Effects of facial paralysis and audiovisual information on stop place identification.

This study investigated how listeners' perceptions of bilabial and lingua-alveolar voiced stops in auditory (A) and audiovisual (AV) presentation modes were influenced by articulatory function in a girl with bilateral facial paralysis (BFP) and a girl with normal facial movement (NFM). The Fuzzy Logic Model of Perception (FLMP) was used to make predictions about listeners' identifications of stop place based on assumptions about the nature (clear, ambiguous, or conflicting) of the A or AV cues produced by each child during /b/ and /d/ CV syllables. As predicted, (a) listeners' identification scores for NFM were very high and reliable, regardless of presentation mode or stop place, (b) listeners' identification scores for BFP were high for lingua-alveolar place, regardless of presentation mode, but more variable and less reliable than for NFM; significantly lower (overall at a chance level) for bilabial place in the A mode; and lowest for bilabial place in the AV mode. Conflicting visual cues for stop place for BFP's productions of /bV/ syllables influenced listeners' perceptions, resulting in most of her bilabial syllables being misidentified in the AV mode. F2 locus equations for each child's /bV/ and /dV/ syllables showed patterns similar to those reported by previous investigators, but with less differentiation between stop place for BFP than NFM. These acoustic results corresponded to the perceptual results obtained. (That is, when presented with only auditory information, on average, listeners perceived BFP's target /b/ syllables to be near the boundary between /b/ and /d/.)

Effects of oral myofunctional therapy on swallowing and sibilant production.

This study investigated the effectiveness of oral myofunctional therapy in eliminating a 16 year-old girl's tongue thrust swallowing pattern and mild sibilant distortion. An ABC design was used where Phase A had eight baseline sessions (no treatment), Phase B had 14 oral myofunctional therapy sessions, and Phase C had four articulation treatment sessions. Dependent measures of swallowing and sibilant production were obtained in each session. A third dependent variable, labial diadochokinetic rate, was also measured each session and served as a control for maturation. Oral myofunctional therapy was shown to be effective in eliminating the tongue thrust swallowing pattern of this subject, but not her sibilant distortion. However, her sibilant distortion reduced after one articulation treatment session and was maintained at negligible levels over the next three treatment sessions. As expected, labial diadochokinetic rate remained stable across the three phases. At the conclusion of Phase C, two bi-weekly home visits revealed that the subject had maintained and generalized her new swallowing pattern. Measures obtained six months after completion of Phase C indicated that the subject had maintained her new swallowing and speech production behaviors. The subject's maximal tongue strength and endurance were below expected normal values at the initiation of the study and increased during the study. Her tongue endurance appeared more sensitive to the effects of oral myofunctional training than tongue strength and, unlike tongue strength, tongue endurance decreased in the six month period following completion of the study.

Patient drug education. Improving the working relationship between general practitioners and pharmacists.

Qualitative research with GPs, pharmacists and consumers explored their views of patients' needs for drug information, and perceived difficulties in communication between GPs, patients and pharmacists. Strategies suggested by participants for improving patient drug education were: guidelines for giving information on medication; conventions for writing the prescription; a referral mechanism from the pharmacist to the GP; distribution of patient education materials; professional bodies to reduce ethical and organisational barriers to inter professional communication; and the development of local networks and education programs.

General practitioners and pharmacists interprofessional communication.

This draft joint statement by the Royal Australian College of General Practitioners and the Pharmaceutical Society of Australia Ltd is published here for comment as a national initiative. All suggestions received will be considered before a final statement is adopted.

Assessment of children with developmental apraxia of speech: a procedure.

General considerations for the assessment process are presented. Then, six assessment goals are defined: (1) Determination of prerequisite behaviors for spoken language; (2) Assessment of current speech and language skills; (3) Definition of the nature and severity of the speech disability and the severity of the handicap; (4) Determination of the effects of facilitating approaches and treatment options; (5) Establishment of the child's prognosis; (6) Determination of the criteria for termination of treatment. Procedures, materials, and tests are described in relation to the assessment goals.

Assessment of children with developmental apraxia of speech: a rationale.

A rationale to guide assessment and subsequent management of children with developmental speech disorders is described. Hypotheses about the nature of praxis, the role of oral-verbal praxis in linguistic processing and speech development, and the effects of disturbances in praxis on speech behavior are presented. Implications of a diagnosis of developmental apraxia of speech (DAS) for treatment planning and expected speech, language, and social communication outcomes are discussed. Misconceptions about children diagnosed with DAS and assumptions underlying the author's approach to assessing children with DAS are identified. The desired functional outcome of the assessment approach advocated is a management plan that addresses the needs of the child and family and maximizes the child's ability to communicate.

Characteristics of speech breathing in young women.

Chest wall kinematic records were obtained from 10 healthy young women in the upright, seated position during resting breathing, conversation, and reading aloud. Breathing frequency, lung volume levels relative to resting end-expiratory level, and relative volume displacements of the rib cage and abdomen were measured. Compared to conversation, group results for reading revealed three differences: an increase in syllables spoken per breath, an absence of filled pauses, and a slight upward shift in end-inspiratory and end-expiratory lung volume levels. Compared to resting breathing, group results for speech revealed four differences: a background chest wall configuration characterized by a relatively larger rib cage and smaller abdomen, slight increases in breathing frequency and in lung volume expenditure, and a slight decrease in rib cage contribution to lung volume displacement. The physical characteristic most strongly associated with rib cage contribution to lung volume displacement in resting breathing was height (r = .76). In comparing the relationship between the same respiratory behavior during resting breathing and speech, a correlation of .83 was obtained for rib cage contribution to volume displacement in the two conditions and of .60 for end-inspiratory volume level in the two conditions. Somewhat weaker positive correlations were obtained for lung volume expenditure and for breathing frequency in the two conditions. Comparison of the present findings for women to those recently reported for comparable men (Hoit & Hixon, 1987) revealed no remarkable differences in speech breathing characteristics. Results suggest that certain physical characteristics and task variables may have greater functional importance than gender in determining normative speech breathing behaviors.