Visual to auditory silent matching task in adults who do and do not stutter

textThe purpose of the present study was to investigate the role of phonological working memory in adults who do and do not stutter through a visual to auditory silent matching task. This task also explored the possible relationship between auditory processing and its ability to affect performance on the task. Participants were 13 adults who stutter (mean age = 28 years), matched in age, gender, handedness, and education level with 13 adults who do not stutter (mean age = 28 years). For the nonvocal visual to auditory task, participants silently read an initial target nonword and matched that target nonword to four subsequent auditory nonword choices. The participants completed this task for 4- syllable and 7- syllable nonwords (N = 8 per set). Results indicated that adults who stutter were significantly less accurate than adults who do not stutter at both syllable lengths. Our present findings support previous research that suggests less efficient phonological working memory in adults who stutter.Communication Sciences and Disorder

Voice and speech functions (B310-B340)

The International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) domain ‘voice and speech functions’ (b3) includes production and quality of voice (b310), articulation functions (b320), fluency and rhythm of speech (b330) and alternative vocalizations (b340, such as making musical sounds and crying, which are not reviewed here)

Speech and language therapy for aphasia following stroke

Background  Aphasia is an acquired language impairment following brain damage that affects some or all language modalities: expression and understanding of speech, reading, and writing. Approximately one third of people who have a stroke experience aphasia.  Objectives  To assess the effects of speech and language therapy (SLT) for aphasia following stroke.  Search methods  We searched the Cochrane Stroke Group Trials Register (last searched 9 September 2015), CENTRAL (2015, Issue 5) and other Cochrane Library Databases (CDSR, DARE, HTA, to 22 September 2015), MEDLINE (1946 to September 2015), EMBASE (1980 to September 2015), CINAHL (1982 to September 2015), AMED (1985 to September 2015), LLBA (1973 to September 2015), and SpeechBITE (2008 to September 2015). We also searched major trials registers for ongoing trials including ClinicalTrials.gov (to 21 September 2015), the Stroke Trials Registry (to 21 September 2015), Current Controlled Trials (to 22 September 2015), and WHO ICTRP (to 22 September 2015). In an effort to identify further published, unpublished, and ongoing trials we also handsearched theInternational Journal of Language and Communication Disorders(1969 to 2005) and reference lists of relevant articles, and we contacted academic institutions and other researchers. There were no language restrictions.  Selection criteria  Randomised controlled trials (RCTs) comparing SLT (a formal intervention that aims to improve language and communication abilities, activity and participation) versus no SLT; social support or stimulation (an intervention that provides social support and communication stimulation but does not include targeted therapeutic interventions); or another SLT intervention (differing in duration, intensity, frequency, intervention methodology or theoretical approach).  Data collection and analysis  We independently extracted the data and assessed the quality of included trials. We sought missing data from investigators.  Main results  We included 57 RCTs (74 randomised comparisons) involving 3002 participants in this review (some appearing in more than one comparison). Twenty-seven randomised comparisons (1620 participants) assessed SLT versus no SLT; SLT resulted in clinically and statistically significant benefits to patients' functional communication (standardised mean difference (SMD) 0.28, 95% confidence interval (CI) 0.06 to 0.49, P = 0.01), reading, writing, and expressive language, but (based on smaller numbers) benefits were not evident at follow-up. Nine randomised comparisons (447 participants) assessed SLT with social support and stimulation; meta-analyses found no evidence of a difference in functional communication, but more participants withdrew from social support interventions than SLT. Thirty-eight randomised comparisons (1242 participants) assessed two approaches to SLT. Functional communication was significantly better in people with aphasia that received therapy at a high intensity, high dose, or over a long duration compared to those that received therapy at a lower intensity, lower dose, or over a shorter period of time. The benefits of a high intensity or a high dose of SLT were confounded by a significantly higher dropout rate in these intervention groups. Generally, trials randomised small numbers of participants across a range of characteristics (age, time since stroke, and severity profiles), interventions, and outcomes.  Authors' conclusions  Our review provides evidence of the effectiveness of SLT for people with aphasia following stroke in terms of improved functional communication, reading, writing, and expressive language compared with no therapy. There is some indication that therapy at high intensity, high dose or over a longer period may be beneficial. HIgh-intensity and high dose interventions may not be acceptable to all

Auditory-motor adaptation is reduced in adults who stutter but not in children who stutter

Previous studies have shown that adults who stutter produce smaller corrective motor responses to compensate for unexpected auditory perturbations in comparison to adults who do not stutter, suggesting that stuttering may be associated with deficits in integration of auditory feedback for online speech monitoring. In this study, we examined whether stuttering is also associated with deficiencies in integrating and using discrepancies between expect ed and received auditory feedback to adaptively update motor programs for accurate speech production. Using a sensorimotor adaptation paradigm, we measured adaptive speech responses to auditory formant frequency perturbations in adults and children who stutter and their matched nonstuttering controls. We found that the magnitude of the speech adaptive response for children who stutter did not differ from that of fluent children. However, the adaptation magnitude of adults who stutter in response to formant perturbation was significantly smaller than the adaptation magnitude of adults who do not stutter. Together these results indicate that stuttering is associated with deficits in integrating discrepancies between predicted and received auditory feedback to calibrate the speech production system in adults but not children. This auditory-motor integration deficit thus appears to be a compensatory effect that develops over years of stuttering

