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1.
Int J Lang Commun Disord ; 58(4): 994-1016, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36478017

RESUMO

BACKGROUND: Written reflective practice (WRP) is a teaching tool used across speech-language therapy (SLT) clinical education programmes. The process aims to support the development of reflective skills required for the workplace (e.g., problem-solving and self-evaluation). AIMS: This cross-sectional and repeated-measures study design investigated students' demonstration of breadth of WRP across the clinical education programme. METHODS & PROCEDURES: The participants were 77 undergraduate SLT students in their first, second or final professional year of the clinical programme. Participants wrote critical reflections following an interaction with a client/s as part of their clinical education experiences. Formative feedback was provided after each written reflection (WR). In total four WRs per participant were coded for breadth of WRP using a modification of Plack et al.'s coding schema from 2005. This was completed for each of the four time points across the academic year for each professional year. OUTCOMES & RESULTS: There was a statistically significant association between time (i.e., professional year of the programme) and likelihood of demonstration of breadth of reflection for the lower level reflective element of 'attend' and higher level reflective element of 're-evaluate'. A positive trend between time and likelihood of demonstration of breadth of reflection was seen for the lower level element of 'reflection-for-action'. Final-professional-year students exhibited significant enhancements in the higher level elements (e.g., 'premise') compared with first- and second-professional-year students. CONCLUSIONS & IMPLICATIONS: This group of SLT students exhibited significant change in breadth of WRP across the degree programme. This finding has positive implications for facilitating WRP with students and using the current coding framework in clinical programmes. WHAT THIS PAPER ADDS: What is already known on this subject WRP is one form of reflective practice (RP) used in SLT, allied health, medical and nursing clinical education programmes. Researchers have suggested that RP skills develop over time for students. Previously, studies examining WRP have focused on one off assessment of skill or over a timeframe of 6-10 weeks. Here, we examine SLT students' WRP skills across the degree programme. What this paper adds to existing knowledge SLT students exhibited significant positive change in breadth of WRP across the degree programme as their clinical experience increased. Our results provide quantitative information in support of using RP as a learning tool throughout clinical education programmes for SLT. What are the potential or actual clinical implications of this work? This study offers support for educators of SLT students; for example, how educators can assess WRP, and how educators can foster SLT student skill development with formative feedback and reflective questioning. This study also offers support for student SLT, for example, describing how WRP can be part of their individualized learning approach and provide a purposeful examination of self and clinical skill development.


Assuntos
Aprendizagem , Estudantes , Humanos , Estudos Transversais , Escolaridade , Resolução de Problemas , Terapia da Linguagem , Fonoterapia
2.
Folia Phoniatr Logop ; 71(5-6): 297-308, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31266009

RESUMO

OBJECTIVE: In the perceptual assessment of dysarthria, various approaches are used to examine the accuracy of listeners' speech transcriptions and their subjective impressions of speech disorder. However, less attention has been given to the effort and cognitive resources required to process speech samples. This study explores the relationship between transcription accuracy, comprehensibility, subjective impressions of speech, and objective measures of reaction time (RT) to further examine the challenges involved in processing dysarthric speech. PATIENTS AND METHODS: Sixteen listeners completed 3 experimental listening tasks: a sentence transcription task, a rating scale task, and an RT task that required responses to veracity statements. In each task, the speech stimuli included speech from 8 individuals with dysarthria. RESULTS: Measurements from the 3 tasks were significantly related, with a correlation coefficient of -0.94 between average RT and transcription-based intelligibility scores and -0.89 between RT and listener ratings of dysarthria. Interrater reliability of RT measurements was relatively low when considering a single person's response to stimuli. However, reliability reached an acceptable level when a mean was taken from 8 listeners. CONCLUSIONS: RT tasks could be developed as a reliable adjunct in the assessment of listener effort and speech processing.


