bluuebunny/crossref_metadata_2025 huggingface dataset:
Voice Refinement Following Conservation Surgery for Cancer of the Larynx
Authors: Doyle Philip C.
Published: July 2014

This paper addresses the effects of conservation laryngectomy, the outcome of voice quality, and a rationale for voice treatment. Conservation or partial laryngectomy surgical procedures seek to remove malignant tissue but also preserve some laryngeal structures, particularly when larger tumors exist. These procedures attempt to maintain both sphincteric and phonatory function of the postoperative larynx. The extent of surgical resection does not always correlate well with a patient's postoperative voice outcome. Thus, preconceived notions of postsurgical vocal function are often problematic. This tutorial discusses: (a) the rationale underlying the use of conservation laryngectomy procedures, (b) the clinical identification of the anatomical and subsequent physiologic basis of voice change following conservation laryngectomy, (c) the potential for functional compensation by the patient following conservation surgery, and (d) a rationale for voice refinement using treatment methods that traditionally have been employed for benign forms of laryngeal pathophysiology.
A Case Study of a Child With Agenesis of the Corpus Callosum
Authors: Sorensen David N.
Published: July 2014

This report presents the results of 10 years of observation and testing of a female child with a congenital agenesis of the corpus callosum. The agenesis was diagnosed from CT scans completed to rule out neurological causes for developmental delays. Results of this longitudinal observation and testing revealed that language and speech evolved over time. Despite extensive speech and language treatment, a persistent language impairment continued to exist. Each year there was a widening gap between the child's language skills and those expected for her age. A prominent feature of the language impairment was a pragmatic deficit. A moderate oral apraxia was also present throughout the 10-year period during which this child was observed.
Recommending Intervention for Toddlers With Specific Language Learning Difficulties
Authors: Olswang Lesley B. , Rodriguez Barbara , Timler Geralyn
Published: July 2014

This paper presents a review of the literature designed to identify child behaviors that shape a profile of toddlers who should receive intervention. The review presents empirically documented predictors of language change and risk factors for language impairment. It examines research addressing the children having difficulty learning language and children developing typically. The argument presented is that toddlers who exhibit few positive predictors of change and many risk factors are more likely to have a true impairment and need intervention than toddlers who exhibit many predictors of change and few risk factors. The review attempts to paint a profile of toddlers for whom treatment should be recommended and those for whom a watch and see approach should be followed.
The Capability-Focus Treatment Framework for Child Speech Disorders
Authors: Kwiatkowski Joan , Shriberg Lawrence D.
Published: July 2014

The goals of this report are to describe a treatment framework for child speech disorders, to summarize findings on the predictive validity of the framework, and to stimulate discussion of associated treatment issues. Since 1984, the capability-focus treatment framework has been used in a university speech clinic by over 200 student clinicians who treated approximately 260 preschool children with speech delay. The framework reflects a treatment philosophy that has been readily endorsed by student clinicians and clinical instructors for its efficacy but is challenging to document because of measurement constraints on the constructs of capability and focus. We describe theoretical and clinical foundations of the capability-focus framework, review findings from three studies using discriminant function and relative risk analyses, and discuss associated issues in measurement, theory, and clinical practice.
Participation of a Conversation Partner in the Word Searches of a Person With Aphasia
Authors: Oelschlaeger Mary L.
Published: July 2014

Conversation analysis was applied to answer the question of when and how a conversation partner participates in the word searches of a person with aphasia. Thirty-eight videotaped conversational sequences from eight naturally occurring conversations of a single couple were analyzed. Sequences were characterized by the spouse’s participation in the self-initiated word searches of her partner, who had aphasia. Sequences were analyzed on a turn-by-turn basis to reveal their sequential organization. Results showed that participation was determined by interactional techniques and interactional resources. Interactional techniques included direct and indirect invitations to participate. Direct invitation was constructed via direct gaze or a wh- question. Indirect invitation was constructed with verbal and nonverbal signals, including specific metalanguage and downward gaze. Interactional resources were information states derived from both life experience and online analysis. Research and clinical implications are discussed.
Assessing the Language of Children With Attention Deficit Hyperactivity Disorder
Authors: Oram Janis , Fine Jonathan , Okamoto Carol , Tannock Rosemary
Published: July 2014

