Monthly Archives: September 2010
Combining acoustic and electric stimulation in the service of speech recognition
The majority of recently implanted, cochlear implant patients can potentially benefit from a hearing aid in the ear contralateral to the implant. When patients combine electric and acoustic stimulation, word recognition in quiet and sentence recognition in noise increase significantly. Several studies suggest that the acoustic information that leads to the increased level of performance resides mostly in the frequency region of the voice fundamental, e.g. 125 Hz for a male voice. Recent studies suggest that this information aids speech recognition in noise by improving the recognition of lexical boundaries or word onsets. In some noise environments, patients with bilateral implants can achieve similar levels of performance as patients who combine electric and acoustic stimulation. Patients who have undergone hearing preservation surgery, and who have electric stimulation from a cochlear implant and who have low-frequency hearing in both the implanted and not-implanted ears, achieve the best performance in a high noise environment.
from the International Journal of Audiology
Is familial adenomatous polyposis associated with sensorineural hearing loss?
The mutation causing familial adenomatous polyposis (FAP) affects the adenomatous polyposis coli (Apc) gene, which has a role in the cytoskeleton and has been shown to be important in the structure of supporting cells in the cochlea. One previous study suggested that FAP sufferers may have sensorineural hearing loss. In order to demonstrate whether this is the case we invited patients known to suffer from familial adenomatous polyposis to take part in our study. Audiograms were performed and compared to normal values for that patient’s age and gender calculated using ISO standard data. Thirteen patients were included in the study analysis. No conductive hearing losses were identified. A statistically significant greater hearing loss was identified at 500 Hz (2.8 dBHL, P = 0.03) and 1000 Hz (2.5 dBHL, P = 0.05). No audiometric difference could be identified between the patients with FAP and attenuated FAP. A power calculation demonstrated that the study was of adequate size. This study did not demonstrate a clinically significant difference in hearing loss between the FAP group and the calculated normal values.
from the International Journal of Audiology
Case report: An approach to the patient with reading difficulties in the primary care setting
A 79-year old right-handed gentleman was admitted to hospital with a right homonymous quandrantanopia associated with pure alexia (alexia without agraphia). His computed tomography and magnetic resonance imaging revealed an ischemic stroke in the left occipital region. Etiological investigations were unrevealing and the cause of his stroke remains unclear. The alexia was characterized by covert letter-by-letter reading with word length effect accompanied by phonological sound spelling errors and a mild visual anomia. While formal language and reading assessments exist (i.e., by a speech–language pathologist), these are not always widely available or are difficult to administer by a physician in a primary care setting. The purpose of the present paper is to describe an informal bedside approach to the patient presenting with reading difficulties with the goal of identifying patients with alexia for formal language assessment and rehabilitation.
from the Journal of Neurolinguistics
Reading in French-speaking adults with dyslexia
This study investigated the reading and reading-related skills of 15 French-speaking adults with dyslexia, whose performance was compared with that of chronological-age controls (CA) and reading-level controls (RL). Experiment 1 assessed the efficiency of their phonological reading-related skills (phonemic awareness, phonological short-term memory, and rapid automatic naming (RAN)) and experiment 2 assessed the efficiency of their lexical and sublexical (or phonological) reading procedures (reading aloud of pseudowords and irregular words of different lengths). Experiment 1 revealed that adults with dyslexia exhibited lower phonological reading-related skills than CAs only, and were better than RL controls on the RAN. In experiment 2, as compared with RL controls, only a deficit in the sublexical reading procedure was observed. The results of the second experiment replicated observations from English-language studies but not those of the first experiment. Several hypotheses are discussed to account for these results, including one related to the transparency of orthographic systems.
from the Annals of Dyslexia
Speech-evoked auditory potentials in attention deficit hyperactivity disorder
Objective: To explore the processing of auditory information through auditory brainstem and higher cortical regions in a sample of children with attention deficit hyperactivity disorder (ADHD) of the combined inattention and hyperactivity subtype (ADHD/C) using auditory evoked potentials. Study Design: Fifteen Arabic speaking ADHD/C children were compared to 15 age-matched normal controls, aged between five and ten years. A Mini-International Neuropsychiatric Interview for Children and Adolescents (Arabic version) was performed to confirm the diagnosis, subtype of ADHD and to exclude comorbid conditions. All children were subjected to Auditory Brainstem Evoked Response (ABR) to click, speech ABR and cortical Mis-Match Negativity (MMN) to speech stimuli. Results: Thirty-three percent of the ADHD/C group showed prolongation of absolute and/or inter-peak wave latencies of the click ABR beyond two standard deviations. The peak latency of the onset waves for speech ABR was abnormal in 87% of the study group. Only three ADHD/C children gave normal MMN. Conclusion: This study demonstrated that abnormal auditory brainstem timing with reduced cortical functions was a characteristic in the studied ADHD/C children. Speech ABR can serve as a biological marker for brainstem neural asynchrony in children with ADHD/C. It might help to organize the highly heterogeneous population of ADHD into more homogeneous subgroups, at least on a particular biological indicator, specifically in individuals who cannot perform the behavioural measures. Further research is needed to determine whether individuals within these subgroups share a similar auditory perceptual profile.
