Unilateral and bilateral cochlear implants and the implant-plus-hearing-aid profile: Comparing self-assessed and measured abilities

from the International Journal of Audiology

Abstract
Patients fitted with one (CI) versus two (CI+CI) cochlear implants, and those fitted with one implant who retain a hearing aid in the non-implanted ear (CI+HA), were compared using the speech, spatial, and qualities of hearing scale (SSQ) (Gatehouse & Noble, 2004). The CI+CI profile yielded significantly higher ability ratings than the CI profile in the spatial hearing domain, and on most aspects of other qualities of hearing (segregation, naturalness, and listening effort). A subset of patients completed the SSQ prior to implantation, and the CI+CI profile showed consistently greater improvement than the CI profile across all domains. Patients in the CI+HA group self-rated no differently from the CI group, post-implant. Measured speech perception and localization performance showed some parallels with the self-rating outcomes. Overall, a unilateral CI provided significant benefit across most hearing functions reflected in the SSQ. Bilateral implantation offered further benefit across a substantial range of those functions.

Growth Promoting Treatment Normalizes Speech Frequency in Turner Syndrome

from Laryngoscope

Abstract:
Objective: To assess objective and subjective voice parameters among Turner syndrome (TS) women in relation to genotype, hearing, growth, and previous treatment with growth hormone (GH) and androgen given that lowering of speaking fundamental frequency (SFF) during treatment is regarded as a negative side effect.

Study Design: Cross-sectional, controlled for karyotype and age.

Methods: Voice function was studied objectively (SFF) and subjectively (questionnaire) in 117 women with TS.

Results: SFF did not differ between treated and nontreated participants or between patients with a spontaneous versus induced puberty. SFF was dependent on karyotype but not age. Subjective voice change was reported four times more often among treated compared with nontreated TS women (odds ratio [OR] = 4.4; 95% confidence interval [CI]: 0.9-20.10), whereas voice and articulation problems were reported three times more often among untreated compared with treated cases (OR = 2.9; 95% CI: 1.0-8.3). Voice symptoms were over-represented among patients having micrognathia (OR = 6.0; 95% CI: 1.6-22.3), hearing loss (OR = 8.6; 95% CI: 1.7-43.1), and monosomy (OR = 6.2; 95% CI: 0.8-36.2) but not among those with an arched palate.

Conclusions: When given to TS girls, GH (33-66 [mu]g/kg/d) and androgen (0.05 mg/kg/d) normalized SFF and reduced voice and articulation problems in adulthood. The TS phenotype includes important voice and speech problems, which in turn are associated with hearing problems, although genotypic, monosomic, and isochromosome patients have more voice problems and also more high-pitched voices than mosaic patients. Most TS women, despite their karyotype or age, exhibit a higher frequency of pitched voice than non-TS women.

Long-Term Hearing Results in Gamma Knife Radiosurgery for Acoustic Neuromas

from Laryngoscope

Abstract:
Objectives: There are many studies that have examined functional outcomes following Gamma Knife treatment; however, few have reported long-term audiometric data. This study analyzed the long-term hearing results of Gamma Knife radiosurgery in the treatment of acoustic neuromas.

Study Design: Retrospective cohort study.

Methods: Seventeen patients were selected from our acoustic neuroma Gamma Knife registry of 113 patients treated from 1991 to 2005. Pretreatment audiograms were analyzed for pure-tone average and word recognition scores and assigned a Gardner-Robertson classification score (GRC). Either a current audiogram was obtained or the most recent audiogram (if the patient was lost to follow-up) was reviewed from clinic charts and these were compared with the preoperative results. Audiometric data of the pre- and posttreatment normal ear were obtained and used as the patient’s own control.

Results: The tumor size ranged from 0.5 to 2.8 cm (mean, 1.33 cm) and patients received a range of 12.5-16 Gy (mean, 13.82 Gy) to 50% isodose line. Patient follow-up ranged from 3 to 82 months with a mean of 33.6 months. Pretreatment pure-tone average for the involved side group was 30.6 dB HL with a word recognition score of 74%. Pretreatment mean GRC was 1.76. posttreatment pure-tone average for the group was 59.7 dB HL with a word recognition score of 37%. posttreatment mean GRC was 3.29. Comparing pre- versus post-Gamma Knife radiosurgery results on the treatment ear, means were statistically significantly different for both pure-tone average and word recognition scores, based on a paired-samples t test (P < .001 for both). The group “normal” ear pure-tone average was 14 dB HL and 17.75 dB HL pre- and posttreat-ment, respectively. Normal ear pre- and posttreatment word recognition score and GRC were 93% and 98%, and 1.13 and 1.31, respectively.

