Monthly Archives: December 2009
Validity and Reliability of Logopedic Assessments of Tongue Function
Objective: This study investigated the validity and reliability of logopedic assessments of tongue function.
Materials and Methods: At two practices for myofunctional therapy, diagnosis of tongue dysfunction according to Kittel (1984, 1996, 2008) was carried out in 52 subjects (aged 5 to 63 years) by three speech pathologists at each practice.
Results: The agreement of the logopedic assessments was mostly satisfactory at one of the two practices but was unsatisfactory in most cases at the other practice.
Conclusion: The inconsistent agreement between the logopedic assessments does not permit a definitive statement about the actual clinical situation.
Speech therapy for children with dysarthria acquired before three years of age
Authors’ conclusions
We found no firm evidence of the effectiveness of speech and language therapy to improve the speech of children with early acquired dysarthria. No change in practice is warranted at the present time. Rigorous research is needed to investigate if the positive changes in children’s speech observed in small descriptive studies are shown in randomised controlled trials. Research should examine change in children’s speech production and intelligibility. It should also investigate the secondary education, health and social care outcomes of intervention, including children’s interaction with family, friends and teachers, their participation in social and educational activities, and their quality of life. Cost and acceptability of interventions must also be investigated.
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Speech therapy for children with early acquired dysarthria
Dysarthria is a disorder which reduces the control of movements for speech. Children with dysarthria often have shallow, irregular breathing and speak on small, residual pockets of air. They have low pitched, harsh voices, nasalised speech and very poor articulation. Together, these difficulties make the children’s speech difficult to understand. Dysarthria is caused by neurological impairment and can arise early in children’s lives, from neurological damage sustained before, during or after birth, such as in cerebral palsy, or in early childhood through traumatic brain injury or neurological disease. Communication difficulties have a profound impact on childrens development. They reduce the quality of life of children with cerebral palsy and place children at risk of social exclusion, educational failure and later unemployment. Speech and language therapy aims to help children to control the movements for breathing and speech and so become more intelligible. Small, observational studies have suggested that for some children therapy might have been associated with positive changes in intelligibility and clarity of children’s voices. This review aimed to investigate if therapy is generally effective for children with dysarthria acquired early in life, and if certain types of therapy may be better than others. We found no randomised controlled trials or controlled group studies which investigate the effects of speech and language therapy to improve the speech of children with dysarthria acquired below three years of age. Rigorous research, using randomised controlled trials, is needed to evaluate if therapy can help children to increase the intelligibility of their speech and if enhanced intelligibility increases children’s participation in social and educational activities and their quality of life.
from NHS Evidence
Semicircular canal versus otolithic involvement in idiopathic sudden hearing loss
Objective: To evaluate the results of vestibular evoked myogenic potential testing in patients with idiopathic sudden hearing loss, and to correlate these results with the findings of caloric testing, the clinical appearance of vertigo and the influence of age.
Materials and methods: Eighty-six patients with unilateral idiopathic sudden hearing loss and 35 healthy controls underwent a standard protocol of neurotological evaluation. Vestibular evoked myogenic potential responses were measured and compared with caloric responses.
Results: On the affected side, 30.2 per cent of patients showed abnormal vestibular evoked myogenic potential responses, while 52.3 per cent had abnormal caloric responses. A statistically significant relationship was found between the results of these two tests. A statistically significant relationship was also found between the type of vestibular lesion and the occurrence of vertigo. Advancing age correlated statistically with more extensive labyrinthic lesions.
Conclusions: A combination of vestibular evoked myogenic potential and electronystagmography testing indicated the existence of vestibular involvement in many patients with idiopathic sudden hearing loss. Both tests are necessary in order to obtain a more thorough and in-depth knowledge of the pathophysiology of idiopathic sudden hearing loss.
from the Journal of Laryngology and Otology
Use of botulinum toxin in voice restoration after laryngectomy
Background: Following laryngectomy, a distinct population of patients fails to achieve successful tracheoesophageal voice. These patients’ voices range from strained and effortful to none at all. Such patients may present with severe hypertonicity or spasm of the pharyngoesophageal segment. Botulinum toxin has been used to chemically denervate the pharyngeal musculature, and is an alternative to invasive surgical procedures. The aim of this article is to review the evidence for using botulinum toxin to achieve an improvement in post-laryngectomy voice.