Role of self-induced sound therapy: Bhramari Pranayama in Tinnitus
Objectives: Treatment of tinnitus is not ‘absolute’ in terms of its approach through a single therapy model. The more recent modes of treatment focus on attenuating somatic perception and on synchronizing the emotional component of tinnitus with more ‘positive’ physiological events in the body, so that the person does not correlate the presence of tinnitus with annoyance and a source of disturbance. Both these goals are possible with neurophysiological ‘habituation’ at proper synapses across the auditory pathway. The present study has been conducted to observe the effects of Bhramari Pranayama (BP) on both the physical and emotional aspects of tinnitus. Bhramari Pranayama is a ‘Yogic’ technique that involves the combination of a relaxing posture and a process of producing sub-tinnitus level humming sound during exhalation along with simultaneous pressing of the closed eyelids. Study Design: A group of patients with tinnitus was administered BP as a therapy. Three other groups of similar patients were given Ginkgo biloba, Masking therapy and a combination of all the above-mentioned modalities, respectively, as treatment for tinnitus. The outcome of the study was determined by analysing the pre- and post-therapeutic values measured for parameters such as: 1) Loudness; 2) THI score; and 3) Anxiety and Depression scale. Results: Demonstrated that BP as well as all the other modalities of treatment significantly reduced the post-therapeutic scores in all the parameters, in all the groups. Conclusion: We concluded that BP significantly reduced the irritability, depression and the anxiety associated with tinnitus. It relieved the symptoms in tinnitus possibly by 1) acting as source of self-generated sound; 2) inducing parasympathetic predominance in the neural milieu; and 3) by acting as a relaxation technique. BP may serve as a cost effective, frequently applicable adjuvant therapy for tinnitus that probably acts through neuromodulating principles.
An analysis of two incidents of medicine administration to a patient with dysphagia
The findings identify the need for continuing professional development (CPD) in medicine administration to provide greater understanding of the contraindications of combining medications and of the legal implications of altering formulations.
from the Journal of Clinical Nursing
Bilingual school psychologists’ assessment practices with English language learners†
This study explored bilingual school psychologists’ assessment practices with students identified as English language learners (ELL). One thousand bilingual National Association of School Psychologist members were recruited nationwide, and 276 participated. Among those conducting language proficiency assessments of ELLs, many (58%) use comprehensive methods across four domains of language use. Participants generally use multifaceted assessment approaches and most (84.1%) assess acculturation as part of the assessment battery. Although few use interpreters, those who did reported a mix of best practices and discouraged practices in their use. Multiple regression results showed that engaging in continuing education activities about assessing ELLs predicted “best practices” when assessing language proficiency, selecting and using measures with ELLs with whom they share a second language, and using interpreters. A relationship was also found between engaging in applied preservice training with bilingual supervision and best practice behaviors assessing student acculturation. © 2010 Wiley Periodicals, Inc.
Short-term memory and auditory processing disorders: Concurrent validity and clinical diagnostic markers†
Auditory processing disorders (APDs) are of interest to educators and clinicians, as they impact school functioning. Little work has been completed to demonstrate how children with APDs perform on clinical tests. In a series of studies, standard clinical (psychometric) tests from the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) were used to establish concurrent validity between tests of short-term auditory memory and two frequently used tests of auditory processing (Dichotic Digits and Frequency Patterns). The diagnostic utility of the short-term memory tests was also explored. In a matched sample, Digit Span forward predicted diagnosis of APD (sensitivity = .81, specificity = .78). Furthermore, within-subjects analyses for the clinical group found that Digit Span forward scores were significantly lower than those for the other psychometric tests (p values <.001 for Digit Span backward, Letter Span nonrhyming and rhyming scores). Although APD is a low base-rate condition, the utility of these tests as a potential screener or marker for APDs was demonstrated. The need for further studies was endorsed. © 2010 Wiley Periodicals, Inc.
Words correct per minute: The variance in standardized reading scores accounted for by reading speed†
The measure words correct per minute (WC/M) incorporates a measure of accurate aloud word reading and a measure of reading speed. The current article describes two studies designed to parse the variance in global reading scores accounted for by reading speed. In Study I, reading speed accounted for more than 40% of the reading composite score variance in 4th-, 5th-, and 10th-grade students. In Study II, reading speed accounted for more than 30% of the reading/language arts composite score variance of fourth- and fifth-grade students. Across both studies, when reading speed was combined with words read correctly and converted to WC/M the additional variance accounted for was less than 10% with one exception, fourth-grade students’ reading/language arts scores. These findings are consistent with various theories regarding reading speed, provide direction for future researchers, and may assuage those concerned that WC/M is primarily a measure of aloud, accurate word reading (i.e., word calling). © 2010 Wiley Periodicals, Inc.
Simulating children’s retrieval errors in picture-naming: A test of Foygel and Dell’s (2000) semantic/phonological model of speech production
This study investigated whether Foygel and Dell’s (2000) interactive two-step model of speech production could simulate the number and type of errors made in picture-naming by 68 children of elementary-school age. Results showed that the model provided a satisfactory simulation of the mean error profile of children aged five, six, seven, eight and eleven years-old. Consistent with previous research, children made a relatively large number of semantic errors when naming pictures. This was particularly noticeable for several of the younger children who made more semantic errors than the model would predict. This discrepancy between the data and the model seemed to occur because some semantic errors made by the younger children reflected a lack of semantic knowledge about the target word rather than retrieval failures. When the simulation was confined to 25 highly familiar picture names, the Foygel and Dell (2000) model provided a good fit to the observed data from children of all ages. Our findings suggest that the differences between the speech production systems used by children and adults are quantitative rather than qualitative. Connections between semantic and lexical representations and between lexical and phonological representations appear to increase in strength linearly as children get older.
from the Journal of Memory and Language
New sound recording device helps doctors study link between cough and reflux
Coughing episodes are closely related to gastroesophageal reflux symptoms in patients who experience chronic cough, irrespective of other diagnoses, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute. Gastroesophageal reflux occurs when the acid contents of the stomach back up, or reflux, into the esophagus. This typically produces heartburn, a burning sensation below the sternum where your ribs come together.
from EurekAlert.org
