Perceived Changes in Communicative Interaction in Atypical Parkinsonism

The aim of this study was to examine if atypical parkinsonism affects the communicative ability in conversational interaction. Fifteen persons close to individuals with atypical parkinsonism answered a questionnaire, “Assessment of Change in Communicative Interaction” (ACCI), estimating perceived change in interactive skills compared to before the onset of the disease. The study also examined if perceived change correlated with disease duration. The results showed that at group level, the participants experienced change in many aspects of conversational interaction, particularly regarding the affected person's speech, body communication, response latency, phrase length, word finding, and ability to make themselves understood. There was no correlation between perceived change and disease duration. In conclusion, results indicated that the communicative interaction of individuals with atypical parkinsonism is significantly affected and that information elicited from significant others can help define specific problem areas or foci of concern that need to be targeted in communicative intervention or at least considered in interaction with these persons

Perceived Changes in Communication as an Effect of STN Surgery in Parkinson's Disease: A Qualitative Interview Study

The aim of the present study was to explore four individuals' perspective of the way their speech and communication changed as a result of subthalamic nucleus deep brain stimulation treatment for Parkinson's disease. Interviews of two men and two women were analyzed using qualitative content analysis. Three themes emerged as a result of the analysis. The first theme included sub-themes describing both increased and unexpected communication difficulties such as a more vulnerable speech function, re-emerging stuttering and cognitive difficulties affecting communication. The second theme comprised strategies to improve communication, using different speech techniques and communicative support, as well as trying to achieve changes in medical and stimulation parameters. The third theme included descriptions of mixed feelings surrounding the surgery. Participants described the surgery as an unavoidable dramatic change, associated both with improved quality of life but also uncertainty and lack of information, particularly regarding speech and communication changes. Despite negative effects on speech, the individuals were generally very pleased with the surgical outcome. More information before surgery regarding possible side effects on speech, meeting with a previously treated patient and possibly voice and speech therapy before or after surgery are suggested to facilitate the adjustment to the new speech conditions

Acoustic and perceptual analysis of dysarthria associated with multiple sclerosis

The specific aims of the investigation were

On the Primary Influences of Age on Articulation and Phonation in Maximum Performance Tasks

Maximum performance tasks have been identified as possible domains where incipient signs of neurological disease may be detected in simple speech and voice samples. However, it is likely that these will simultaneously be influenced by the age and sex of the speaker. In this study, a comprehensive set of acoustic quantifications were collected from the literature and applied to productions of sustained [a] productions and Alternating Motion Rate diadochokinetic (DDK) syllable sequences made by 130 (62 women, 68 men) healthy speakers, aged 20-90 years. The participants were asked to produce as stable (sustained [a] and DDK) and fast (DDK) productions as possible. The full set of features were reduced to a functional subset that most efficiently modeled sex-specific differences between younger and older speakers using a cross-validation procedure. Twelve measures of [a] and 16 measures of DDK sequences were identified across men and women and investigated in terms of how they were altered with increasing age of speakers. Increased production instability is observed in both tasks, primarily above the age of 60 years. DDK sequences were slower in older speakers, but also altered in their syllable and segment level acoustic properties. Increasing age does not appear to affect phonation or articulation uniformly, and men and women are affected differently in most quantifications investigated

How well does DDK task performance predict fluent speech articulation?

The oral diadokochinesia (DDK) task is an established tool for assessing speech motor control that has been used across a range of conditions. The predominant outcome measure reported after the patient have performed the task is the maximum syllable rate achieved by the patient. More recent reports have also highlighted stability in pace of the sequence as quantifications that may be indicative of speech impairment. While the DDK task affords quick and easy administration, concerns have been raised regarding the strength of association between DDK task performance and patients’s articulation in fluent speech. It may not be assumed that a reduced DDK rate or rate stability will cause fluent speech also to be perceived as slowed or dysrhythmic. And, patients may well improve their syllable rate at the expense of articulatory quality, which is currently not easily captured in an objective outcome measure. We report here on an effort to assess to what degree information from an expanded quantification of DDK sequences may be used identify patients with dysarthria and to model clinical assessments of fluent speech. Acoustic quantifications of the consonant and consonant-vowel relationship are combined with previously used measures, and applied to manually processed DDK sequences produced by patients with Parkinson’s disease and normal control speakers. We observe how well these quantifications may form the basis for accurate identification of patients among normal controls, and predict the outcome of blinded and randomized clinical assessments of patients’ production of fluent speech.Rapid repetition of CV syllables (oral diadochokinesis, DDK) puts pressure on the speech motor system in order to afford detection of a deteriorating articulatory ability. This study assessed  how well objective quantifications of DDK sequences can be used to identify PD speakers among age matched controls (NC), and how well a reduced articulatory ability in PD speakers may be predicted using quantifications of DDK sequences performed in the same recording session. The comprehensive DDK sequence quantification achieved a 93% classification accuracy for speaker group and a 79% accuracy for reduced fluent speech articulatory quality.

Aphasia and Computerised Writing Aid Supported Treatment

Abstract in UndeterminedBackground: Individuals with aphasia often experience difficulties in writing. Word processors with a spell checker and a grammar checker can compensate for some of the writing difficulties associated with aphasia. Aims: To determine if writing difficulties associated with aphasia may be reduced by the use of a computerised writing aid when training patients. Methods Procedures: The writing aids used in this study were originally designed specifically for persons with developmental reading and writing difficulties and are based on statistics of frequent misspellings and phonotactic rules. Three participants with aphasia selected one of two offered writing aids. Written production during treatment and evaluation was recorded and analysed by keystroke logging. The study had a single-subject ABA design replicated across three participants. The baseline (A) was established by measuring four dependent variables. During a 9-week intervention phase (B) the dependent variables were measured once a week. A follow-up (A) was done 10 months after the training was finished. The dependent variables were: total number of words in a writing task; proportion of correctly written words; words per minute; proportion of successful edits. The results were analysed both visually and by statistical calculations. Outcomes Results: All participants experienced a positive improvement in their writing ability. Results showed individual differences; after completed training the first participant made more successful edits, the second wrote more words, had a larger proportion of correctly written words, and made more successful edits. The third participant's results did not show any improvement that could be statistically supported. Conclusions: This study showed that the computerised training facilitated the generating process and made the revision process more efficient for the participants. The results are important in that they indicate possible ways of designing writing treatment. However, they also show the need for careful analyses when evaluating different treatment strategies and in discussing what improved writing ability may be

Logopedi

Logopedi definieras som läran om språk-, röst- och talstörningar och deras behandling. Detta är den första heltäckande läroboken i logopedi på svenska och består av 40 kapitel av 44 olika författare. I en introducerande del beskrivs funktion och utveckling med anknytning till de fyra logopediska huvudområdena röst, språk, tal och sväljning. Därefter beskrivs karakteristik, diagnostik och intervention vid språkstörningar, röststörningar och talstörningar hos barn, ungdomar och vuxna. Vidare behandlas alternativ och kompletterande kommunikation samt sväljningsstörningar. Boken avslutas med en del som beskriver logopedi ur ett historiskt perspektiv, i nutid och med utblickar mot framtiden. Boken är avsedd för studerande på logopedprogrammen. Den vänder sig även till verksamma logopeder i Sverige och övriga Norden. Boken kan också tjäna som uppslagsverk för personer med intresse för logopedi från andra discipliner inom såväl sjukvården som universitetsvärlden och kanske också för den intresserade allmänheten