bluuebunny/crossref_metadata_2025 huggingface dataset:
Beyond randomised controlled trials: The case for effective case studies of the effects of treatment in aphasia
Authors: Howard David
Published: November 2007

Randomised controlled trials (RCTs) of aphasia therapy have not established that speech therapy is effective with aphasic patients. The characteristics of RCTs, and the assumptions they make, are examined and it is argued that RCTs could never have produced useful information about the effects of treatment with aphasic patients; it is not sensible to investigate the effects of a set of heterogeneous treatment techniques applied to a heterogeneous group of subjects measuring improvement with generalised and insensitive assessment techniques. Instead, effective studies of treatment in aphasia will investigate the usefulness of specific and motivated treatment methods applied to specific aphasic patients. The methodological requirements of scientific studies of aphasia treatment of this kind are discussed, and the appropriateness of three types of experimental design is considered.
Evaluating the effects of speech therapy for aphasics: Developing the single case methodology
Authors: Pring T. R.
Published: November 2007

Dissatisfaction with the group study approach to treatment efficacy for aphasia has led to widespread advocacy of single case studies. Such studies may also be important since they allow the individual clinician to evaluate her/his own therapy. Despite a wide literature on single case studies in general the details of their application in this area have received little discussion. It is argued that the approach is most compatible with the application of well defined treatment procedures to specific areas of linguistic deficit. Moreover the requirement for frequent assessments of progress is only likely to be met by the use of brief and equally specific assessment procedures designed by the therapist. Finally the likelihood that progress may be slow and may need to be dissociated from improvements due to natural recovery indicates the need for statistical analysis. Since the appropriate methods are little known some possible statistical procedures are discussed.
In defence of randomised controlled trials, with suggestions about the possible use of meta‐analysis
Authors: Fitz‐Gibbon C. T.
Published: November 2007

Howard and Pring, in this Forum, appear to attack RCTs, especially in their abstracts. A closer look at their articles and the arguments advanced will, it is argued, leave intact the reputation of RCTs as the most appropriate methodology for testing hypotheses. It is also argued here that it might be desirable to move away from reliance on statistical significance testing and focus instead on estimating Effect Sizes. Meta‐analysis is a technique of research synthesis which does this.
Microcomputer speech therapy for dysphasic adults: A comparison with two conventionally administered tasks*
Authors: Kinsey Claire
Published: November 2007

There has been a great deal of speculation regarding the role of microcomputers in the re‐training of dysphasic patients. Enthusiasm should be tempered with caution and each application in this new and exciting area has to be clearly defined if it is to have an impact in the future. This study is one of a series and compares the performances of dysphasic stroke patients on selected speech therapy tasks administered both in the conventional way and using a microcomputer. The twelve subjects were assessed on linguistic and non‐linguistic tasks, which were matched across the two situations. Both quantitative and qualitative measures of patients performances were analysed. After an initial familiarity task, no significant differences were noted between the scores in each situation. Theoretical and practical implications of using the computer to supplement speech therapy are discussed.
The development of conversational disability: a case study
Authors: Conti‐Ramsden Gina , Gunn Margaret
Published: November 2007

Along with the pragmatic revolution has come the realisation that some children have major difficulties in engaging and maintaining conversational interaction. The present study displays the evolving profile of a boy, Tony, who experiences problems in this area. It is argued that in order to understand the nature of such problems it is necessary not only to have detailed and rigorous analysis of language samples but also data collected across time and in areas other than conversational development.
EMG biofeedback and relaxation in the treatment of hyperfunctional dysphonia
Authors: Andrews Mrs Shirley , Warner Jennifer , Stewart Robert
Published: November 2007

Two methods of relaxing laryngeal musculature were investigated in adults with hyperfunctional dysphonia. Assessments were conducted pre‐treatment, post‐treatment and at three month follow‐up. Measures included the level of superficial laryngeal tension using an electromyogram, control of vocal fold vibration using Fx traces from an electrolaryngograph and an auditory evaluation using a phonation profile. Two personality questionnaires were administered and the subjects' self‐rating of voice was recorded. The duration of treatment was noted. Subjects were matched into groups receiving either laryngeal EMG biofeedback or progressive relaxation, both within a graded voice training programme. A significant improvement in all measures occurred for both programmes, which was maintained at follow‐up. No significant difference between the two approaches emerged. Implications for the assessment and treatment of hyperfunctional dysphonia are discussed.
Intelligibility: a linguistic view
Authors: Connolly John H.
Published: November 2007

The concepts of speech intelligibility and unintelligibility are examined from a theoretical linguistic point of view, and it is argued that unintelligibility is a special case of a broader phenomenon which is here termed indeterminability. It is further contended that the identification of potential sources of unintelligibility and other kinds of indeterminability should be an aim of linguistic assessment procedures.
Atypical dysarthria in Munchausen syndrome
Authors: Kallen Deborah , Marshall Robert C. , Casey Daniel E.
Published: November 2007