Assuntos
Disartria/psicologia , Tempo de Reação , Percepção da Fala , Adulto , Idoso , Compreensão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
3.
J Acoust Soc Am ; 141(3): EL293, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28372040

RESUMO

This study examines acoustic features of speech production in speakers of Mandarin with Parkinson's disease (PD) and relates them to intelligibility outcomes. Data from 11 participants with PD and 7 controls are compared on several acoustic measures. In speakers with PD, the strength of association between these measures and intelligibility is investigated. Speakers with PD exhibited significant differences in fundamental frequency, pitch variation, vowel space, and rate relative to controls. However, in contrast to the English studies, speech rate was consistently slow and most strongly correlated with intelligibility. Thus, acoustic cues that strongly influence intelligibility in PD may vary cross-linguistically.


Assuntos
Idioma , Doença de Parkinson/psicologia , Acústica da Fala , Inteligibilidade da Fala , Percepção da Fala , Qualidade da Voz , Acústica , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Sinais (Psicologia) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/diagnóstico , Doença de Parkinson/fisiopatologia , Medida da Produção da Fala , Fatores de Tempo
4.
J Acoust Soc Am ; 138(4): 2132-9, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26520296

RESUMO

This study examined the relationship between average vowel duration and spectral vowel quality across a group of 149 New Zealand English speakers aged 65 to 90 yr. The primary intent was to determine whether participants who had a natural tendency to speak slowly would also produce more spectrally distinct vowel segments. As a secondary aim, this study investigated whether advancing age exhibited a measurable effect on vowel quality and vowel durations within the group. In examining vowel quality, both flexible and static formant extraction points were compared. Two formant measurements, from selected [ɐ:], [ i:], and [ o:] vowels, were extracted from a standard passage and used to calculate two measurements of vowel space area (VSA) for each speaker. Average vowel duration was calculated from segments across the passage. The study found a statistically significant relationship between speakers' average vowel durations and VSA measurements indicating that, on average, speakers with slower speech rates produced more acoustically distinct speech segments. As expected, increases in average vowel duration were found with advancing age. However, speakers' formant values remained unchanged. It is suggested that the use of a habitually slower speaking rate may assist speakers in maintaining acoustically distinct vowels.


Assuntos
Idoso/psicologia , Fonação , Fonética , Fatores Etários , Idoso de 80 Anos ou mais , Feminino , Hábitos , Humanos , Masculino , Fatores Sexuais , Espectrografia do Som , Acústica da Fala , Medida da Produção da Fala , Fatores de Tempo , Comportamento Verbal
5.
Am J Speech Lang Pathol ; 33(2): 736-755, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38092050

RESUMO

PURPOSE: While communication changes associated with Parkinson's disease (PD) have been documented, research on the impact of these changes on family members is just beginning to emerge. With this new focus on family, questions arise as to how well speech-language pathology services address their needs communicating with their loved one with PD. The purpose of this study was to explore the experiences of family members of people with PD (PwPD) and their recommendations for speech-language pathology services that incorporated their needs. METHOD: Seventeen spouses/partners of PwPD participated in focus groups that were recorded, transcribed, and analyzed using thematic analyses. RESULTS: Three themes emerged, all focusing around the central tenet that the experiences of family members, and hence their need for speech-language pathology support, transitioned through the stages of PD progression. Theme 1 summarized increasing burdens on family to manage communication as PD progressed beyond a brief period of independent strategy use by PwPD. Theme 2 highlighted multifactorial contributors to communication burdens on families, with cognitive impairments being the most underrecognized. Theme 3 illustrated how families wanted more intervention options from speech-language pathologists (SLPs) that included them, but with a tailored approach for PD stages and personal preferences. CONCLUSIONS: When SLPs provide families with either generic communication strategies or strategies that do not fit the individualized needs of PwPD and their families, we may inadvertently be increasing the burden on families. There is a need for systematic, evidence-based, family-centered interventions that include, but go beyond, current speech-focused interventions to meet the shared communication needs of PwPD and their families.