Attention deficit hyperactivity disorder (ADHD) involves, according to theory, an underlying impairment of executive function—the cognitively based control system that regulates behavior. It is possible that this executive dysfunction interferes with performance on certain tasks used to identify language impairment (LI). We compared the performance of 3 groups of children aged 7 to 11 years: ADHDonly (
n
= 25), ADHD+LI (
n
= 28), and non-ADHD controls (
n
= 24), on 18 tasks within 3 language measures (Test of Word Finding, Rosner’s Auditory Analysis Test, Clinical Evaluation of Language Fundamentals-Revised). Children with ADHD-only performed like those without the disorder on most tasks examined. However, the CELF-R Formulated Sentences subtest was particularly difficult for children with ADHD-only. In-depth error analysis indicated that aspects of the executive dysfunction in ADHD such as impulsivity and pragmatic deficits may have influenced performance on this subtest. Clinical implications for testing children with ADHD are discussed.
Early Reading Achievement in Children With Expressive Phonological Disorders
Authors: Larrivee Linda S. , Catts Hugh W.
Published: July 2014

In this study, 30 children with expressive phonological disorders and 27 children with normally developing phonological and language abilities were administered measures of expressive phonology, phonological awareness, and language ability at the end of kindergarten. A year later, children were given tests of reading achievement. Although the group with expressive phonological disorders performed significantly less well than the control group on tests of reading achievement, a great deal of within-group variability was observed. Children with expressive phonological disorders were divided into those with good and poor reading outcomes and compared on measures of expressive phonology, phonological awareness, and language ability. Children with poor reading outcomes had more severe expressive phonological disorders (as measured by a multisyllabic word and nonword repetition task; MULTI-PCC), poorer phonological awareness, and poorer language skills than did children in the good reading outcome group. Hierarchical multiple regression indicated that expressive phonology (as measured by MULTI-PCC) and phonological awareness in kindergarten accounted for significant amounts of variance in first-grade reading achievement. Variability in children’s expressive phonology and phonological awareness may be a reflection of individual differences in their development of phonological representations. Clinical implications of these findings for identification and remediation of reading disabilities are discussed.
The Main and Interactive Effect of Oral Reading Rate on the Frequency of Stuttering
Authors: Vanryckeghem Martine , Glessing Jeffrey J. , Brutten Gene J. , McAlindon Peter
Published: July 2014

Twenty-four adults participated in a 2 (group) by 3 (rate) factorial study designed to determine the main and interactive effects of speech rate during reading on the frequency of stuttering. In this regard, the participants orally read three passages, one at their normal rate, one that was 30% faster than this rate, and one that was 30% slower. Rate was controlled by means of a computer software program, and passage order and reading rate were counter-balanced. The main effect of rate was significant. There was statistically more stuttering in the fast rate condition than in either the normal or slow rate condition. However, the frequency of stuttering in the normal and the slow rate conditions was not significantly different. Analysis of the experimental data of the eight participants who stuttered the most and the eight who stuttered the least, during base-rate oral readings, evidenced the presence of an interaction between group and rate. Those who stuttered the most showed a statistically significant increase in stuttering between the slow, normal, and fast rate conditions. In contrast, there was no significant difference in frequency between any of the three conditions for the group of eight participants who stuttered the least. These findings suggest that the extent to which rate affects fluency is a function of the degree to which stuttering is displayed. This possibility warrants consideration in relation to the use of rate management procedures.
Preparation of Speech-Language Pathologists to Provide Services to Patients With a Tracheostomy Tube
Authors: Manley Stacy B. , Frank Elaine M. , Melvin Caryn F.
Published: July 2014

Speech-language pathologists often are consulted to facilitate communication and swallowing for patients with a tracheostomy tube. The purpose of this study was to survey the clinical knowledge base of speech-language pathologists serving patients with tracheotomy and the level of confidence they place in their ability to provide professional treatment to these persons. Practicing speech-language pathologists have varying levels of didactic preparation for making treatment decisions with these patients; results revealed that only about half report that they feel confident serving this population. Speech-language pathologists requested additional coursework, inservice training, and clinical exposure to tracheostomized patients to increase their confidence in serving these patients. Ethical considerations related to professional preparation and training are discussed.
The Relationship Between Stimulability and Phonological Acquisition in Children With Normally Developing and Disordered Phonologies
Authors: Miccio Adele W. , Elbert Mary , Forrest Karen
Published: July 2014

The relationship between stimulability and phonological acquisition was investigated in eight children, four with phonological disorders who were aged 3;10 (years;months) to 5;7 and four with normally developing phonologies who were aged 3;6 to 4;1. Children with disordered phonologies received treatment on one nonstimulable fricative. A multiple baseline, across subjects, single-subject design was used for experimental control of the treatment aspect of this study. Children with normally developing phonologies were examined at the beginning of the study and upon termination of treatment for the children with disorders. These data were obtained to determine the relationship of stimulability to normal acquisition. In both cases stimulable sounds underwent the most change and stimulability was related to the learning patterns observed. This study supports the hypothesis that nonstimulable sounds are least likely to change without treatment. The results also suggest that stimulability for production of a sound may signal that it is being acquired naturally.
The Development and Enhancement of Narrative Skills in a Preschool Classroom: Towards a Solution to Clinician-Client Mismatch
Authors: McGregor Karla K.
Published: July 2014

