聴覚障害を持つ高齢者の認知機能測定 : Mini-Mental State Examination (MMSE)施行上の工夫

We created a modified version of the Mini-Mental State Examination (MMSE) for persons with hearing loss (HL) and tested its reliability, validity and effectiveness among 40 elderly participants. We extracted the MMSE items `registration\u27, `recall\u27, `repetition\u27 and `comprehension\u27 and in the HL condition, these four items were only presented with simultaneous spoken and written instructions. The results were as follows: (1) The HL test-retest coefficient of correlation was r = 0.74; Cronbach\u27s α was 0.64. (2) In the non-hearing loss group, the HL test results showed a correlation with the MMSE, the Oldest-Old version of the Cognitive Assessment Questionnaire and the Clinical Dementia Rating(CDR-J). (3) A 2-way ANOVA was conducted with cognitive function as the within-subjects factor and hearing loss as the between-subjects factor; for total score, `registration\u27 and `repetition\u27, the effect of cognitive function test was significant only in the hearing loss group. The retest reliability of HL, its concurrent validity and its effectiveness were confirmed. It is desirable to administer the standard MMSE to persons with hearing loss if they can use hearing aids or adjustments can be made to the volume. However, if such modifications are not possible, HL may be useful in cases where it is necessary to repeat questions

聴覚障害を持つ認知症者の認知機能測定方法開発のための予備的検討 : Mini-Mental State Examination(MMSE)文字化による試み

We developed a Japanese version of the written Mini-Mental Status Examination (wMMSE-J) for assessing the actual cognitive functions of dementia patients with hearing impairment and performed a preliminary test in 25 dementia patients (mean age 85.4 ± 7.9 years). Patients were divided into hearing impaired (17 patients) and non-hearing impaired groups (8 patients) on the basis of pure-tone average. The correlation coefficient between MMSE and wMMSE-J for all subjects was r = 0.80 (p = 0.00). However, a t-test indicated that scores for wMMSE-J were significantly lower. Stratification by the level of dementia revealed that the wMMSE-J score was lower than the MMSE score for all groups other than the slight dementia group. Among the non-hearing impaired, significant difference was found between MMSE and wMMSE-J. However, among the hearing impaired, significant differences in overall score and in the subtests of comprehension and writing, both of which require long written instructions, were found between MMSE and wMMSE-J. Because wMMSE-J has limited usefulness, further innovations are required, such as improving the written instructions so that they can be comprehended by groups other than those with slight dementia as well as by those with dementia and hearing impairment

維持期感覚性失語症者に対する語音弁別訓練の検討 : 単音節・有意味二音節の訓練が聴覚的理解力に及ぼす効果

Two types of monosyllabic speech discrimination training and two types of meaningful disyllabic speech discrimination training were conducted in a man with chronic Wernicke\u27s aphasia. The effects of training on speech discrimination ability and auditory comprehension were investigated. The patient was a 48-year-old, right-handed male who started training about 4 years after putaminal hemorrhage. The training comprised a daily home task for a total of about 4 months, and the training results were measured once a week by a speech, language hearing therapist. In the monosyllabic speech discrimination training, a significant increase was seen in speech discrimination ability both in training with and without using written characters. In the speech discrimination training with meaningful disyllabic words, a better effect of training was seen with a method using oral reading of Kanji characters compared with a method of listening to sounds and comparing them with written characters. In an investigation of the effect using a Test of Lexical Processing in Aphasia for auditory comprehension, no change was observed with monosyllabic speech discrimination training; however, a significant increase in the number of correct answers was observed with speech discrimination training using meaningful disyllabic words

構音障害を主訴に来学した発達性読み書き障害児の1例

Here we present the case of a child who visited the university with the chief complaint of dysarthria. He initially suffered from dysarthria and mild mental retardation, but later developed serious problems with reading and writing. We considered his phonological processing ability and a possible connection with developmental dyslexia. The child was a 7-year-old boy who was in second grade at a regular elementary school. At 5 years of age, he was diagnosed with a submucous cleft palate and underwent surgery to correct this. After surgery, he was evaluated and started receiving training. He was diagnosed with language delay due to mild mental retardation and dysgraphia accompanying underdeveloped dysarthria, and received 7 months of ST training. In the re-evaluation that followed his training, he was not seen to have general mental retardation, but his problems with reading and writing became apparent. Cross-examining his problems reading and writing with a triangle model and visual cognition processes suggested a problem with bilateral processing of writing and phonology. This was a decoding problem, which is the basic condition of a patient with developmental dyslexia. The boy\u27s core problem thus appeared to be a phonological type of developmental dyslexia