The evaluation and treatment of a 40 year old man with a diagnosis of Munchausen syndrome with accompanying dysarthria is described. The patient responded to symptomatic behavioural therapy similar to that for other functional speech and voice disorders. The speech pathologist may serve an important role in the management of such cases.
A case of mixed transcortical aphasia following drug overdose
Authors: Chenery H. J. , Murdoch B. E.
Published: November 2007

A case is presented of a 35‐year‐old, right‐handed man who exhibited a range of clinical features indicative of mixed transcortical aphasia subsequent to a heroin overdose. The findings of a comprehensive language evaluation, neurological assessment and neuroradiological examination are described and discussed. The major feature of the patient's language disorder was the relative loss of the voluntary aspects of language (eg spontaneous speech; the ability to initiate or actively participate in conversations) compared to the preservation of the automatic, non‐volitional components of language (eg repetition; rules of syntactic agreement; completion phenomena; and verbal automatisms). It was concluded that the features of mixed transcortical aphasia demonstrated were most likely the result of anoxic changes in the arterial borderzone occurring secondary to the drug overdose.
Acquisition of syntax in Panjabi and English
Authors: Duncan Deirdre M. , Gibbs Dorothy A.
Published: November 2007

Ninety‐nine bilingual children with Panjabi as a mother‐tongue and English as a second language were assessed, in three age/term groups between six and a half and eight and a half years, on oral expressive language tests of their syntax development in Panjabi and in English. The two major findings were, firstly, that in English second language development seems to follow, broadly speaking, first language acquisition patterns and, secondly, that there are almost no data to support the idea of language transfer as far as mixing of Panjabi syntax into English is concerned, while there appears to be intrusion of English into Panjabi in specific structures.
On choosing a methodology to assess the effectiveness of therapeutic interventions: a brief reply to FitzGibbon
Authors: Pring T. R.
Published: November 2007

Discussion of the problems involved in assessing the effects of therapies offered to aphasic patients appears to have become a dispute about methodology. Since it is important that therapists devote more effort to experimentally evaluating therapy, uncertainty about the appropriate methodology is unlikely to be helpful. The choice of methodology in this instance reflects the current state of knowledge about aphasia therapy and the nature of the questions we wish to answer. Since therapists will wish to discover effective therapies further large scale studies of the general impact of therapy are unlikely to be informative.
Aetiologies of aphonia following closed head injury
Authors: Scholefield Judith A.
Published: November 2007

Three patients in a neurosurgical unit following road traffic accident are described. Patient A was aphonic post‐traumatically. Voice returned suddenly and spontaneously three months post trauma. Patient B, with a severe closed head injury, presented with localised oedema of the vocal cords and laryngeal stridor caused by removing his own endotracheal tube thirteen days post trauma, resulting in aphonia. Voice returned gradually over the next sixteen days. Patient C sustained a spinal injury in addition to a severe closed head injury. He was also aphonic post trauma. The initial stage of this was thought to be traumatic mutism. A residual lower motor neurone dysarthrophonia remained, however. Various explanations for the aphonia are explored; in particular for Patient A the possibility is discussed of frontal lobe‐limbic involvement, nerve damage at both upper and lower motor neurone levels and right hemisphere involvement. Diagnoses of aphonia following head injury and therapeutic procedures are discussed.
Articulatory description and treatment of “lateral /s/” using electropalatography: a case study
Authors: Gibbon F. , Hardcastle W.
Published: November 2007

Cases of so‐called “lateral /s/” articulation are frequently encountered in the clinic but are difficult to treat using conventional therapy. In this study, the technique of electropalatography (EPG) is used on a 12 year old with a lateral /s/ as a therapeutic tool providing a real‐time visual feedback display of tongue contacts with the palate during speech. EPG provided detailed articulatory information, unavailable from an auditory‐based analysis, which could be incorporated into the therapy programme. A normal /s/ pattern was achieved in connected speech after only four clinical sessions, and was maintained when reassessed after six months.
Psychological change and fluency therapy: a pilot project
Authors: Leahy M. , O'Sullivan B.
Published: November 2007

A brief account of psychological group therapy using personal construct theory with stuttering clients is given. The analysis of repertory grids before and after therapy demonstrates the areas that are the focus for change and the amount of changes that did occur during a short (three month) period. Results provide positive support for the use of such an approach.
Accelerated speech in dysarthria after acquired brain injury: Acoustic correlates
Authors: Ziegler W. , Hoole P. , Hartmann E. , von Cramon D.
Published: November 2007

The present study reports on some acoustic dimensions of perceptually accelerated speech in dysarthria. Twelve dysarthric patients who were clinically judged as presenting an increased speech rate were investigated. Control groups of slowed dysarthrics (n = 12) and of normal subjects (n = 15) were also examined. The speech material consisted of chains of plosive‐vowel syllables uttered in a sentence repetition task. The speech wave envelope of these sentences was evaluated with respect to characteristic temporal and amplitude patterns. Proportions of stop gaps, noise segments and segments of quasiperiodic oscillation were also determined.