Methods: A Medline literature review (1966 to January 2009) and a search of the Cochrane database were performed. Foreign language articles and those not pertaining to post-laryngectomy voice restoration were excluded.
Results: Nine articles reporting a total of 134 patients were identified. Although there were differences in the outcome measures used, objective improvement in voice production occurred in between 70 and 100 per cent of cases.
Conclusion: Botulinum toxin can be used as a safe and cost-effective treatment in patients with confirmed pharyngoesophageal segment hypertonicity and/or spasm following laryngectomy, to obtain an improvement in voice quality.
from the Journal of Laryngology and Otology
Advances in auditory and vestibular medicine
Auditory and vestibular medicine is becoming more accepted as a specialty in its own right. Recent advances in the field have been instrumental in the understanding of the scientific foundations, pathophysiology, clinical approach and management of patients with hearing and vestibular disorders. This paper will review these advances.
Effect of peer review on accuracy of reported auditory brainstem response thresholds in newborn hearing screening programme referrals
Conclusion: Peer review provides opportunities for peer support and continuing professional development. A system of formal peer review is strongly advocated.
Effects of classroom noise on the speech perception of bilingual children learning in their second language: Preliminary results
Conclusion: Under adverse conditions, non-native speech communication in children seems to be less effective. We look forward with optimism in the hope that these data will be directly applied to more engineering-oriented disciplines associated with speech communication (i.e. speech intelligibility in room acoustics, design of communication systems).
Age and speaker skills in receding languages: how far do community evaluations and linguists’ evaluations agree?
The assumption that age will show a correlation with proficiency in the verbal performance of receding-language speakers often has a general validity where group profiles are considered, but exceptions on the individual level can be striking. Individual speaker profiles offered by Aikhenvald for a contemporary Tariana-speaking community and by Bloomfield for the Menomini-speaking community of his time are reviewed in this light and compared with several speaker profiles representing a contracting Gaelic-speaking community in Scotland. Community evaluations of speakers’ abilities are shown to reflect local conceptions of speaking well and do not always accord with linguists’ assessment of speaker skills. Linguists may need to be more cautious when attaching importance to the role of age as a correlate of proficiency.
First language attrition and reversion among older migrants
Emigration usually requires speakers to become bilingual, and eventually they may even become dominant in their second language. This can lead to a gradual loss of proficiency in the first language, a phenomenon referred to as first language attrition. As migrants become elderly, however, they sometimes report a “reversion” in language dominance, whereby the second language, which they have used in their daily lives for years or decades, recedes and the first language becomes stronger again. There are largely anecdotal cases of communication between such speakers and their children who were not brought up to speak their parents’ first language becoming impossible. It is, however, very difficult to separate fact from fiction in such reports.
This article will give an overview of changes in lexical access and fluency in the first language of adult migrants. It will assess simplistic predictions for a linear development of first and second languages against a more complex perspective which takes into account psycholinguistic aspects of activation, inhibition, and cognitive ageing. The predictions made on this basis will be tested on a large-scale quantitative investigation of language proficiency among migrants of German and Dutch descent in the Netherlands and Canada.
