operations involved at the perceptual, attentional, and linguistic levels necessary for successful comprehension of speech in sentences and discourse. We describe how challenges to speech comprehension imposed by hearing loss and cognitive limitations in the capacity of attentional and working memory resources can be counterbalanced to a significant degree by utilization of linguistic knowledge and contextual support, including the use of naturally-occurring speech prosody. We conclude by considering factors that may affect one’s willingness to expend the attentional effort that may be necessary for successful listening behavior and comprehension performance.

Interactions between cognition, compression, and listening conditions: effects on speech-in-noise performance in a two-channel hearing aid

from the Journal of the American Academy of Audiology

This study which included 23 experienced hearing aid users replicated several of the experiments reported in Gatehouse et al (2003, 2006) with new speech test material, language, and test procedure. The performance measure used was SNR required for 80% correct words in a sentence test. Consistent with Gatehouse et al, this study indicated that subjects showing a low score in a cognitive test (visual letter monitoring) performed better in the speech recognition test with slow time constants than with fast time constants, and performed better in unmodulated noise than in modulated noise, while subjects with high scores on the cognitive test showed the opposite pattern. Furthermore, cognitive test scores were significantly correlated with the differential advantage of fast-acting versus slow-acting compression in conditions of modulated noise. The pure tone average threshold explained 30% of the variance in aided speech recognition in noise under relatively simple listening conditions, while cognitive test scores explained about 40% of the variance under more complex, fluctuating listening conditions, where the pure tone average explained less than 5% of the variance. This suggests that speech recognition under steady-state noise conditions may underestimate the role of cognition in real-life listening.

Recognition of speech in noise with new hearing instrument compression release settings requires explicit cognitive storage and processing capacity

from the Journal of the American Academy of Audiology

Evidence suggests that cognitive capacity predicts the ability to benefit from specific compression release settings in non-linear digital hearing instruments. Previous studies have investigated the predictive value of various cognitive tests in relation to aided speech recognition in noise using compression release settings that have been experienced for a certain period. However, the predictive value of cognitive tests with new settings, to which the user has not had the opportunity to become accustomed, has not been studied. In the present study, we compare the predictive values of two cognitive tests, reading span and letter monitoring, in relation to aided speech recognition in noise for 32 habitual hearing instrument users using new compression release settings. We found that reading span was a strong predictor of speech recognition in noise with new compression release settings. This result generalizes previous findings for experienced test settings to new test settings, for both speech recognition in noise tests used in the present study, Hagerman sentences and HINT. Letter monitoring, on the other hand, was not found to be a strong predictor of speech recognition in noise with new compression release settings.

The role of cognition in age-related hearing loss

from the Journal of the American Academy of Audiology

The article presents a commentary on the accompanying six papers from the perspective of a cognitive psychologist. Treisman’s (1964, 1969) levels of analysis model of selective attention is suggested as a framework within which the interactions between ‘bottom-up’ auditory factors and ‘top-down’ cognitive factors may be understood. The complementary roles of auditory and cognitive aspects of hearing are explored, and their mutually compensatory properties discussed. The findings and ideas reported in the six accompanying papers fit well into such a ‘levels of processing’ framework, which may therefore be proposed as a model for understanding the effects of aging on speech processing and comprehension.

The contributions of audibility and cognitive factors to the benefit provided by amplified speech to older adults

from the Journal of the American Academy of Audiology

In this review of recent studies from our laboratory at Indiana University, it is argued that audibility is the primary contributor to the speech-understanding difficulties of older adults in unaided listening, but that other factors, especially cognitive factors, emerge when the role of audibility has been minimized. The advantages and disadvantages of three basic approaches used in our laboratory to minimize the role of audibility are examined. The first of these made use of clinical fits of personal amplification devices, but generally failed to make the aided speech stimuli sufficiently audible for the listeners. As a result, hearing loss remained the predominant predictor of performance. The second approach made use of raised and spectrally shaped stimuli with identical shaping applied for all listeners. The third approach used spectrally shaped speech that ensured audibility (at least 10 dB sensation level) of the stimuli up to at least 4000 Hz for each individual listener. With few exceptions, the importance of cognitive factors was revealed once the speech stimuli were made sufficiently audible.

The role of event-related brain potentials in assessing central auditory processing

from the Journal of the American Academy of Audiology

The perception of complex acoustic signals such as speech and music depends on the interaction between peripheral and central auditory processing. As information travels from the cochlea to primary and associative auditory cortices, the incoming sound is subjected to increasingly more detailed and refined analysis. These various levels of analyses are thought to include low-level automatic processes that detect, discriminate and group sounds that are similar in physical attributes such as frequency, intensity, and location as well as higher-level schema-driven processes that reflect listeners’ experience and knowledge of the auditory environment. In this review, we describe studies that have used event-related brain potentials in investigating the processing of complex acoustic signals (e.g., speech, music). In particular, we examine the role of hearing loss on the neural representation of sound and how cognitive factors and learning can help compensate for perceptual difficulties. The notion of auditory scene analysis is used as a conceptual framework for interpreting and studying the perception of sound.