Three studies focused on the development and enhancement of narrative skills within a preschool classroom. The purpose of Study 1 was to collect local norms on narrative development. Fifty-two preschool African American English speakers representing 3-, 4-, and 5-year-old age groups, narrated a familiar storybook. Some children in each age group evidenced use of nine story element types. Developmental changes were characterized by growth in types as well as tokens of story elements. Study 2 demonstrated that preschoolers’ narratives can be influenced by the narratives of their peers. Paired children narrated a familiar storybook to each other. The stories of paired children were significantly more similar in form (shared story element types) and content (shared lexical types) than those of unpaired children. Study 3 provided a preliminary test of an intervention designed to exploit the effect of peer models for long-term gain in narrative abilities. Two tutees practiced book narration following the clinician-prompted models of their peer tutors. As a result, the tutees demonstrated an expanded repertoire of story elements and an increased frequency of use of story element types in both trained and untrained stories. Their rate of growth in story element use was superior to that of their classmates who had not participated in the intervention. The benefit of peers for achieving instructional congruence in cases of clinicianclient mismatch is emphasized.
Intelligibility/Severity Measurements of Prekindergarten Children’s Speech
Authors: Gordon-Brannan Mary , Hodson Barbara Williams
Published: July 2014

Intelligibility/severity measurements were obtained for 48 prekindergarten children with varying levels of phonological proficiency/ deficiency. The measure used as the “standard” was percentage of words understood (i.e., orthographically transcribed correctly) in continuous speech in a known context by unfamiliar trained listeners. The children were divided into four groups based on the percentage of words understood from their continuous speech samples. The ranges of intelligibility for each group were: (a) 91–100% for children with “adult-like” speech; (b) 83–90% for children in the “mild” category; (c) 68–81% for children with moderate intelligibility/speech involvement; and (d) 16–63% for the 12 children in the “severe” (i.e., least intelligible) category. When the percentages of the children in the severe group were excluded, the range of the top three groups combined was 68–100% and the mean was 85%. For a child 4 years of age or older, any percentage of words understood in connected speech that falls below 66% (2 standard deviations below the mean) may be a potential indicator of speech difficulty.

In addition, data were obtained from the 48 children to determine the correlations between the standard measure and the following intelligibility/severity measures: (a) imitated sentences, (b) imitated words, (c) listener ratings of intelligibility, and (d) phonological deviation averages. All five measures, including the standard measure, investigated in this study were strongly intercorrelated. Multiple regression analysis results yielded a prediction model that included listener ratings and imitated sentences measures. Results of multivariate analysis of variance (MANOVA), univariate analysis, and post-hoc Bonferroni tests indicated that differences between all pairs of groups were significant for the listener rating measure based on the continuous speech sample. For the percentage of words understood in continuous speech samples, the differences between all pairs of groups, except between the adult-like and mild groups, were also significant. The only group that differed significantly from the other three groups for all five measures was the severe group.
Growth of Language Skills in Preschool Children With Specific Language Impairment: Implications for Assessment and Intervention
Authors: Goffman Lisa , Leonard Jeanette
Published: July 2014

A retrospective longitudinal study of 9 preschool-aged children, all meeting the criteria for specific language impairment (SLI), was conducted. Language growth was documented while the children were between the ages of 3 and 5 years and enrolled in a language intervention program. Three language measures were obtained across this period, including mean length of utterance (MLU) in morphemes, lexical diversity (i.e., number of different words used per 50 utterances), and a finite verb morphology composite (i.e., percent correct production of regular past -
ed
, present third person singular -
s
, and both the copula and auxiliary forms of
is
,
are
, and
am
) . These longitudinal data were compared with cross-sectional data from 99 normally developing children who resided in the same community. Age-based comparisons revealed that, for most children with SLI, lexical diversity approached normal levels by the second year of data collection, whereas the production of finite verb morphology continued to be significantly delayed. A second set of comparisons, in which the children with SLI were compared with younger controls matched for MLU, further accentuated the persistence of difficulties with finite verb morphology. Applications of these language growth measures to assessment and intervention are discussed.
Physical Examination of the Rib Cage Wall by the Speech-Language Pathologist
Authors: Hixon Thomas J. , Hoit Jeannette D.
Published: July 2014