Conclusion: Gamma Knife radiosurgery remains a noninvasive treatment option for patients with acoustic neuromas; however, they may experience a delayed hearing loss. Of those patients with useful audition pretreatment, 42% maintained useful hearing posttreatment.

(C) The American Laryngological, Rhinological

Hearing status among commercial pilots in a Swedish airline company

from the International Journal of Audiology

Abstract
The aim was to study hearing impairment in commercial pilots. A total of 634 male and 30 female pilots (n=664) in a Swedish airline company underwent repeated audiological tests during the period 1974-2005. The last test was used to study hearing impairment. The mean values for the hearing test at 3, 4, and 6 kHz were used for the ear with worse hearing impairment. Data was compared with a general adult Swedish population (n=603) not occupationally exposed to noise. Equivalent noise levels gate to gate (Leq) were measured in the cockpit of different aircraft. Leq was 75-81 dB (A), peak exposures were 105 dB (A) from the cabin call signal. Median values were similar as in the reference group at all ages. There was no association between years of employment, tobacco smoking, and hearing impairment, when adjusted for age and gender by multiple logistic regressions analysis. In conclusion, pilots are exposed to equivalent noise levels below the current Swedish occupational standard of 85 dB (A), with short peak exposures above the standard, and have normal age-matched hearing thresholds.

LIST and LINT: Sentences and numbers for quantifying speech understanding in severely impaired listeners for Flanders and the Netherlands

from the International Journal of Audiology

Abstract
A Dutch sentence test (LIST) and a Dutch number test (LINT) have been developed and validated for the accurate measurement of speech reception thresholds (SRT) in quiet and in noise with severely hearing-impaired individuals and cochlear implant recipients in Flanders and the Netherlands. The LIST consists of 35 lists of 10 sentences of equal known difficulty uttered by a female speaker; while the LINT consists of 400 numbers (1-100) by two male and two female speakers. Normative values were determined at fixed S/N ratios and using the adaptive method (Plomp & Mimpen, 1979), yielding identical results for SRT and slope. For the LIST, average fitted SRTs were 27.1 (0.9) dB SPL in quiet and -7.8 dB (0.2) SNR in noise. In addition, the LIST in noise displayed a steep discrimination function (17%/dB) and good reliability (within-subject standard deviation=1.2 dB). For the LINT average fitted SRTs in quiet were 20.7 (0.9) dB SPL and about -9.0 dB SNR in noise. Again, the slopes of the performance intensity functions were relatively steep, i.e. 8.5%/dB in quiet and 15.2%/dB in noise, suggesting that the LINT is accurate and efficient and thus capable of reflecting subtle changes in performance. First data with cochlear implanted subjects show that both LIST and LINT are feasible and are capable of mapping a large range of hearing disabilities.

New cochlear implant coding strategy for tonal language speakers

from the International Journal of Audiology

Abstract
Accurate pitch perception on the basis of fundamental frequency patterns is essential for the processing of lexical tones in tonal languages such as Cantonese. Speech intelligibility in Cantonese-speaking CI recipients was compared using current signal processing strategies, which typically result in poor pitch perception, and a new strategy, known as the multi-channel envelope modulation (MEM) strategy, was designed to enhance temporal periodicity cues to the fundamental frequency. Performance of nine postlingually hearing-impaired adult cochlear implant users was measured twice using each strategy, initially after a four week trial, and again after two weeks of use with each strategy. Speech intelligibility in speech-spectrum shaped noise was measured using the Cantonese hearing in noise test. A fixed noise level of 65 dB A was used and the signal-to-noise ratios were fixed at either +10, +15, or +20 dB, depending on the baseline performance of individual subjects using the clinical processor. Self-reported benefit in 18 listening situations and overall preference for strategies were obtained at the end of these trial periods. Results showed poorer speech intelligibility with CIS while results obtained using ACE and MEM were comparable. Unfamiliar place coding might have contributed to poorer performance using CIS. Self-reported benefit across strategies did not differ in most listening situations. Participants preferred ACE for listening overall in daily situations, and a few preferred MEM in noise. Whilst the results did not demonstrate any advantages for speech recognition in noise when using MEM compared to ACE, no degradation in performance was observed. This implies that the form of processing employed by MEM retains similar segmental information to that provided by ACE and that potentially, future variations/optimizations of MEM may lead to some improvement in tone perception.

