The association of bisphenol A and paraben exposure with sensorineural hearing loss in children.

Bisphenol A (BPA) and parabens (PBs) are chemicals that are extensively used in personal care products (PCPs). In early childhood development, hearing is critical to speech and language development, communication, and learning. In vitro and in vivo, BPA/PBs exhibited neurotoxicity through elevated levels of oxidative stress. BPA also has the potential to be an ototoxicant. Therefore, this study aimed to determine the association of exposure to BPA/PBs with sensorineural hearing loss in children. A cross-sectional study based on hearing tests was conducted. This study enrolled 320 children aged 6-12 years from elementary school. Urinary BPA and PB concentrations were analyzed by using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Logistic regression models were employed to determine the association of BPA/PB exposure with sensorineural hearing loss. Children with sensorineural hearing loss had higher BPA concentrations than normal-hearing children (0.22 ng/ml vs. 0.10 ng/ml, p = 0.05). After adjustment for covariates, the risk of hearing loss at middle frequencies reached 1.83-fold (95% CI: 1.12-2.99) when BPA concentrations increased by 1 log10. The risk of slight hearing loss reached 2.24-fold (95% CI: 1.05-4.78) when children had a tenfold increase in ethyl paraben (EP) concentration. This study clarifies the role of exposure to BPA/PBs in hearing loss in children. Future research needs to be expanded to include cohort designs and nationwide studies to identify causality.

Contributions of Forward-Focused Voice to Audio-Vocal Feedback Measured Using Nasal Accelerometry and Power Spectral Analysis of Vocal Fundamental Frequency.

PURPOSE: The spectral powers of the modulations of vocal fundamental frequency (f o) less than 3 Hz (low-frequency power, LFP) and between 3 and 8 Hz (middle-frequency power, MFP) had been established to indicate the audio-vocal feedback status and vocal efficiency of a speaker, and a resonant voice may enhance the auditory-vocal feedback. This study aims to determine whether the auditory feedback can be augmented by a forward and resonant voice and therefore contribute to the modulations of f o variability. METHOD: Vocal signals and accelerometric signals of lateral nasal cartilage were obtained from 27 healthy adults who, respectively, sustained vowels /a/ and /i/ with their habitual speaking voice and with a forward-focused voice under three auditory conditions: natural hearing (N0), high-level noise exposure (N90), and low-level noise exposure (N60). Nasal skin vibrations were measured using a nasal accelerometry to reflect voice resonance status. Vocal intensity and f o variability were also analyzed to show the auditory-vocal interactions under varied conditions of auditory feedback and voice resonance. RESULTS: In both N0 and N90 conditions, forward-focused voice showed a significantly lower LFP than the speakers' habitual voice. In addition, LFP of f o would significantly increase during natural voice production as the voice feedback was greatly masked by high-intensity noise; however, with a forward-focused voice, the noise-induced variation in LFP was significantly decreased. Under N90, MFP significantly decreased during forward-focused voice production compared with that measured during natural voice production. The stability of f o modulations was not adversely affected by N60. CONCLUSION: The results support the idea that vocalizing with a forward-focused voice enhance the auditory feedback of the speaker's own voice and, thus, reduce the variability of f o during sustained phonation, especially when vocalizing in the high noise condition.

A pilot study shows the positive effects of continuous airway pressure for treating hypernasal speech in children with infantile-onset Pompe disease.

Children with infantile-onset Pompe disease (IOPD) demonstrate hypernasality. This study aimed to evaluate whether continuous positive airway pressure (CPAP) training may reduce hypernasality in children with IOPD. Five children with IOPD were enrolled in a single-subject experimental design of type A-B-A'. The intervention comprised an 8-week, 6-day-per-week regimen of CPAP training at home. Participants continued traditional speech therapy once per week throughout the 24-week study duration. The outcome measurements included the degree of hypernasality (DH), the percentage of consonants correct (PCC), and the speech intelligibility score (SIS). C-statistic analysis with an α of 0.05 was used along with visual analysis to assess speech changes. Three patients completed the study. During the CPAP training phase, the DH, PCC, and SIS were significantly improved compared with the baseline (p < 0.05). At the follow-up phase, both DH and SIS were improved compared with the baseline (p < 0.05), but the PCC had returned to the baseline level. CPAP training demonstrated effectiveness in reducing nasal sounds in IOPD patients. Further studies training younger children with normal hearing may help elucidate the persistence of the effects in children with IOPD.