Intergenerational phonological change in the Famagusta dialect of Turkish Cypriots
There have been countless speculations about the phenomenon of languages changing in time from generation to generation. As the age difference between generations increases, changes in the language passed down from the older generation to the younger become much more noticeable. Over time, Cypriot Turkish (i.e., the variety of Turkish used by the Turkish Cypriot community in Northern Cyprus) has been exposed to a variety of internal and external changes through contact with Standard Turkish. The main purpose of this article is to explore the intergenerational phonological shift over apparent time in the city of Famagusta in Northern Cyprus. The focus is on the competition between the traditional non-standard Turkish Cypriot voiced obstruent stop variants [g], [d], and [b] and the Standard Turkish voiceless variants [k], [t], and [p]. The results show sociolinguistic variation depending on age and gender, and point to the possibility of a long-term decline in Cypriot Turkish in favor of Standard Turkish.
Language choice and code switching of the elderly and the youth
The language of the aged has not been given as much attention as that of the youth. Hence, the aim of this research is to compare the language choices and discoursal features of the aged with that of the youth. This study focuses on the Chinese community from Tangkak, Johor, in Peninsular Malaysia, who use the Hokkien dialect. The older informants preferred to speak in their dialect while the younger informants preferred Mandarin. Older informants seldom code-switched but when they did, the codes in their mixed discourse were Hokkien and Mandarin, while that of the younger informants were Mandarin, Malay, and/or English. On the basis of an analysis of the audio recordings, observations, field notes, and informal interviews, the features are identified in the discourse of the aged, i.e., off-target verbosity (OTV), painful self-disclosure (PSD), and self-handicapping talk. The study shows that the discoursal features of the aged are clearly different from that of the youth.
Gaelic on the Isle of Skye: older speakers’ identity in a language-shift situation
This article examines age and identity in the context of language shift occurring in a community on the Isle of Skye, Scotland. Via a language ability test and a language usage survey, 19 speakers were assessed; it was determined that the older (40+) and the younger speakers (<40) in this community are distinguishable on the basis of language ability, particularly in terms of synthetic forms, conditional forms, and post-nominal possession. The usage survey revealed a decline in older speakers' longitudinal use of Gaelic, and although younger speakers are making an effort to speak Gaelic and are not accommodated by older speakers switching to English, we can still conclude that, to some degree, older speakers are somewhat linguistically isolated in this community. Finally, we propose identity negotiation and the possibility of the age and identity correlation as perpetuating factors in the language shift.
Laryngeal mechanisms in speech: The contributions of Jan Gauffin
Jan Gauffin was an early user of fiber optics which allowed him to discover that laryngeal structures above the glottal level are involved in speech. His research led him to postulate three independently controlled mechanisms: fundamental frequency control, glottal adduction/abduction, and laryngealization, the latter derived from the protective closure function. He argued that phonetic theory must be revised to account for the main phonation types of the world’s languages. He saw them as combinations of two interacting dimensions: adduction/abduction and laryngealization. Secondly he gave the aryepiglottic sphincter an explanatory role in accounting for the production of low pitch and downward pitch inflections. During his lifetime his work received limited attention. However, later laryngoscopic research has confirmed and extended his thinking and findings. His contribution was a pioneering one.
The multifaceted category of “generation”: elderly French men and women talking about May ’68
In this article we focus on the communicative relevance of the category of generation, which is often, in sociolinguistic research, restricted to the meaning of age group, connected in a more or less explicit way to an almost conservative attitude on (linguistic) values. We examine the generational references in the life narratives of elderly French men and women in order to ascertain the personal meaning as it takes place in discourse. This analysis is based on statements made about May ’68 in France. The events of May ’68, as well as their historical and current importance, have been described as promulgating the concept of generation: May ’68 can be considered a generational keyword. The statements in the narratives discussed in this article reveal a variety of standpoints and references made in old age, statements that challenge the idea of a homogeneous age group in terms of historical evaluation and memory. On the basis of four case studies of interviews with elderly people, we trace the sequential structure of a personal generational identity created when talking about May ’68. In the individual points of view expressed therein, we find four dimensions of the concept of generation: (i) in the opposition of values; (ii) in the opposition of old and young; (iii) in the opposition of the generations in a family and their ideological implications; and (iv) as a generation of ideas and possibilities, pertaining — as the member of such a generation — to the past.