On the auditory and cognitive functions that may explain an individual’s elevation of the speech reception threshold in noise

from the International Journal of Audiology

Abstract
It is generally recognized that poor results of speech-in-noise tests by hearing-impaired persons cannot be fully explained by the elevated pure-tone hearing threshold. Plomp has shown, among others, that an additional factor has to be taken into account, often referred to in general terms as distortion. In an attempt to specify auditory and cognitive functions which may underlie this distortion, various studies on this topic originating from Plomp’s research group are reviewed, as well as other relevant studies which provide quantitative data on the correlations between various types of auditory or cognitive tests (the predictor tests) and speech-in-noise tests. The predictor variables considered include, besides the pure-tone audiogram, measures of spectral and temporal resolution, intensity difference limen, age, and some cognitive aspects. The results indicate that, by and large, these variables fall short in fully explaining the variance observed in the speech-in-noise tests. This strongly suggests that the predictor variables considered so far do not cover all sources of variance relevant for speech reception in noise.

The Taiwanese Mandarin hearing in noise test

from the International Journal of Audiology

No abstract available.

Reliability and validity of the Functional Outcome Questionnaire for Aphasia (FOQ-A).

from Rehabilitation Psychology

Objective: To perform a psychometric evaluation of the Functional Outcome Questionnaire for Aphasia (FOQ-A), a 32-item instrument designed to assess the extent to which a person who has had a stroke performs several important functional communication behaviors. Research Design: The FOQ-A was administered to family caregivers of persons with a history of left hemisphere stroke (N = 91) undergoing a comprehensive screening assessment to determine their eligibility for participation in research trials for novel stroke rehabilitation interventions. Results: Statistical analyses provided strong support for the internal consistency reliability and the convergent and discriminant validity of the FOQ-A. An exploratory factor analysis revealed a two-factor solution, Basic Verbal Expression and Conversational Response Skills. Conclusions: The present findings build on earlier evidence indicating that the FOQ-A has good psychometric properties and considerable promise as a measure of functional communication in aphasia rehabilitation. Future research will focus on the test-retest reliability, criterion-oriented validity, and predictive validity of the instrument. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

On the relation between structural case, determiners, and verbs in agrammatism: A study of Hebrew and Dutch

from Aphasiology

Background: This study explored the relation between the production of determiners and case markers and the production of verbs and verb inflections in agrammatism. Determiners and case markers require case and therefore depend on the existence of case-assigning constituents.

Aims: Since verbs and verb inflections are case assigners, and are impaired in agrammatism, we tested whether the presence of verbs and verb inflection affects the production of determiners and case markers in Dutch and Hebrew agrammatism.

Methods & Procedures: A total of 11 Hebrew-speaking and 8 Dutch-speaking individuals with agrammatism participated in picture description and sentence elicitation tasks, and their spontaneous speech was analysed.

Outcomes & Results: The production of case-related morphemes was closely connected to the presence of a case assigner in the sentence. In Hebrew, object case was produced correctly 98% of the time, and always when a transitive verb was present in the sentence. In Dutch the production of determiners on the subject was related to the presence of a finite verb. The production of complete object noun phrases related to the presence of a transitive verb.

Conclusions: The results indicate that case itself, as well as determiners and case markers, which depend on case, are not impaired in agrammatic production. The apparent deficit is rather tightly related to the deficit in verbs and verb inflection. This suggests that the production of determiners and pronouns should be treated within sentence context, in which a special emphasis should be given to the production of correctly inflected verbs.

Influence of verbal and nonverbal references to print on preschoolers’ visual attention to print during storybook reading

from Developmental Psychology

How much do preschool children look at print within storybooks when adults read to them? This study sought to answer this question as well as to examine the effects of adult verbal and nonverbal references to print on children’s visual attention to print during storybook reading. Forty-four preschool-aged children participated in this study designed to determine the amount of visual attention children paid to print in 4 planned variations of storybook reading. Children’s visual attention to print was examined when adults commented and questioned about print (verbal print condition) or pointed to and tracked the print (nonverbal print condition), relative to 2 comparison conditions (verbatim reading and verbal picture conditions). Results showed that children rarely look at print, with about 5%-6% of their fixations allocated to print in verbatim and verbal picture reading conditions. However, preschoolers’ visual attention to print increases significantly when adults verbally and nonverbally reference print; both reading styles exerted similar effects. The authors conclude that explicit referencing of print is 1 way to increase young children’s contacts with print during shared storybook reading. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