Narrative abilities of Mandarin-speaking children with and without specific language impairment: macrostructure and microstructure.

This study analyzed narratives from 18 Mandarin-speaking children with specific language impairment (SLI) and 18 typically developing children matched on chronological age. The narrative data were based on Frog, where are you? Participant's narratives were analyzed at the macrostructure and microstructure levels. Regarding the macrostructure, the results revealed that the narratives of children with SLI included significantly less story grammar components, less evaluative comments, and were less coherent than those of TD controls. With respect to the microstructure, the two groups of children exhibited no significant differences in measures such as story length, syntactic complexity, and use of conjunctions; on the other hand, the SLI group employed significantly less variety of words. The outcomes underscore the merit of conducting a wide array of macrostructural measures in narratives, and evince the potential of the causal network model to assess the macrostructure of narratives in SLI. Overall, this study demonstrated the utility of macrostructure and lexical diversity in differentiating Mandarin-speaking children with and without SLI.

Longitudinal follow-up to evaluate speech disorders in early-treated patients with infantile-onset Pompe disease.

BACKGROUND: Patients with infantile-onset Pompe disease (IOPD) can be treated by recombinant human acid alpha glucosidase (rhGAA) replacement beginning at birth with excellent survival rates, but they still commonly present with speech disorders. This study investigated the progress of speech disorders in these early-treated patients and ascertained the relationship with treatments. METHODS: Speech disorders, including hypernasal resonance, articulation disorders, and speech intelligibility, were scored by speech-language pathologists using auditory perception in seven early-treated patients over a period of 6 years. Statistical analysis of the first and last evaluations of the patients was performed with the Wilcoxon signed-rank test. RESULTS: A total of 29 speech samples were analyzed. All the patients suffered from hypernasality, articulation disorder, and impairment in speech intelligibility at the age of 3 years. The conditions were stable, and 2 patients developed normal or near normal speech during follow-up. Speech therapy and a high dose of rhGAA appeared to improve articulation in 6 of the 7 patients (86%, p = 0.028) by decreasing the omission of consonants, which consequently increased speech intelligibility (p = 0.041). Severity of hypernasality greatly reduced only in 2 patients (29%, p = 0.131). CONCLUSION: Speech disorders were common even in early and successfully treated patients with IOPD; however, aggressive speech therapy and high-dose rhGAA could improve their speech disorders.

Production of mental state terms in narratives of Mandarin-speaking children with autism spectrum disorder.

This study investigates the ability of Mandarin-speaking children with autism spectrum disorder (ASD) to use mental state terms in narratives. The narrative data are from 16 children with ASD and 16 typically developing children, matched on language and cognitive abilities. The narratives were elicited using Frog, where are you? Participants' use of lexical expressions referring to emotion, cognition, desire and perception was examined. The 'deer episode' of the story was chosen to analyse children's ability to talk about misrepresentation. The results reveal that the two groups of children performed comparably in basic narrative measures, overall use of mental state terms and references to the misrepresentation. The outcomes underscore the importance of examining different types of mental state terms separately. These findings are discussed in relation to linguistic and cognitive factors in mental-state attribution.

Acoustic voice analysis does not identify presence of penetration/aspiration as confirmed by videofluoroscopic swallowing study.

OBJECTIVE: To investigate whether acoustic voice analysis can identify the presence of penetration/aspiration (P/A) as confirmed by videofluoroscopic swallowing study (VFSS). DESIGN: Repeated measures within subjects. SETTING: Rehabilitation department in a tertiary teaching hospital. PARTICIPANTS: Patients (N=44) with swallowing disorders referred for VFSS. INTERVENTIONS: Patients were asked to sustain phonations /a/ for at least 3 seconds before and after swallowing 5mL of liquid barium during a standardized VFSS. The acoustic voice analysis program was used to analyze vocal quality change. MAIN OUTCOME MEASURES: Five acoustic parameters including average fundamental frequency, relative average perturbation, shimmer percentage, noise-to-harmonic ratio, and voice turbulence index were analyzed for each participant before and after swallowing during VFSS. Differences in the pre- and postmeasures were compared between those participants who demonstrated VFSS-confirmed P/A (n=17) and those who did not (n=27). RESULTS: No significant changes were noted in the 5 acoustic parameters in or between P/A and nonpenetration/aspiration groups (P>.05). CONCLUSIONS: As used in this study, acoustic voice analysis does not identify the presence of P/A confirmed by VFSS.