A protocol is offered for use by the speech-language pathologist in conducting a physical examination of the rib cage wall. Structural and performance observations are used to reveal possible rib cage wall dysfunction. A worksheet is provided to guide the examiner. The present protocol, together with those presented in companion publications on the diaphragm (Hixon & Hoit, 1998) and the abdominal wall (Hixon & Hoit, 1999), provide the bases for a comprehensive physical examination of the status and function of the breathing apparatus by the speech-language pathologist.
Enhancing Children’s Print and Word Awareness Through Home-Based Parent Intervention
Authors: Justice Laura M. , Ezell Helen K.
Published: July 2014

This investigation examined the efficacy of a home-based book reading intervention program for enhancing parents’ use of print-referencing behaviors and for stimulating children’s early literacy skills in the areas of print and word awareness. Participants included 28 parents and their typically developing 4-year-old children. Each dyad was assigned to a control or experimental group, using a pretest-posttest control group research design. Pretest measures of parents’ book-reading behaviors and children’s early literacy skills were collected. Each dyad then completed a home-based shared reading program, in which they read two books each week over a 4-week period. Parents in the experimental group were instructed to use nonverbal and verbal print-referencing behaviors in their reading sessions. Control group parents did not receive this instruction. Posttest measures found that parents in the experimental group showed a significant increase in their use of verbal and nonverbal references to print. Results also indicated that parental use of these print-referencing behaviors significantly enhanced their children’s early literacy skills in several areas of print and word awareness. Clinical implications of this intervention are discussed.
A Coding System for Describing Conversational Breakdowns in Preschool Children
Authors: Yont Kristine M. , Hewitt Lynne E. , Miccio Adele W.
Published: July 2014

Analysis of children’s breakdowns offers a rich data source, potentially revealing patterns of weakness in children’s communication ability. The purpose of the present study was to present a fine-grained instrument, the Breakdown Coding System (BCS; Yont, 1998), for measuring conversational breakdowns in preschoolers. The BCS was applied to language samples collected from five typically developing children (ages 3;11–4;2 years) during naturalistic interactions with familiar caregivers. Results indicated that the BCS was a useful tool for describing children’s breakdowns. Further support for the BCS was seen in the high interobserver reliability for identifying (kappa = .8834) and describing (kappa = .9170) breakdowns and in its usefulness for profiling individual patterns of breakdown types across children. This study is an important first step in developing a valid and useful measure for clinical analysis of breakdowns in young children’s conversational samples.
The Association of Intervention Receipt With Speech-Language Profiles and Social-Demographic Variables
Authors: Zhang Xuyang , Tomblin J. Bruce
Published: July 2014

This study explored the effects of oral communication and demographic characteristics on intervention receipt. Oral communication characteristics included speech-sound production and receptive and expressive language status. Demographic characteristics included race, sex, residential strata, and neighborhood income level. With regard to speech-sound production and language, 1,929 kindergartners were divided into four speech-language subgroups: speech impaired only, language impaired only, speech and language impaired, and normal in both speech and language. In terms of expressive and receptive language modalities, the group of children was divided into four expressive-receptive subgroups: expressive impaired only, receptive impaired only, expressive and receptive impaired, and normal in both expressive and receptive language. Associations of speech versus language and expressive language versus receptive language with intervention receipt were examined in both categorical and continuous manners. Results showed that speech had a stronger effect on intervention receipt than language, but that this difference could not be explained by the effect of speech on social and academic functions compared to that of language. Expressive language had a stronger effect on intervention receipt than receptive language (when treated as continuous variables). This also could not be explained by the effect of these variables on social and academic function. These results suggest that the current referral and service delivery system depends on communication characteristics that are expressive and, thus, most readily observable. This referral and service delivery approach, however, fails to identify children that have the greatest social and academic risks. Methods of reversing this trend were discussed. Among all demographic variables examined, only sex is related to intervention receipt, that is, boys were more likely to have received intervention.
Survey of Hearing Aid Fitting Practices for Children with Multiple Impairments
Authors: Tharpe Anne Marie , Fino-Szumski Mary Sue , Bess Fred H.
Published: July 2014

The fitting of amplification on young children with multiple impairments in addition to hearing loss is a challenge faced regularly by audiologists. However, very little has been published on this topic in the audiological literature. The purpose of this survey was to document hearing aid fitting practices for this population within the United States. Specifically, audiologists who regularly serve children were asked to complete a series of questions on their educational preparation and their hearing aid selection, fitting, and verification practices for children with multiple impairments. For purposes of this survey, multiple impairments included vision impairment, mental retardation, physical impairment, and autism spectrum disorders. Findings from this survey suggest that children with special needs in addition to hearing loss are typically fit in the same way and with the same type of amplification as those with hearing loss only. In addition, differences were noted in hearing aid selection, fitting, and verification practices across work settings. Future directions and research needs are suggested.
Electrode Configuration for Auditory Brainstem Response Audiometry
Authors: King A. Joyce , Sininger Yvonne S.
Published: July 2014