The patients with accelerated speech had normal or near‐to‐normal syllabic rates. Segmental contrast was more or less reduced, depending on the degree of severity. Concerning the proportions of voiced and voiceless segments two different types of impairment could be discerned. Possible physiological interpretations of these results and the relation between acoustic and perceptual dimensions of speech tempo are discussed.
Language‐impaired children's comprehension of active versus passive sentences
Authors: Precious Ann , Conti‐Ramsden Gina
Published: November 2007

This study investigated comprehension of active vs passive sentences by language‐impaired children. Twelve language‐impaired children age ranged from 5;0 to 7;4 with comprehension ages ranging from 2;11 to 6;0 participated in this study. Subjects acted out 12 active and passive voice sentences which varied in three dimensions: probable agent, improbable agent and reversible agent. A comprehension maturity effect was found with the children of younger comprehension age interpreting active sentences more accurately than passives while those of older comprehension age interpreted both active and passive sentences more correctly. There was also a differential plausibility effect. The range of strategies used by the language‐impaired children was similar to that used by non‐language‐impaired subjects, showing evidence of a delay, but some qualitative differences were also noted. The strategies were often acquired at a later comprehension age and were used for a longer period of time. Some of the language‐impaired children seemed to reach a plateau and were reluctant to abandon developmentally immature strategies. Comprehension age appeared to be a better predictor of the performance of language‐impaired children than chronological age.
The perception of phoneme sequence: A comparison of dyspraxic and normal children
Authors: Bridgeman Elizabeth , Snowling Maggie
Published: November 2007

The present experiment examined the perception of phoneme sequence by dyspraxic and normal children, matched on reading age. Both groups of children could discriminate real words equally well but the dyspraxic children had problems in non‐word discrimination. The findings suggest that the dyspraxics have difficulty, not at a peripheral level of auditory discrimination, but at a later stage of phonemic processing where segmentation and coding of phonemes is required.
The maternal language environment of children with language delay
Authors: Davis Hilton , Stroud Amanda , Green Lynette
Published: November 2007

This paper presents potentially interesting data derived by chance while conducting a much larger study of families of children with global delay. The data relate to a comparison of aspects of the maternal language environment of working‐class children with and without language delay, and to the mothers' perceptions of their children. In free play, mothers of children with language delay were found to talk less and to use proportionally more commands. However, these differences disappeared in an instruction situation. These findings were considered in relation to the fact that mothers of the delayed children construed their children in a somewhat more negative way. Although it was not possible to draw causal inferences, the results were discussed in relation to the implications for the subsequent development of the child and intervention strategies generally.
Communication aids provision 1983–1986
Authors: Rowley C. M. , Stowe J. , Bryant J. , Chamberlain M. A.
Published: November 2007

In 1983, a study was undertaken to document aspects of communication aids provision. Two national surveys (one of manufacturers and the other of district speech therapists), were carried out (Phase I), and then a prospective year's study, based on Phase 1 data, set up in nine selected districts (Phase 2). Data on 32 new adult users of 39 communication aids were gathered and various findings summarised: (1) the need to ensure maximum compatibility between user and aid through thorough assessment, the involvement of both user and carer, training in aid usage and regular monitoring by the therapist; (2) the extent of use is not important, rather the importance placed on the degree of use by the user; (3) the need to promote more extensive clinical trials of communication aids; (4) a wider training for speech therapy students in the new technology and then post‐college opportunities to keep abreast of current developments. Regarding policy, the usefulness of a loan bank is proven, together with the need for easier access to funding. Further, direct referral procedures help to ensure speedy, effective provision.
Compensatory articulation in a subject with total glossectomy
Authors: Morrish Elizabeth C. E.
Published: November 2007

The study examines the intelligibility, articulation and acoustic features of the vowels and plosives of a male subject (GS) who has undergone total glossectomy. Overall the subject was found to be between 58 per cent and 65 per cent comprehensible according to stringent auditory tests. Videotape analysis and EMG confirmed that GS makes all plosive consonants biblabially, although he introduces extra lip protrusion to distinguish ‘alveolar’ from ‘bilabial’ articulations. However, individual plosives were not well recognised. Vowel production was investigated using videofluoroscopy. GS was observed to be effectively constricting his vocal tract in the pharyngeal region by compensatory use of the epiglottis and the grafted flap which re‐lined the floor of the mouth. Acoustically GS displays a greatly reduced vowel space from normal. The study shows that compensatory articulatory strategies are available to the glossectomee and that perception of his speech is facilitated by the large amount of redundancy in normal speech. The conclusion is that glossectomy does not necessarily prevent the recovery of functional speech of sufficient intelligibility to allow social rehabilitation of the glossectomy patient.
Surgical voice restoration following laryngectomy: the tracheo‐oesophageal fistula technique (Singer‐Blom)
Authors: Perry Alison
Published: November 2007

