Auditory-vocal integration impairment: New challenges and opportunities for voice assessment and therapy / Alteración de la integración auditivo-vocal: nuevos retos y oportunidades para la evaluación y la terapia de la voz

This reflection paper addresses the importance of the interaction between voice perception and voice production, emphasizing the processes of auditory-vocal in-tegration that are not yet widely reported in the context of voice clinicians. Given the above, this article seeks to 1) highlight the important link between voice pro-duction and voice perception and 2) consider whether this relationship might be exploited clinically for diagnostic purposes and therapeutic benefit. Existing theories on speech production and its interaction with auditory perception provide context for discussing why the evaluation of auditory-vocal processes could help identify associ-ated origins of dysphonia and inform the clinician around appropriate management strategies. Incorporating auditory-vocal integration assessment through sensorimotor adaptation paradigm testing could prove to be an important addition to voice assess-ment protocols at the clinical level. Further, if future studies can specify the means to manipulate and enhance a person's auditory-vocal integration, the efficiency of voice therapy could be increased, leading to improved quality of life for people with voice disorders

Este artículo de reflexión aborda la importancia de la interacción entre la percepción y la producción de la voz, haciendo hincapié en los procesos de integración auditivo-vocal, los cuales aún no han sido muy divulgados en el contexto de los clínicos de voz. Dado lo anterior, este articulo busca: 1) destacar la importante relación entre la producción y la percepción de la voz y 2) considerar si esta relación pudiese explotarse clínicamente con fines diagnósticos y terapéuticos. Las teorías existentes sobre la producción de la voz y su interacción con la percepción auditiva proporcionan el contexto para discutir por qué la evaluación de los procesos auditivo-vocales podría ayudar a identificar los orígenes asociados a cierto tipo de disfonías e informar al clínico sobre las estrategias de abordaje adecuadas. La incorporación de la evaluación de la integración auditivo-vocal a través de la prueba del paradigma de adaptación sensoriomotora podría ser una importante adición a los protocolos de evaluación de la voz a nivel clínico. Además, si los estudios futuros pueden especificar los medios para manipular y mejorar la integración auditivo-vocal de una persona, la eficacia de la terapia de la voz podría aumentar, lo que llevaría a mejorar la calidad de vida de las personas con trastornos de la voz

Assessment of Deformational Plagiocephaly Severity and Neonatal Developmental Delay.

Deformational plagiocephaly (DP) in infants has been associated with developmental delay that can last until adolescence. Despite this association and a 5-fold increase in incidence of DP over the past 2 decades, there are currently no guidelines regarding screening for developmental delay or identification of which infants with DP are at the greatest risk of delay. A prospective, nonrandomized study was performed. Infants diagnosed with DP who had no prior intervention were eligible for enrollment. Cranial deformity was measured by cross-cranial measurements using calipers, and developmental delay was measured using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Correlation between cranial deformity and developmental delay was analyzed using a linear regression. Twenty-seven infants, ages 4.0 to 11.0 months (mean = 6.61 months) diagnosed with DP were studied. Developmental delay was observed on the composite language (n = 3 of 27, 11%), and composite motor (n = 5 of 23, 22%) scales, but not the cognitive scale. Severity of cranial deformity did not correlate with scores on any Bayley-III scales (cognitive R = 0.058, P = 0.238; composite language R = 0.03, P = 0.399; composite motor R = 0.0195, P = 0.536). This study demonstrates that severity of cranial deformity cannot be used to predict presence or degree of developmental delay. Craniofacial surgeons should be aware of this risk and consider developmental screening based on clinical suspicion.

Listeners' perceptions of the personality of male alaryngeal speakers.

Currently, there is limited information on listeners' perceptions of an individual with a laryngectomy. The purpose of this study is to determine whether listeners have different impressions of a laryngectomized speaker's personality based on mode of alaryngeal speech. Fifty-one listeners were presented with a reading passage produced by three male, alaryngeal speakers. Listeners were instructed to rate each speaker's personality and overall speech on a seven-point scale. Results showed that listeners' perceptions of personality were not affected by mode of alaryngeal speech, although listener's perceptions of overall speech were shown to be significantly affected by mode. Results, however, should be interpreted with caution due to small sample size and limited speaker representation. A portion of this information was previously presented at the American Speech Language and Hearing Association (ASHA) Annual Convention, Chicago, IL, November 13-15, 2003.