A vertical recording montage (C
z
to the seventh cervical vertebra or C
7
) has been shown to yield significantly lower auditory brainstem response (ABR) threshold when compared with a horizontal or anterior-posterior montage (Sininger & Don, 1989). The present study further examines the relationship between electrode placement and the amplitude of the ABR to low-level stimuli. Four electrode arrays were compared—the commonly-used clinical configuration of forehead to ipsilateral mastoid, the vertical array from the previous study (C
z
to C
7
), and two additional montages employing linked mastoids as reference to either the vertex or forehead electrode. ABRs were recorded simultaneously in four channels in response to 8000 click stimuli at 10, 20, and 30 dB SL from 9 male and 9 female adult subjects with normal hearing. The effect of electrode channel was significant at <.0001, with the vertical channel revealing the largest wave V amplitudes at all stimulus levels. Female subjects, as expected, produced larger ABR amplitudes than male subjects in all recording conditions, but electrode-channel effects were independent of gender.
Recent Advances in Tinnitus
Authors: Tyler Richard S. , Aran Jean-Marie , Dauman René
Published: July 2014

Tinnitus can be the most debilitating symptom faced by people with hearing impairments. In the past 10 years, there has been a large increase in tinnitus research and in the development of clinical protocols. New animal models and physiological procedures provide an important contribution to the understanding and measurement of tinnitus. The annoyance of tinnitus likely depends on its loudness and the psychological makeup of the patient. The loudness of a person's tinnitus can be compared with the equivalent loudness of a 1000 Hz tone in a normal ear. Several questionnaires have recently been introduced to quantify the handicap caused by tinnitus. Tinnitus maskers are apparently ineffective for most patients but they can be helpful in a few patients. Medications are largely ineffective in reducing tinnitus in most people. However, several psychological techniques for reducing the stress associated with tinnitus are currently under investigation, and preliminary results show some promise. Tinnitus can be reduced by electrical stimulation in a few patients, and this is also an important area for future research.
A Different Approach to the Noise Problem of the Hearing Impaired
Authors: Villchur Edgar
Published: July 2014

Hearing aid design to alleviate the noise problem has concentrated on improving the signal-to-noise ratio with the aid, using devices such as directional microphones, adaptive filters, and circuits that discriminate between steady-state noise and speech. The design approach discussed here is directed at improving the speech recognition of hearing-impaired listeners at a given signal-to-noise ratio, by restoring to their perception speech cues they no longer hear because of their impairment. This allows them to retain more of the redundant information in speech after masking has taken its toll, and empowers their ability to separate desired from undesired signals (what Broadbent calls "selective listening" in persons with normal hearing). Experimental results are presented.
Monitoring Preschoolers’ Hearing Aids
Authors: Elfenbein Jill L.
Published: July 2014

Review of data obtained from a small sample of parents of preschoolers indicates that although most parents are aware of the need to monitor hearing aids for signs of malfunction, they do not always have the equipment and the skills needed to accomplish the task. Information from studies of physician/parent and audiologist/parent relationships provides a foundation for examining the problem. Data from these sources suggest that marked changes may be possible if clinicians change the ways they interact with parents.
Comparison of the Multipeak and Spectral Peak Speech Coding Strategies of the Nucleus

TM

22-Channel Cochlear Implant System
Authors: Holden Laura K. , Skinner Margaret W. , Holden Timothy A. , Binzer Susan M.
Published: July 2014

Eight subjects participated in a comparison of the multipeak (MPEAK) and spectral peak (SPEAK) speech coding strategies of the Nucleus

TM

22-channel cochlear implant system as part of a long-term monitoring study. Sound-field threshold levels and speech recognition performance on the Bamford-Kowal-Bench Sentence Test, NU-6 Monosyllabic Word Test, and Connected Speech Test or CID Everyday Sentence Test were analyzed for the two speech coding strategies. For the group, speech recognition performance was significantly higher with the SPEAK speech coding strategy than with the MPEAK strategy on all speech tests. For individual subjects, scores with the SPEAK strategy were significantly higher for some subjects on each of the speech tests. None of the subjects scored significantly higher on any of the tests with MPEAK.
Identification of Hearing Loss in Children and Young Adults Using Measures of Transient Otoacoustic Emission Reproducibility
Authors: Glattke Theodore J. , Pafitis Irene A. , Cummiskey Cynthia , Herer Gilbert R.
Published: July 2014