Surgical voice restoration, as described by Singer and Blom, provides a valid means of restoring speech after laryngectomy. It is an endoscopic technique to surgically create a tracheo‐oesophageal fistula or ‘puncture’ into which is later fitted a voice prosthesis. A controlled midline puncture is created endoscopically under general anaesthetic and stented with a 14 French gauge catheter that extends from the trachea into the oesophagus and stomach for at least 48 hours.

Results in the primary series, i.e. those given voice restoration at the time of initial laryngectomy, have been exceptionally good (94 per cent successful at 3 months postsurgery). The success rates in the secondary series, i.e. those receiving a tracheo‐oesophageal ‘puncture’ months, or years, postlaryngectomy, have been less good (79 per cent at 3 months). This paper examines the reasons for those failures and indicates ways of improving the selection of patients for this procedure.
What shall we do with ‘medial’ sounds?
Authors: French Ann
Published: November 2007

Phonological analysis in speech therapy clinics has traditionally been carried out by examining consonants in three word positions: initial, medial and final. More recent techniques, however, suggest a two‐pronged approach in which the occurrence of consonants is studied with regard to their position both in whole words and in the syllables making up these words. This study looks at the approach taken by three current procedures for phonological analysis to the traditional ‘word‐medial’ consonant or consonant sequence. The theoretical basis of one of these approaches is then examined, and phonological data from a normally developing 3‐year‐old is used to assess its descriptive validity. It is concluded that, for the child described, a sequence of two or more consonants in word‐medial position can be divided into syllable‐final and syllable‐initial consonants in a principled manner. When only a single consonant occurs in this position, the decision is more difficult and these consonants are described simply as intervocalic. It is suggested, however, that the correct approach to medial consonants and consonant sequences may vary from child to child, and that this has implications for the management of phonologically disordered children.
Clarification requests of normal and language‐impaired children
Authors: Hargrove Patricia M. , Straka Elizabeth M. , Medders Emily G.
Published: November 2007

This report describes the verbal and non‐verbal clarification requests that normal and language‐impaired children emit when faced with sentences that are difficult to understand. The experiment involved 13 language‐impaired children and 13 children with normally developing language who were matched by their level of receptive vocabulary. The results indicated that children with normal language and children with impaired language have the capacity to provide feedback regarding their failure to understand verbal messages. Language‐impaired children generally are not as sophisticated as their normal peers and tend to emit non‐specific clarification requests.
Assessment of language disorders after right hemisphere damage
Authors: Bryan K. L.
Published: November 2007

A set of tests was developed to examine areas of language previously described as involving right hemisphere processing. These tests were constructed to be simple to administer and clinically useful. The tests included metaphorical comprehension, the understanding of inferred meaning and humour. A discourse analysis was also performed to investigate whether any language deficits were evident in more functional communication. Testing for aphasia was carried out using the Western Aphasia Battery. Groups of subjects with left or right cerebral hemisphere damage and a group of normal subjects were assessed.

The results showed that the right hemisphere damaged subjects were impaired as compared to the control subjects on all of the language tests. However, they were not significantly different on the aphasia test.

These results indicate that subtle language problems can occur after right hemisphere damage and these are apparent in functional communication (as assessed by discourse analysis). It is suggested that these language problems particularly concern inability to utilise linguistic information in context. It is further suggested that these language difficulties may account for some of the apparent social and emotional problems following right hemisphere damage.
An investigation into non‐fluency in Down's syndrome*
Authors: Willcox Amanda
Published: November 2007

Previous studies of the non‐fluencies noted in Down's syndrome individuals have failed to take account of the linguistic age and competence of the subjects. The hypothesis of this study was that, if the language age of Down's syndrome subjects were delayed in comparison to chronological age, more insight might be gained if their non‐fluencies were considered as normal non‐fluency, a phenomenon observed in normally developing children at an early language age. The non‐fluencies of five Down's syndrome subjects were examined in relation to those of five developmentally normal subjects with equivalent language ages. The non‐fluencies in the Down's group shared some characteristics with those of the normal children, but were different in other ways. It was felt to be more appropriate to consider their non‐fluencies in relation to their language deficit and to the non‐fluencies noted in language‐impaired children. The findings thus add weight to the hypothesis of deviant language development in Down's syndrome.
Speech therapy for psychogenic voice disorder: A survey of current practice and training
Authors: Elias A. , Raven R. , Butcher P. , Littlejohns D. W.
Published: November 2007