Assuntos
Transtornos da Comunicação , Doença de Parkinson , Patologia da Fala e Linguagem , Humanos , Doença de Parkinson/complicações , Família , Idioma , Transtornos da Comunicação/terapia , Transtornos da Comunicação/complicações
6.
J Speech Lang Hear Res ; 67(9): 2856-2871, 2024 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-38573834

RESUMO

PURPOSE: Reduced speech intelligibility is often a hallmark of children with dysarthria secondary to cerebral palsy (CP), but effects of speech strategies for increasing intelligibility are understudied, especially in children who speak languages other than English. This study examined the effects of (the Korean translation of) two cues, "speak with your big mouth" and "speak with your strong voice," on speech acoustics and intelligibility of Korean-speaking children with CP. METHOD: Fifteen Korean-speaking children with CP repeated words and sentences in habitual, big mouth, and strong voice conditions. Acoustic analyses were performed and intelligibility was assessed by means of 90 blinded listeners' ease-of-understanding (EoU) ratings and percentage of words correctly transcribed (PWC). RESULTS: In response to both cues, children's vocal intensity and utterance duration increased significantly and differentially, whereas their vowel space area gains did not reach statistical significance. EoU increased significantly in the big mouth condition at word, but not sentence, level, whereas in the strong voice condition, EoU increased significantly at both levels. PWC increases were not statistically significant. Considerable variability in children's responses to cues was noted overall. CONCLUSIONS: Korean-speaking children with CP modify their speech styles differentially when provided with cues aimed to increase their articulatory working space and vocal intensity. The results provide preliminary support for the use of the strong voice cue, in particular, to increase EoU. While the findings do not offer conclusive evidence of the intelligibility benefits of these cues, investigation with a larger sample size should provide further insight into optimal cueing strategies for increasing intelligibility in this population. Implications for language-specific versus language-independent treatment approaches are discussed. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25521052.


Assuntos
Paralisia Cerebral , Sinais (Psicologia) , Acústica da Fala , Inteligibilidade da Fala , Humanos , Paralisia Cerebral/complicações , Feminino , Masculino , Criança , República da Coreia , Disartria/etiologia , Disartria/fisiopatologia , Idioma , Percepção da Fala
7.
J Speech Lang Hear Res ; 67(10): 3631-3642, 2024 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-39265100

RESUMO

PURPOSE: Up to 90% of people with Parkinson's disease (PD) develop communication difficulties over the course of the disease. While the negative effect of dysarthria on communicative participation has been well-documented, the impact of the occurrence of acquired stuttered disfluencies on communication in different speech situations is unknown. This study aimed to determine if the frequency of occurrence of stuttered disfluencies affects communicative participation in individuals with PD, and whether such a relationship is mediated by examiner- and self-rated measures of disease severity. METHOD: Conversational speech samples were collected from 100 people with PD aged 53-91 years to calculate the frequency of occurrence of stuttered disfluencies. Participants completed the Communicative Participation Item Bank to assess participation in communicative situations. Information on overall speech, cognitive, and motor performance was collected using both self-rated and examiner-rated methods. RESULTS: Participants with PD presented with 0.2%-9.9% stuttered disfluencies during conversation. Overall, participants with PD reported their communicative participation to be impacted "a little" (19.5 ± 7.0), but there was considerable interindividual variation. A higher frequency of stuttered disfluencies was associated with significantly lower communicative participation (ρ = -0.32, p < .01). In addition, examiner-rated frequency of stuttered disfluencies (p < .01), speech (p < .01), and motor severity (p = .04) were all significant predictors of communicative participation. Using self-ratings, speech (p < .01) and cognitive (p < .01) measures significantly predicted communicative participation. CONCLUSIONS: In people with PD, communicative participation was significantly worse for those with a higher frequency of stuttered disfluencies. Examiner- and self-rated measures of disease severity contributed different information related to communicative constraints. Together, these results highlight the importance of individualized and holistic speech therapy that considers a wide variety of symptoms, including stuttered disfluencies, to ensure positive functional outcomes. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.26850169.