Measures of transient evoked otoacoustic emission (TEOAE) reproducibility were obtained for 506 ears of 260 children and young adults. Frequency-specific and whole reproducibility (WR) data were obtained using ILO88 hardware and software and were analyzed with respect to pure-tone threshold and immittance data for the same ears. Reproducibility scores were most robust in the frequency region of 2,000 Hz. In addition, the 2,000-Hz reproducibility score was the most efficient of all measurements (0.85 to 0.91) in separating normal and hearing-impaired ears, regardless of the frequency or frequencies at which the hearing loss occurred. Conductive hearing loss precluded detection of emissions. The present findings suggest that TEOAEs provide useful information in routine clinical practice and that they may be employed to screen for the presence of hearing loss in children and young adults.
Audiologic Assessment of Children With Down Syndrome
Authors: Kile Jack E.
Published: July 2014

It has been suggested that many children with Down syndrome possess unique physical and behavioral characteristics that should be considered when doing audiologic assessments. Possible test modifications have been suggested to maximize attending behavior and to improve test reliability and validity. It has been reported that children with Down syndrome may not hear as well as other children, and determining the presence of hearing impairment can be problematic. Research needs have been highlighted. Because these children are at risk for middle ear disease and hearing impairment, audiologic assessment should occur early (infancy) and frequently (4–6 month intervals), with use of amplification when appropriate.
Autoimmune Inner Ear Disease (AIED)
Authors: Hurley Raymond M. , Sells Janet P.
Published: July 2014

A portion of idiopathic rapidly progressive sensorineural hearing loss (SNHL) cases can be attributed to an immunological process in the cochlea that has been designated "autoimmune inner ear disease" (AIED). AIED is characterized by asymmetric bilateral SNHL that progresses over weeks or months, is often accompanied by vestibular symptoms, and responds positively to immunosuppressant medication. Historically, the inner ear was thought to be protected from autoimmune pathology; however, recent evidence suggests that the perisacular tissue surrounding the endolymphatic sac contains the necessary components for an immunological reaction. In addition, the inner ear is capable of producing an autoimmune response to sensitized cells that can enter the cochlea from the circulatory system through the spiral modiolar vein. Thus, AIED can be organ-specific, originating within the inner ear, or non-organ-specific, originating outside the inner ear. Although AIED is a recognized form of SNHL that may be stabilized or even reversed by appropriate medication, it remains the subject of controversy and debate. This paper discusses the pathogenesis of AIED, diagnostic strategy and treatment procedures for AIED, and the role of the audiologist in patient management.
Effect of Computerized Auditory Training on Speech Perception of Adults With Hearing Impairment
Authors: Pizarek Rachel , Shafiro Valeriy , McCarthy Patricia
Published: July 2014

Computerized auditory training (CAT) is a convenient, low-cost approach to improving communication of individuals with hearing loss or other communicative disorders. A number of CAT programs are being marketed to patients and audiologists. The present literature review is an examination of evidence for the effectiveness of CAT in improving speech perception in adults with hearing impairments. Six current CAT programs, used in 9 published studies, were reviewed. In all 9 studies, some benefit of CAT for speech perception was demonstrated. Although these results are encouraging, the overall quality of available evidence remains low, and many programs currently on the market have not yet been evaluated. Thus, caution is needed when selecting CAT programs for specific patients. It is hoped that future researchers will (a) examine a greater number of CAT programs using more rigorous experimental designs, (b) determine which program features and training regimens are most effective, and (c) indicate which patients may benefit from CAT the most.
SIG 14 Perspectives Vol. 19, No. 2, July 2012
Authors: Harris Joyce L. , Fleming Valarie B. , Harris Cheryl L.
Published: July 2014

Sorry, this activity is no longer available for CEUs. Visit the SIG 14 page on the
ASHA Store
to see available CE activities.

Use the CE questions PDF here as study questions to guide your Perspectives reading.
SIG 14 Perspectives Vol. 19, No. 3, December 2012
Authors: Mashima Pauline A.
Published: July 2014

Sorry, this activity is no longer available for CEUs. Visit the SIG 14 page on the
ASHA Store
to see available CE activities.

Use the CE questions PDF here as study questions to guide your Perspectives reading.
Effectiveness of Two Different Approaches to Accent Modification Services for Non-Native English Speakers of Korean Background
Authors: Lee Sue Ann S. , Sancibrian Sherry
Published: July 2014

This study evaluated effectiveness of two different approaches to accent modification for non-native English speakers. Eight native Korean speakers of English participated. English labio-dental fricatives, liquids, and front vowels were targeted. Half of the participants received accent modification services with a focus on individual sound drills (segmental approach) while the other half received services using minimal pairs (contrastive approach). The percentage of correct pronunciation was measured for each consonant and vowel category during each session. The results of this study revealed that both groups of Korean speakers showed a similar percentage of correct pronunciation for consonant production. However, those who received the contrastive approach demonstrated higher accuracy in vowel production than those who received the segmental approach. The results of this study suggest that contrastive approaches may be useful for non-native English speakers of Korean background, especially for vowel production.
Functional Speech Disorders and Personality: A Decade of Research
Authors: Bloch Ellin L. , Goodstein Leonard D.
Published: July 2014

This paper summarizes and evaluates the research literature published between 1958 and 1968, relating measured personality and adjustment to the functional (non-organic) speech problems of articulation, delayed speech, voice, and stuttering. For each of these disorders, a review and evaluation of the research is presented on the personality and adjustment of (1) children suffering from that disorder; (2) their parents; and, where appropriate, (3) adults with that disorder. Methodological and conceptual problems are discussed in the context of the studies.