Preschool home literacy practices and children’s literacy development: A longitudinal analysis

from the Journal of Educational Psychology

In this 3-year longitudinal study, the authors tested and extended M. Sénéchal and J. Le Fevre’s (2002) model of the relationships between preschool home literacy practices and children’s literacy and language development. Parent-child reading (Home Literacy Environment Questionnaire plus a children’s Title Recognition Test) and parental teaching of letters, words, and name writing were assessed 6 months prior to children’s school entry. The 143 children (55% male participants; mean age = 5.36 years, SD = 0.29) attended Gold Coast, Australia government preschools. Parent-child reading and literacy teaching were only weakly correlated (r = .18) and were related to different outcomes consistent with the original model. Age, gender, memory, and nonverbal ability were controlled. Parental teaching was independently related to R. W. Woodcock’s (1997) preschool Letter-Word Identification scores (R²-sub(change) = 4.58%, p = .008). This relationship then mediated the relationships between parental teaching and Grades 1 and 2 letter-word identification, single-word reading and spelling rates, and phonological awareness (rhyme detection and phonological deletion). Parent-child reading was independently related to Grade 1 vocabulary (R²-sub(change) = 5.6%, p = .005). Thus, both home practices are relevant but to different aspects of literacy and language development. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

Relationships of three components of reading fluency to reading comprehension

from the Journal of Educational Psychology

This study examined the relationships of 3 levels of reading fluency–the individual word, the syntactic unit, and the whole passage–to reading comprehension among 278 5th graders heterogeneous in reading ability. Hierarchical regression analyses revealed that reading fluency at each level related uniquely to performance on a standardized reading comprehension test in a model including inferencing skill and background knowledge. The study supports an automaticity effect for word recognition speed and an automaticity-like effect related to syntactic processing skill. In addition, hierarchical regressions using longitudinal data suggest that fluency and reading comprehension have a bidirectional relationship. The discussion emphasizes the theoretical expansion of reading fluency to 3 levels of cognitive processes and the relations of these processes to reading comprehension. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

Repeated reading intervention: Outcomes and interactions with readers’ skills and classroom instruction

from the Journal of Educational Psychology

This study examined effects of a repeated reading intervention, Quick Reads, with incidental word-level scaffolding instruction. Second- and third-grade students with passage-reading fluency performance between the 10th and 60th percentiles were randomly assigned to dyads, which were in turn randomly assigned to treatment (paired tutoring, n = 82) or control (no tutoring, n = 80) conditions. Paraeducators tutored dyads for 30 min per day, 4 days per week, for 15 weeks (November-March). At midintervention, most teachers with students in the study were formally observed during their literacy blocks. Multilevel modeling was used to test for direct treatment effects on pretest-posttest gains as well as to test for unique treatment effects after classroom oral text reading time, 2 pretests, and corresponding interactions were accounted for. Model results revealed both direct and unique treatment effects on gains in word reading and fluency. Moreover, complex interactions between group, oral text reading time, and pretests were also detected, suggesting that pretest skills should be taken into account when considering repeated reading instruction for 2nd and 3rd graders with low to average passage-reading fluency. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

Socioeconomic differences in reading trajectories: The contribution of family, neighborhood, and school contexts

from the Journal of Educational Psychology

In the present study, the authors use the Early Childhood Longitudinal Study, Kindergarten Cohort of 1998-1999, to examine the extent to which family, school, and neighborhood factors account for the impact of socioeconomic status (SES) on children’s early reading. Through the use of hierarchical linear modeling techniques, growth curve models were estimated to depict children’s reading trajectories from kindergarten to 3rd grade. Family characteristics made the largest contribution to the prediction of initial kindergarten reading disparities. This included home literacy environment, parental involvement in school, and parental role strain. However, school and neighborhood conditions contributed more than family characteristics to SES differences in learning rates in reading. The association between school characteristics and reading outcomes suggests that makeup of the student population, as indexed by poverty concentration and number of children with reading deficits in the school, is related to reading outcomes. The findings imply that multiple contexts combine and are associated with young children’s reading achievement and growth and help account for the robust relation of SES to reading outcomes. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

Brief Report: Narratives of Personal Events in Children with Autism and Developmental Language Disorders: Unshared Memories

from the Journal of Autism and Developmental Disorders

Abstract Narrative analysis of personal events provides an opportunity for identifying autism specific issues related to language and social impairments. Eight personal events were elicited from three groups of schoolage children: 14 high-functioning with Autism Spectrum Disorders (HFA), 12 non-autistic with developmental language disorders (DLD), and 12 typically developing matched for chronological age and non-verbal IQ. The coding focused on narrative format (constituents) and style (coherence). The analyses indicate basic knowledge of conventional narrative format in all groups but a consistent lack of high-point in HFA children’s stories interpreted as a consequence of their lack of social understanding of narrative. The results suggest novel interventions to foster autobiographical memory in HFA children which may assist in their self-awareness development.