A survey of speech therapists in the United Kingdom showed that they usually undertook the treatment of psychogenic voice disorders. Their pre‐qualification education had provided advice that was usually reflected accurately in the experience they gained in practice, though during their education about a third had lacked any opportunity to treat or observe psychogenic voice disorders. The appropriate duration of treatment appears to be in doubt. At present, speech therapists acquire many of the psychological skills required for treatment after qualification. There is a substantial need for post‐qualification courses, although more practical instruction on psychological treatment might advantageously be incorporated in initial education.
Differential naming difficulties in elderly dysphasic subjects and subjects with senile dementia of the Alzheimer type
Authors: Stevens S. J.
Published: November 2007

This paper reports the results of a study in which elderly dysphasic subjects, and elderly subjects with senile dementia of the Alzheimer type (SDAT) were asked to name two representations of familiar objects. These were presented as coloured photographs, and as black and white line drawings. The results show that, although patients with SDAT perform better overall, there is a significant difference in their ability to name drawings compared to photographs. Analysis of the errors made by both subject groups shows significant differences, especially with regard to errors of visual misperception. The implications of these differences are discussed.
Autism, Asperger's syndrome and semantic‐pragmatic disorder: Where are the boundaries?
Authors: Bishop D. V. M.
Published: November 2007

The diagnostic criteria for autism have been refined and made more objective since Kanner first described the syndrome, so there is now reasonable consistency in how this diagnosis is applied. However, many children do not meet these criteria, yet show some of the features of autism. Where language development is impaired, such children tend to be classed as cases of developmental dysphasia (or specific language impairment) whereas those who learn to talk at the normal age may be diagnosed as having Asperger's syndrome. It is argued that rather than thinking in terms of rigid diagnostic categories, we should recognise that the core syndrome of autism shades into other milder forms of disorder in which language or non‐verbal behaviour may be disproportionately impaired.
Conversational characteristics of children with semantic‐pragmatic disorder. I: Exchange structure, turntaking, repairs and cohesion
Authors: Adams C. , Bishop D. V. M.
Published: November 2007

Conversational samples were obtained from 57 children aged from 8 to 12 years with specific language impairment, and 67 control children aged from 4 to 12 years. Fourteen of the language‐impaired children fitted the clinical description of semantic‐pragmatic disorder. It was found that exchange structure, turntaking, conversational repair and use of cohesive devices could be assessed with adequate inter‐rater and test‐retest reliability. Children with semantic‐pragmatic disorder produced more initiations than other children. Some of these children also violated turntaking rules by interrupting the conversational partner to an unusual degree. Use of cohesion was normal for children with semantic‐pragmatic disorder, but limited in other language‐impaired children. Analysis of conversations may be more useful than conventional language tests for identifying linguistic abnormalities in children with semantic‐pragmatic disorder.
What colour are the alligators?* A critical look at methods used to assess communication skills in adults with learning difficulties
Authors: Dormandy Klara , van der Gaag Anna
Published: November 2007

This paper describes the assessment of communication skills in 120 adults with severe to moderate learning difficulties. Each subject was assessed on the Communication Assessment Profile (CASP), a new communication assessment procedure for use with this client group. Qualitative and quantitative comparisons were made between three different methods of assessment used in CASP. These included observational assessment, elicited conversation and a structured language task. The relative usefulness of each method was evaluated, and the implications for communication assessment outlined.
Communication disorders: Planning a service to meet the needs
Authors: Enderby Pam , Davies Philip
Published: November 2007

This paper reviews the size of the speech and language‐disabled population in the United Kingdom by client groups and attempts to determine (1) those for whom speech therapy might be appropriate, (2) what pattern and level of speech therapy is appropriate and (3) how many speech therapists are required to provide this pattern and level of speech therapy. It is concluded that under present patterns of speech therapy provision, approximately 26 qualified speech therapists may be required per 100 000 population. However, it is argued that speech therapy may be trying to do too much and may be venturing into areas in which little, if anything, is known about its effectiveness. In conclusion, the paper argues that solutions to the current problems of speech therapy provision must come from the demand and the supply sides of the speech therapy service. The importance of treatment evaluation and further knowledge about patterns of spontaneous recovery are also discussed.
Teacher‐pupil talk: Integrated vs segregated environments for children with severe learning difficulties
Authors: Conti‐Ramsden Gina , Taylor Janet
Published: November 2007