The literature reviewed has yielded few conclusive findings and few new perspectives regarding the role of personality variables in the four major functional speech disorders. The methodological and conceptual inadequacies of most studies have been striking, and steady research efforts have yielded no firm evidence that differentiates speech-defective persons and their parents from normal speakers and their parents in terms of general adjustment or broadly identifiable personality patterns. It would be profitable to concentrate future research on specific within-group variables, such as improvement in therapy, rather than to continue the present focus.
The Efficacy of Language Rehabilitation in Aphasia
Authors: Darley Frederic L.
Published: July 2014

Studies of the effect of therapy on the course of recovery from aphasia yield inconsistent results and permit no generalization to the population of aphasic patients. Future investigations of the efficacy of therapy should specify the nature of the language disorders treated, the limits of the period of spontaneous recovery, objective measurement of relevant behavioral changes, and the nature, intensity, and quality of therapy provided. In subject selection, age, educational and social status, intelligence, health, social milieu, etiology, site and extent of lesion, time lapse since onset, type of aphasia, and nonlanguage behavior characteristics should be controlled if interpretable results are to be obtained.
Clinical Equipment for Measurement of Middle-Ear Muscle Reflexes and Tympanometry
Authors: Liden Gunnor , Bjorkman Gote , Peterson John L.
Published: July 2014

The range of applications of middle-ear muscle reflex measurements is reviewed. Different methods for measuring the relative impedance change, including extratympanic manometry and a method of tympanometry, are discussed in relation to the authors' equipment, which is of four main kinds: the intra-aural reflex indicator, a pressure transducer system for extratympanic manometry, a system for changing and monitoring the air pressure in the ear canal for tympanometry, and a four-channel recorder. The authors have found that intra-aural reflex thresholds are highly similar, whether determined by changes in amplitude or amplitude-phase. Furthermore, extratympanic manometry performed by the authors' method does not show reflex thresholds to be as sensitive as do the other methods. In studies of reflex growth and preliminary measurements of the decay of the stapedial reflex, amplitude-phase method seems superior because of larger responses. The method of tympanometry for measuring ear-drum mobility and the status of the ossicular chain and middle-ear cavity will identify certain pathological conditions of the middle ear. We have found 800 Hz to be the preferred working frequency for this measurement.
Some Relationships Between Measures of Early Language Development
Authors: Sharf Donald J.
Published: July 2014

Some relationships between language measures based on verbal output (Mean Length of Response and Number of Different Words) and those based on structural analysis (Length-Complexity Index and Developmental Sentence Types) were investigated by longitudinally analyzing the early language development of 13 children. Seven recordings were made of eight boys and five girls at two- to four-month intervals beginning at an average age of 21 months. A method for quantifying the DST was devised, and all the recordings were analyzed to compare scores for the measures. It was found that (1) variability in the rate of increase in language development scores made age a poor basis for comparing children, using any language measure; (2) there was considerable agreement among measures in reflecting the rate of language development; (3) all the language measure scores seemed to be equally related to language growth, so each provided a reasonable index of the complexity of the underlying language structure; and (4) the reliability of trained scorers was as good for measures based on structural analysis as it was for those based on verbal output.
Rehabilitation for Dysphagia Paralytica
Authors: Larsen George L.
Published: July 2014

Dysphagia paralytica is a disorder of swallowing resulting from a lesion of the cranial nerves or brain stem, in particular the medulla oblongata. Rehabilitation of this disorder depends on careful assessment of spared and damaged processes responsible for swallowing. The management technique is maximum use of assets, capitalizing on intelligence to support reflex bahavior. The various roles of the rehabilitation team are described.
Aphasia Therapy: A New Look
Authors: Wepman Joseph M.
Published: July 2014