Bilateral Cochlear Implantation: Candidacy, Outcomes, Research

from the National Library for Health

Special Guest Presenter: Susan B. Waltzman, Professor of Otolaryngology NYU School of Medicine

Abstract: The benefits of binaural hearing including speech understanding in noise and localization have been well documented and confirmed in many bilateral hearing aid and cochlear implant users. These positive results have led many unilateral cochlear implant users to explore the viability of a second implant. This talk will review the benefits of binaural hearing with sensory aids and, more specifically, examine speech perception outcomes in sequentially implanted children, adolescents and adults and explore the variables affecting post-implantation performance.

Biography: Susan B. Waltzman, PhD is Professor of Otolaryngology and Co-Director of the Cochlear Implant Center at NYU School of Medicine. Dr. Waltzman has been involved in research related to cochlear implantation for 20 years and has published books, book chapters and numerous articles in peer-reviewed journals on outcomes with cochlear implants She is also a frequent contributor and invited speaker at national and international conferences. Her research interests are focused on outcome studies with cochlear implants.

When: Thursday 26th June 2008 at 5.30 pm UK Time

Time Zone: (Note this is UK time-please convert as necessary) please go to http://www.worldtimezone.com/ for conversion

To register for this event, please go the following link:

http://www.hearingseminars.com/swaltzman0608/event/registration.html

Establishing a Public School Dysphagia Program: A Model for Administration and Service Provision

from Language, Speech, and Hearing Services in Schools

Purpose: Many school-based speech-language pathologists (SLPs) are hampered in participating in managing children with dysphagia by their school systems’ lack of supportive policies and procedures.Aneed exists to better define the dysphagiatrained SLP’s role and clarify the district’s responsibility. The purpose of this article is to address the critical administrative issues and administrative components surrounding dysphagia in the schools and to offer the SLP some solutions to these problems. Method: A narrative review of the relevant literature addresses the following questions that are important for administrative planning and implementation of programs for students with dysphagia in the schools: (a) Should school systems assume responsibility for working with students with dysphagia? (b) Why is a systemsupported procedure recommended? (c) What service delivery models can a system use to serve students with dysphagia? (d)What components should be included in a dysphagia procedure? Conclusion: SLPs should be proactive in providing dysphagia services to students in the schools. A procedure that is adopted by a school system for all of its employees to follow will offer direction and guidance. This system-supported procedure may provide assurance that dysphagia services are being provided in a professionally acceptable manner. Ongoing staff development and training is essential. A system can implement dysphagia services using existing staff, when possible, and policies and procedures that have been approved by the system. [ABSTRACT FROM AUTHOR]

Ethical Issues in Providing Services in Schools to Children With Swallowing and Feeding Disorders

from Language, Speech, and Hearing Services in Schools

Purpose: This article is a commentary and discussion of ethical issues in dysphagia services as related to school-based practice in speech-language pathology. Method: A review of the literature on ethical issues in the provision of speech-language pathology services to individuals with dysphagia was conducted, with particular emphasis on students receiving school-based services. Results: Issues in dysphagia management that were identified in the literature review are discussed from the perspective of biomedical ethics, professional ethics, and professional practice issues pertinent to the school setting. Conclusion: Considerations, suggestions, and resources for ethically responsive action on the part of the school-based speech-language pathologist are provided. [ABSTRACT FROM AUTHOR]

Family and Cultural Issues in a School Swallowing and Feeding Program

from Language, Speech, and Hearing Services in Schools

Purpose: This article presents a rationale for speechlanguage pathologists (SLPs) to provide culturally competent evaluation, diagnostic, and intervention services for children with oral motor, swallowing, and feeding disorders in school settings. There is also a discussion of how changing American public school demographics necessitate the consideration of cultural issues and family-focused approaches to dysphagia services. Method: This article provides an overview of cultural, religious, and health beliefs of several ethnic groups, as well as information on the dynamics and requirements of cultural competence and family-focused intervention. Ethnographic interviewing is presented as a culturally sensitive diagnostic method. Information on structuring a culturally relevant individualized educational program process is provided. Guidance in the use of interpreters and translators is also offered. Conclusion: Attention to cultural and family issues in the diagnosis and treatment of dysphagia in a school setting optimizes the opportunities for successful outcomes and better meets the needs of children and families from culturally/linguistically diverse backgrounds. [ABSTRACT FROM AUTHOR]