The present study aimed to investigate the linguistic environment of children with severe learning difficulties attending nursery school. Teacher‐pupil talk with three normal language learners and five children‐with severe learning difficulties was examined in segregated and integrated settings. A cognitively based dialogue system analysis was used to ascertain the style and level of teacher and pupil interactions. Results revealed that teachers are able to adjust their speech when interacting with children of differing abilities but they do so by assuming a dominating role in dialogue through initiation and the use of obliges.
Constraint questions: How can they be taught to children with special needs?
Authors: Mann‐Mandelbaum Susan E.
Published: November 2007

The current study was designed to determine whether efficient question‐asking strategies can be taught to children who do not display them spontaneously. The relative efficacy of two different teaching techniques was compared to determine which would increase the quality of question asking. This study is descriptive in nature. Twenty‐eight students served as subjects. The treatment took place during a 28‐day time period and consisted of a pre‐test, two teaching sessions and a post‐test session, each 14 days apart. An array of 25 pictorial objects and animals was used to stimulate constraint questions, which are more efficient than hypothesis questions for information seeking. A major finding in this investigation was that 6‐year‐old children with special needs could be taught to ask constraint questions and generalise this strategy using a self‐evaluative teaching method. The number of constraint questions asked increased significantly using this method in comparison to the modelling teaching method. The findings of this study contribute to a better understanding of the relationship between teaching methods and cognitive‐linguistic strategy development.
The remediation of conduction aphasia via sentence repetition: A case study
Authors: Kohn Susan E. , Smith Katherine L. , Arsenault Joan Kelly
Published: November 2007

Repetition is viewed typically as a primary deficit in conduction aphasia. Consequently, repetition is considered to be a target of treatment, as opposed to an approach to treatment for this syndrome. However, our experience with a conduction aphasic who had greater speech fluency in repetition than in conversation encouraged us to develop a treatment programme based on sentence repetition. The treatment programme has three components: (1) a pre‐/post‐test of sentence repetition; (2) the treatment component, in which a new set of sentences is introduced each week in outpatient therapy for daily repetition; (3) analysis of verbal picture description prior to and following treatment as an independent language measure. The patient CM participated in 2 months of sentence repetition treatment, after which he displayed improvement in both sentence repetition and picture description. The reasons for such improvement and the general utility of the treatment programme are discussed.
Impressions of parkinsonian patients from their recorded voices
Authors: Pitcairn Thomas K. , Clemie Susan , Gray John M. , Pentland Brian
Published: November 2007

The voices of patients suffering from Parkinson's disease change in various ways. This paper sets out to examine the effect of these changes on the impressions made on listeners, and to try to see what vocalic and prosodic features account for these impressions. Tape recordings from segments of interviews with 4 patients, and 4 control subjects with ischaemic heart disease, were played to 16 naive listeners. These listeners were asked to rate their impressions of these voices on 15 dimensions of personality. There were significant differences on most of the dimensions, despite the fact that there were no differences between the two groups on such scales as Beck's depression inventory and the mood adjective check list. The parkinsonian patients were seen to be cold, withdrawn and anxious, not to relate well to the interviewer and to be enjoying the interview less than the controls. These ratings are very similar to those previously reported for the same patients, using silent video recordings only. The voice recordings were analysed along various dimensions of prosody. The factors which were different between the groups included the frequency and type of pauses in speech and the range or variability of the fundamental frequency. The implications of this exploratory study for intervention are discussed.
Abnormal vowel patterns in phonological disorder: Some data and a hypothesis
Authors: Reynolds Joseph
Published: November 2007

This article examines the vowel systems of a group of phonologically disordered children who show abnormalities in their vowel patterns. The conclusions emerging from the analysis of disordered speech are presented, along with examples from the data. It is argued that there are relatively common context‐free processes of simplification of the vowel system in the data, and that these represent natural changes that may occur in normal development. Other less common processes may be idiosyncratic, and indicate some measure of disordered development. Some difficulties with vowels may relate to difficulties in the consonant system, or to difficulties with prosodic or paralinguistic features. Variability is an important part of the data, relevant to understanding the disorder and the process of development. It is hypothesised that the proposed framework will be relevant to clinical decision‐making.
Language development at 3 years in pre‐term children of birth weight below 1000 g
Authors: Grunau Ruth V. E. , Kearney Sheila M. , Whitfield Michael F.
Published: November 2007

Language development at 3 years of pre‐term children born below 1000 g birth weight was compared with full‐term controls matched for social background. The pre‐term group used less complex expressive language and showed lower receptive understanding, auditory memory and verbal reasoning. Language outcome was related to intraventricular haemorrhage but not to global indication of postnatal illness such as number of days on the ventilator. Average verbal intelligence in environmentally low risk, extremely low birth weight children is an insufficient indicator of complex language functioning.
Preliminary results from using the Panjabi adaptation of the Aphasia Screening Test
Authors: Mumby Katharyn
Published: November 2007