The paper presents some personal clinical observations on aphasia and aphasia therapy. It discusses the relative merits of direct language-centered therapy and a more indirect context-centered therapy. It presents a viewpoint on when therapy should be undertaken and by whom. It elaborates some new concepts about aphasia as a thought-process defect rather than a linguistic disturbance. It introduces the idea that the word-finding problem in aphasia is related to involuntary inhibition or what has been called “the shutter principle.” It presents some guidelines for considering when therapy should be discontinued.
The Use of Parent-Child Interaction Patterns in Therapy for Young Stutterers
Authors: Egolf Donald B. , Shames George H. , Johnson Peter R. , Kasprisin-Burrelli Arlene
Published: July 2014

Nine school-age stutterers were seen in an experimental therapy program. The basic feature of the program was that parent-child interaction patterns were used in the planning of therapy. Such behaviors by the parent as verbal aggression, silence, and interruptions were identified in the parent-child interaction. These events were hypothesized as maintaining factors of stuttering, and were manipulated during therapy. Results support the hypothesized relationship. Clinical and experimental implications are discussed.
Scaling Aphasics' Error Responses
Authors: Davis Naida , Leach Edwin
Published: July 2014

An aphasic’s error response may roughly approximate the desired response or it may closely approximate the desired response. Since the relationship between actual response and desired response may have diagnostic and therapeutic utility, this study analyzed this relationship using a similarity continuum of gross, syntactic, and phonological components. The results indicated that recording of error responses as incorrect omits potentially useful clinical information.
What is Deviant Language?
Authors: Leonard Laurence B.
Published: July 2014

This paper presents a detailed description of deviant language, employing the transformational model. In addition to a review of existing work in the area, new information based on a comparison of data obtained from matched groups of normal and deviant language users is presented.
The Denver Articulation Screening Exam
Authors: Drumwright Amelia , Van Natta Pearl , Camp Bonnie , Frankenburg William , Drexler Hazel
Published: July 2014

This report describes the development of an articulation-screening test for economically disadvantaged children. The test is unique in that it was designed for use by trained nonprofessional workers. Thirty-four sound elements were administered to over 1500 Anglos, blacks, and Mexican-Americans two and one-half to six years of age. They varied significantly on the production of four sounds, which were eliminated from further study. In their production of the remaining 30 sounds, no significant differences were noted among cultural groups or between males and females. Age normative data in pronunciation of the 30 sounds were combined for all three cultural groups and displayed in a percentile rank format for each age category. Validation studies using nonprofessional screeners established the fifteenth percentile as the cutoff point for referral of abnormal children. Test-retest reliability was 0.95. Application of the test to large populations of children and use of nonprofessional screeners are discussed.
A Study of Pharyngeal Speech
Authors: Weinberg Bernd , Westerhouse Jan
Published: July 2014

Pharyngeal speech represents one of several types of alaryngeal speech; however, its use as a primary method of communication is rare. This report relates the principal findings of an intensive study of a 12-year-old girl with laryngeal papillomatosis who has used pharyngeal speech as an exclusive method of oral communication since age two. The unique physiologic mechanisms of pharyngeal speech are described and differentiated from other forms of alaryngeal speech. This girl’s reduced pharyngeal speech intelligibility for consonant and vowel rhyme-test words, her unfavorable phonation time and maximum phonation duration characteristics, her low average fundamental frequency, and her markedly hoarse pharyngeal voice quality all are distinct vocal liabilities. These findings lend strong support to the hypothesis that pharyngeal speech should not be regarded as a desirable or practical primary method of alaryngeal speech.
Modification of Lip Hypertonia in Dysarthria Using EMG Feedback
Authors: Netsell Ronald , Cleeland Charles S.
Published: July 2014

This is a case report of an attempt to reduce the postural hypertonicity in certain facial muscles of a Parkinsonian patient. We believed that such a reduction would facilitate the movements of the lip during speech. The patient, a 64-year-old woman with a 15-year history of Parkinsonism, had complete bilateral retraction of the upper lip, with associated eye squint and wrinkling of the forehead. Her attempts at bilabial consonants were produced with lower lip contacts against the upper teeth. Surface electrodes were placed over muscles that were contracting to retract the upper lip. The patient was presented with a tone whose frequency was analogous to the voltages recorded from the electrodes. Her task was to concentrate on lowering this tone and, hence, the hypertonicity in the lip. At the close of five half-hour sessions, the patient demonstrated considerable progress toward removing the undesirable lip retraction. Speculations about the basis of these neuromuscular modifications and the origin of the lip retraction are presented.
Regularities in Abnormal Child Phonology
Authors: Oller D. Kimbrough
Published: July 2014

This paper reports conclusions from a study which attempted to determine the usefulness of applying generative notational conventions to a phonology of sound substitutions of abnormal children. The results suggest that the conventions make it possible to capture numerous generalizations which must be left unstated in more traditional frameworks. The results also suggest that there is much more regularity in abnormal speech than there would appear to be at first glance. The author argues that these regularities reflect remarkable abilities which abnormal children possess.