Assuntos
Disartria , Doença de Parkinson , Humanos , Doença de Parkinson/psicologia , Doença de Parkinson/fisiopatologia , Doença de Parkinson/complicações , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Disartria/etiologia , Disartria/fisiopatologia , Disartria/psicologia , Índice de Gravidade de Doença , Comunicação , Fala/fisiologia
8.
J Acoust Soc Am ; 133(1): 474-82, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23297919

RESUMO

This investigation examined perceptual learning of dysarthric speech. Forty listeners were randomly assigned to one of two identification training tasks, aimed at highlighting either the linguistic (word identification task) or indexical (speaker identification task) properties of the neurologically degraded signal. Twenty additional listeners served as a control group, passively exposed to the training stimuli. Immediately following exposure to dysarthric speech, all three listener groups completed an identical phrase transcription task. Analysis of listener transcripts revealed remarkably similar intelligibility improvements for listeners trained to attend to either the linguistic or the indexical properties of the signal. Perceptual learning effects were also evaluated with regards to underlying error patterns indicative of segmental and suprasegmental processing. The findings of this study suggest that elements within both the linguistic and indexical properties of the dysarthric signal are learnable and interact to promote improved processing of this type and severity of speech degradation. Thus, the current study extends support for the development of a model of perceptual processing in which the learning of indexical properties is encoded and retained in conjunction with linguistic properties of the signal.


Assuntos
Aprendizagem por Discriminação , Disartria/fisiopatologia , Fonética , Reconhecimento Psicológico , Acústica da Fala , Inteligibilidade da Fala , Percepção da Fala , Qualidade da Voz , Estimulação Acústica , Adulto , Análise de Variância , Atenção , Audiometria de Tons Puros , Audiometria da Fala , Limiar Auditivo , Distribuição de Qui-Quadrado , Sinais (Psicologia) , Feminino , Humanos , Aprendizagem , Masculino , Modelos Psicológicos , Índice de Gravidade de Doença , Adulto Jovem
9.
J Acoust Soc Am ; 134(2): 1358-68, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23927132

RESUMO

This study examined younger (n = 16) and older (n = 16) listeners' processing of dysarthric speech-a naturally occurring form of signal degradation. It aimed to determine how age, hearing acuity, memory, and vocabulary knowledge interacted in speech recognition and lexical segmentation. Listener transcripts were coded for accuracy and pattern of lexical boundary errors. For younger listeners, transcription accuracy was predicted by receptive vocabulary. For older listeners, this same effect existed but was moderated by pure-tone hearing thresholds. While both groups employed syllabic stress cues to inform lexical segmentation, older listeners were less reliant on this perceptual strategy. The results were interpreted to suggest that individuals with larger receptive vocabularies, with their presumed greater language familiarity, were better able to leverage cue redundancies within the speech signal to form lexical hypothesis-leading to an improved ability to comprehend dysarthric speech. This advantage was minimized as hearing thresholds increased. While the differing levels of reliance on stress cues across the listener groups could not be attributed to specific individual differences, it was hypothesized that some combination of larger vocabularies and reduced hearing thresholds in the older participant group led to them prioritize lexical cues as a segmentation frame.


Assuntos
Disartria/fisiopatologia , Fonética , Acústica da Fala , Percepção da Fala , Vocabulário , Qualidade da Voz , Estimulação Acústica , Adolescente , Fatores Etários , Idoso , Audiometria de Tons Puros , Audiometria da Fala , Limiar Auditivo , Sinais (Psicologia) , Disartria/psicologia , Feminino , Audição , Humanos , Masculino , Pessoa de Meia-Idade , Reconhecimento Fisiológico de Modelo , Reconhecimento Psicológico , Adulto Jovem
10.
Int J Speech Lang Pathol ; : 1-15, 2023 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-38058000

RESUMO

PURPOSE: Engaging in reflective practice (RP) and demonstrating reflective abilities is an essential graduate skill for speech-language pathologists (SLPs), yet limited studies have examined the perspectives of practicing SLPs and how and why they engage in RP. This qualitative study aimed to examine SLPs' experiences and perspectives of RP in diverse workplaces. METHOD: Individual semi-structured interviews were conducted with 30 SLPs working in health, education, or private practice sectors. Interviews were analysed using thematic analysis. RESULT: Three themes were developed from the data, describing what SLPs use RP for, what SLPs perceive as important in order to engage in RP in the workplace, as well as the barriers they have identified, and how SLPs have observed a change in engaging in RP as they have progressed in their careers. CONCLUSION: SLPs described that RP is valued in the workplace for supporting client focused care, problem-solving, and lifelong learning. SLPs wanted time to be protected for RP at all stages of their career and valued the relationships with others as contributing positively to RP. Perceptions of and engagement in RP changed in relation to SLPs' clinical experience. Implications for clinical practice are discussed.