The Panjabi adaptation of the Aphasia Screening Test (AST) has been used with a small group of stroke patients and the preliminary results are reported. All the patients are described and their test results plotted. Observations are made about the test procedure, with recommendations for its further use.
The use of hypnosis in speech therapy: A questionnaire study
Authors: Macfarlane Freya K. , Duckworth Martin
Published: November 2007

Speech therapists trained in the use of hypnosis were asked to identify the client groups with whom hypnosis was used and the main benefits of hypnosis in the management of these clients. Thirty‐six (42%) of the questionnaires produced usable data. The majority of respondents use hypnosis in the treatment of voice or fluency disorders although hypnosis is used in the treatment of acquired neurological disorders too. Respondents were less inclined to use hypnosis with children than with adults. The major use of hypnosis in fluency and voice disorders is as a means of achieving relaxation and of encouraging self‐esteem in the client. Of respondents 87% use autohypnosis. Problems encountered in the use of hypnosis and autohypnosis are explored. The results suggest that a closer examination of the purpose and efficacy of hypnosis is called for.
Augmentative communication systems taught to cerebral palsied children — A longitudinal study. I. The acquisition of signs and symbols, and syntactic aspects of their use over time
Authors: Udwin Orlee , Yule William
Published: November 2007

A longitudinal study of augmentative communication training with 40 language‐impaired, cerebral palsied children examined the acquisition of Blissymbols and Makaton Vocabulary signs and syntactic aspects of their use over an 18‐month period. The children made measurable gains in these areas over time, but progress was very slow and they continued to show severe limitations in the repertoires of signs/symbols they acquired and in the average number, length and complexity of utterances they produced in semi‐structured conversational settings. Possible reasons for these findings are discussed with reference to subject and system characteristics, and the teaching practices adopted in the schools. Comparisons between the Bliss and signing groups suggest that neither augmentative system facilitated greater progress in sign/symbol acquisition and use than the other. However, there was wide variability in performance among the children within each group.
Long‐term recovery patterns of severe dysarthria following head injury
Authors: Enderby Pam , Crow Esther
Published: November 2007

This study gives detailed information regarding the changes of bulbar dysfunction in a long‐term follow‐up of four severely brain‐damaged young persons. There are similarities in the pathology and symptomatology of the four and all made measurable improvements albeit these did not start for some considerable time following injury. Few gains in bulbar function were noted in the first 18 months. One subject began to improve after 24 months, another after 30 months with the most substantial changes for all subjects being seen by 48 months post‐injury. Further small improvements continued to be recorded up until the end of the study. The four subjects with severe dysarthria and profound physical disability following head injury were monitored for 7 years. All were assessed using the Frenchay Dysarthria Assessment (FDA) at regular intervals. The gains were not so significant that any became independent oral speakers. Although the subjects remain severely dysarthric and all use communication aids, the improvements are seen to have functional relevance. The timing of the maximum improvement was noted to follow the cessation of specific remediation of bulbar function. The results of this study raise interesting questions with regard to neurological recovery and rehabilitation management. It is possible to speculate that oral/motor therapy should be implemented at a later stage with severely head‐injured patients in an attempt to exploit and extend returning function.
Training counterparts in cleft palate speech therapy in the less developed world: An extended report
Authors: Wirt Anne , Wyatt Rosemary , Sell Debbie , Mars Michael , Grunwell Pamela , Lamabadusuriya Sanath
Published: November 2007

This paper describes the training of five counterparts in cleft palate speech therapy which took place in Sri Lanka. The context in which this training occurred is described. The original aims of the training, and criteria drawn up for the selection of the counterparts, are contrasted with the modifications required to these once the British therapists started working in Sri Lanka. Information is given on the training objectives, syllabus, curriculum and methods of evaluation of the counterparts' progress. The achievements of the counterparts are described, and factors relating to the difficulties and ease with which the counterparts were trained are discussed. The paper concludes with a discussion of the cultural, political and clinical problems encountered in this type of training, and highlights the special difficulties encountered in the training of counterparts in the field of speech therapy in less developed countries.
Vocal fold contact area patterns in normal speakers: An investigation using the electrolaryngograph interface system
Authors: Winstanley Sue , Wright Hazel
Published: November 2007

ABSTRACTS

This study investigates patterns of vocal fold movement in normal speakers. With the use of new computer software, laryngograph (Lx) waveforms from 100 normal speakers were examined. Specifically, four phases of the Lx waveform were observed and measured. These were then compared on both an interpersonal and intrapersonal basis. The results indicated that four phases were clearly identifiable in almost all subjects and that measurements of the closure and closed phases showed a high degree of consistency. The opening and open phases were more variable. In addition the onset and offset patterns of phonation were observed. Clear patterns were identified, consistent between speakers. The results are discussed with reference to the degree of consistency that can be expected in the vocal fold movement of normal speakers.