Rett症候群一例に対する言語聴覚療法の経過

We report our experience with a infant with Rett syndrome (RS) for whom we performed speechlanguage-hearing therapy on a weekly, with reference to the course of training and the importance of support for infants with RS.The infant was a 3-year-old girl who had been diagnosed with RS at the age of 1 year and 4 months, and began receiving speech-language-hearing therapy at our department at 2 years and 11 months.The infant followed a different course from that classic- RS, and showed developmental changes without regression of language and communication skills. With regard to language skills, the infant progressed from the word level to the word sequence level in terms of both comprehension and expression. As for communication skills, the infant became able to actively interact with others.These findings suggest that even in infants with disorders such as RS, developmental changes in language and communication skills can be achieved by performing individualized speech-languagehearing therapy that considers the child\u27s developmental stage from an early stage.Therefore, in order to support children with these disorders from an early stage, it is important in the future to actively report cases and to promote the recognition of the need for speech-language-hearing therapy

2歳代の語彙発達 : 語彙チェックリストを用いた表出語彙の分析

This study examined 300 children aged 24-35 months to clarify expressive vocabulary development using the vocabulary checklist questionnaire. Children were classified into 4 periods: first period, 24-26 months; second period, 27-29 months; third period, 30-32 months; and fourth period, 33-35 months. We analyzed median and quartiles of expressive vocabulary and performed one-way analysis of variance to determine which periods differed significantly from other periods. As a result, median total expressive vocabulary was 238.0 in the first period, 423.0 in the second period, 508.0 in the third period, and 661.0 in the fourth period. A clear correlation was seen between total expressive vocabulary, noun vocabulary, verb vocabulary, adjective vocabulary and child age. No significant difference in total expressive vocabulary was evident between second and third periods. These results indicate an incubation period in which the expressive vocabulary is invariable. A significant difference was apparent between the second and third periods in the verb vocabulary, suggesting a qualitative change in the expressive vocabulary. However, the term of increasing verb vocabulary was shorter than that for the noun vocabulary, which previous studies have reported in children aged 18-30 months

発達性読み書き障害児に対するATを用いた言語訓練

In the present study, we introduced an assistive technology (AT) for a child with developmental dyslexia and dysgraphia who demonstrated difficulty writing kanji characters, and reviewed the effects using the information processing model. The patient was an 11-year-old boy in the fifth grade at a regular elementary school. He had problems in the visual memory and retention stage of the information processing model and presented with kanji dysgraphia. Memory recall of kanji shape, which was poorly memorized and retained by the patient, was achieved through typing. As this method was therefore believed to be beneficial, the language training using computer-based AT commenced. Content over the year of training was divided into three phases: I, II, and III. Word input (three characters) typing speed was approximately 60 seconds in phase I, approximately 20 seconds in phase II and 3 to 5 seconds in phase III; as each training was repeated, speed gradually increased. The number of characters that could be typed also increased from monosyllables in phase I to words in phase II and short sentences in phase III. The above findings suggest that computer substitution in the area of difficulty for the patient provided an effective support method for dysgraphia

言語聴覚士実習生の臨床実習への満足度に影響する要因 : テキストマイニングによる検討

Objective: We investigated satisfaction with on-the-job training among 129 speech, language, and hearing therapy trainees.Materials and methods: Text mining analysis was performed to analyze factors that influenced trainee satisfaction regarding on-the-job training. Results: Among trainees with higher satisfaction and higher grades, the training opportunity increased their internal locus of control through the knowledge and therapy skills acquired and the exchanges with trainers and other staff. However, trainees with lower satisfaction tended to cite external factors such as the length of training or the training format as the cause. Conclusion: Our results suggest that students with a lower internal locus of control need to experience many successes throughout an intramural simulated on-the-job training curriculum