Hyperacusis in children: a preliminary study on the effects of hypersensitivity to sound on speech and language

There is a growing awareness that children may experience hyperacusis, a condition that is often associated with behavioral and developmental disorders. This preliminary study was aimed to investigate the effects of hyperacusis alone on various components of speech and language in children without developmental disorders. This study was conducted on 109 children aged between 4 and 7 years attending kindergarten and primary school. Hyperacusis was assessed through behavioral observation of children and questionnaires for parents. Different components of speech and language were assessed through specific tests. Hyperacusis was diagnosed in fifteen children (13.8%); ten (66.7%) were attending primary school and five (33.3%) kindergarten. A significant difference between children with and without hyperacusis was found for tests evaluating the average number of words in a sentence and phonemic fluency; older children appeared to have more difficulties. Several differences in education profiles were found: parents of children with hyperacusis spent less time with their children compared to parents of children without hyperacusis. Our preliminary results suggest some difficulties in lexical access and the use of shorter sentences by children with hypersensitivity to sound; however, the small size of our sample and the largely unknown interactions between hyperacusis and developmental disorders suggest caution when interpreting these results. Further studies on larger samples are necessary to gain additional knowledge on the effects of hyperacusis on speech and language in children without developmental disorders

Central auditory processing disorder: a literature review on inter-disciplinary management, intervention, and implications for educators

Clinical Questions: What top-down and bottom-up interventions across the psychology, audiology, educational, and speech language pathology domains are most effective for children and adolescents with Central Auditory Processing Disorder (CAPD)? What considerations for planning research and intervention might be offered to a classroom teacher to further support students diagnosed with CAPD, especially in relation to the Multi-Tiered System of Supports (MTSS), formerly known as Response to Intervention (RTI)? Method: Inter-Disciplinary Literature Review Study Sources: PsycInfo, Linguistics and Language Behavior Abstracts, ProQuest, International Journal of Audiology, American-Speech-Language Hearing Association, Journal of Neurotherapy, Medline-Esbcohost, ERIC Ebscohost, Professional Development Collection Education, and What Works Clearinghouse Number of Included Studies: 16 Age Range: 2-13 years Primary Results: 1) Phonological awareness training was the primary reading educational construct found among the included interventions in this literature review. 2) Most CAPD studies employed a combination of both bottom-up and top-down treatments in intervention. This finding may possibly indicate that in order for a CAPD intervention to be even more beneficial to the student, both bottom-up and top-down treatments should be considered and incorporated in relation to the student\u27s individualized needs. Conclusions: Results confirmed very little research and few intervention implications on CAPD students within the educational research discipline, including special education. Search results primarily included methods to improve listening in the classroom environment, but did not specifically mention intervention in relation to CAPD and its implications. Results also confirmed that a multi-disciplinary effort is needed to provide clinical decision and effective intervention for the CAPD population

Factors influencing the efficacy of delayed auditory feedback in treating dysarthria associated with Parkinson\u27s disease

Parkinson\u27s disease patients exhibit a high prevalence of speech deficits including excessive speech rate, reduced intelligibility, and disfluencies. The present study examined the effects of delayed auditory feedback (DAF) as a rate control intervention for dysarthric speakers with Parkinson\u27s disease. Adverse reactions to relatively long delay intervals are commonly observed during clinical use of DAF, and seem to result from improper matching of the delayed signal. To facilitate optimal use of DAF, therefore, clinicians must provide instruction, modeling, and feedback. Clinician instruction is frequently used in speech-language therapy, but has not been evaluated during use of DAF-based interventions. Therefore, the primary purpose of the present study was to evaluate the impact of clinician instruction on the effectiveness of DAF in treating speech deficits. A related purpose was to compare the effects of different delay intervals on speech behaviors. An A-B-A-B single-subject design was utilized. The A phases consisted of a sentence reading task using DAF, while the B phases incorporated clinician instruction into the DAF protocol. During each of the 16 experimental sessions, speakers read with four different delay intervals (0 ms, 50 ms, 100 ms, and 150 ms). During the B phases, the experimenter provided verbal feedback and modeling pertaining to how precisely the speaker matched the delayed signal. Dependent variables measured were speech rate, percent intelligible syllables, and percent disfluencies. Three males with Parkinson\u27s disease and an associated dysarthria participated in the study. Results revealed that for all three speakers, DAF significantly reduced reading rate and produced significant improvements in either intelligibility (for Speaker 3) or fluency (for Speakers 1 and 2). A delay interval of 150 ms produced the greatest reductions in reading rates for all three speakers, although any of the DAF settings used was sufficient to produce significant improvements in either intelligibility or fluency. In addition, supplementing the DAF intervention with clinician instruction resulted in significantly greater gains achieved with DAF. These findings confirmed the effectiveness of various intervals of DAF in improving speech deficits in Parkinson\u27s disease speakers, particular when patients are provided with instruction and modeling from the clinician