Cette étude analyse le mouvement des cordes vocales chez les locuteurs normaux. En utilisant un nouveau logiciel, les enregistrements des courbes laryngographiques (Lx) de 100 sujets normaux ont été examinés. Chaque période du signal est décomposée en quatre phases qui sont ensuite étudiées et mesurées avec précision. Des comparaisons interpersonnelles et intrapersonnelles ont été effectuées. Les résultats montrent que les quatre phases sont clairement identifiables chez presque tous les sujets. Les mesures sur la phase de fermeture et la phase fermée ont montrées une bonne consistance, alors que la phase d'ouverture et la phase ouverte se sont montrées moins régulières. Par ailleurs, les débuts et fins de phonation ont été étudiés. Des régularités interlocuteurs ont été mises à jour. Les résultats sont discutés en se référant au niveau de consistance qui peut être attendu dans les mouvements des cordes vocales chez les locuteurs normaux.

In dieser Studie werden die Stimmlippenbewegungen normaler Sprecher untersucht. Mit Hilfe von neuen Softwareprogrammen untersuchten wir die laryngografischen Wellenformen (Lx) von 100 gesunden Sprechern. Es wurden vier Phasen der Lx‐welle beobachtet und gemessen. Sowohl intra‐ als auch interindividuelle Vergleiche wurden gemacht. Die Ergebnisse zeigten vier bei fast alien Versuchspersonen deutlich erkennbare Phasen. Die Daten für die Verschlußphase und die verschloßene Phase zeigten einen hohen Niveau der Übereinstimmung. Bei der Eröffnungsphase und in der offenen Phase war eine größere Variabilitöt zu sehen. Dazu haben wir Phonationsanfangs‐ und Verschlußzeiten beobachtet. Wir stellten deutliche Tendenzen fest, die zwischen verschiedenen Sprechern konsistent waren. Die Ergebnisse werden mit Hinsicht auf den Konsistenzgrad besprochen, der bei den Stimmbandbewegungen normaler Sprecher zu erwarten ist.
Visual display of tongue‐palate contact: Electropalatography in the assessment and remediation of speech disorders
Authors: Hardcastle W. J. , Gibbon F. E. , Jones W.
Published: November 2007

ABSTRACTS

The technique of electropalatography (EPG) records the location and timing of tongue contacts with the hard palate during continuous speech. Recent developments in hardware and software design of the Reading electropalatograph are described and applications of the technique in assessment and remediation of a variety of speech disorders are outlined. In assessment, it is shown that EPG can provide insights into possible origins of auditorily perceived errors, and case descriptions illustrate how this information can lead to a more rationalised approach to treatment. In therapy, the provision of real‐time visual feedback of tongue movement can be effective in the remediation of certain types of intractable speech problems. Finally, the importance of techniques such as EPG in the objective evaluation of treatment procedures is discussed in the light of the increasing demand for accountability within the speech therapy service.

La technique de l'electropalatographie (EPG) permet d'enregistrer la position du lieu de contact entre la langue et le palais pendant la parole. Le développement récent en hardware et software de l'EPG est décrit dans cet article et des applications de cette technique pour l'évaluation et la rééducation de différents troubles de la parole sont présentées. Pour l'évaluation, il est montré que l'EPG peut aider à trouver des explications aux erreurs perçues à l'oreille, et la description de cas illustre comment ces données peuvent mener à une approche du traitement plus rationnelle. En thérapie, la présentation en temps réel d'un retour visuel du mouvement de la langue peut être efficace pour certains types de troubles de la parole intraitables. Finalement, l'importance des techniques telles que l'EPG dans l'évaluation objective des procédures de traitement est discutée à la lumière de l'exigence croissante pour plus de rationnalité dans les services d'orthophonie.

Die Elektropalatografie (EPG) ermöglicht die Aufnahme der Stelle und die Zeitabmessung der Zungenkontakte mit dem Gaumen beim laufenden Sprechen. Wir beschreiben neuere Entwicklungen im Hard‐ und Software der Readinger‐EPG; die Anwendung bei der Bewertung und Behandlung verschiedener Sprechstörungen wird im Umriß dargestellt. Wir zeigen, daß die EPG bei der Bewertung eine Einsicht in den möglichen Ursprung eines auditiv wahrgenommenen Fehlers ermöglicht, und durch Fallbeschreibungen wird illustriert, wie diese Daten zu einer rationalisierten Behandlung führen. Wir beschreiben, wie das Vorhandensein eines realtime, visuellen Feedbacks der Zungenbewegungen bei der Therapie bestimmter, unlenksamer Sprechstörungen wirkungsvoll sein kann. Schließlich besprechen wir, mit Hinsicht auf das zunehmende Verlangen nach Verantwortlichkeit bei der Logopädie, die Wichtigkeit von Techniken wie die EPG bei der objektiven Bewertung von Therapieverfahren.