11.
J Speech Lang Hear Res ; 66(8S): 2999-3012, 2023 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-36508721

RESUMO

PURPOSE: The purpose of this study was to examine selected baseline acoustic features of hypokinetic dysarthria in Spanish speakers with Parkinson's disease (PD) and identify potential acoustic predictors of ease of understanding in Spanish. METHOD: Seventeen Spanish-speaking individuals with mild-to-moderate hypokinetic dysarthria secondary to PD and eight healthy controls were recorded reading a translation of the Rainbow Passage. Acoustic measures of vowel space area, as indicated by the formant centralization ratio (FCR), envelope modulation spectra (EMS), and articulation rate were derived from the speech samples. Additionally, 15 healthy adults rated ease of understanding of the recordings on a visual analogue scale. A multiple linear regression model was implemented to investigate the predictive value of the selected acoustic parameters on ease of understanding. RESULTS: Listeners' ease of understanding was significantly lower for speakers with dysarthria than for healthy controls. The FCR, EMS from the first 10 s of the reading passage, and the difference in EMS between the end and the beginning sections of the passage differed significantly between the two groups of speakers. Findings indicated that 67.7% of the variability in ease of understanding was explained by the predictive model, suggesting a moderately strong relationship between the acoustic and perceptual domains. CONCLUSIONS: Measures of envelope modulation spectra were found to be highly significant model predictors of ease of understanding of Spanish-speaking individuals with hypokinetic dysarthria associated with PD. Articulation rate was also found to be important (albeit to a lesser degree) in the predictive model. The formant centralization ratio should be further examined with a larger sample size and more severe dysarthria to determine its efficacy in predicting ease of understanding.


Assuntos
Disartria , Doença de Parkinson , Humanos , Disartria/complicações , Inteligibilidade da Fala , Acústica da Fala , Doença de Parkinson/complicações , Acústica , Medida da Produção da Fala
12.
Mov Disord Clin Pract ; 10(6): 956-966, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37332649

RESUMO

Background: Parkinson's disease frequently causes communication impairments, but knowledge about the occurrence of new-onset stuttering is limited. Objectives: To determine the presence of acquired neurogenic stuttering and its relationship with cognitive and motor functioning in individuals with Parkinson's disease. Method: Conversation, picture description, and reading samples were collected from 100 people with Parkinson's disease and 25 controls to identify the presence of stuttered disfluencies (SD) and their association with neuropsychological test performance and motor function. Results: Participants with Parkinson's disease presented with twice as many stuttered disfluencies during conversation (2.2% ± 1.8%SD) compared to control participants (1.2% ± 1.2%SD; P < 0.01). 21% of people with Parkinson's disease (n = 20/94) met the diagnostic criterion for stuttering, compared with 1/25 controls. Stuttered disfluencies also differed significantly across speech tasks, with more disfluencies during conversation compared to reading (P < 0.01). Stuttered disfluencies in those with Parkinson's disease were associated with longer time since disease onset (P < 0.01), higher levodopa equivalent dosage (P < 0.01), and lower cognitive (P < 0.01) and motor scores (P < 0.01). Conclusion: One in five participants with Parkinson's disease presented with acquired neurogenic stuttering, suggesting that speech disfluency assessment, monitoring and intervention should be part of standard care. Conversation was the most informative task for identifying stuttered disfluencies. The frequency of stuttered disfluencies was higher in participants with worse motor functioning, and lower cognitive functioning. This challenges previous suggestions that the development of stuttered disfluencies in Parkinson's disease has purely a motoric basis.

13.
J Acoust Soc Am ; 132(2): EL102-8, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22894306

RESUMO

Differences in perceptual strategies for lexical segmentation of moderate hypokinetic dysarthric speech, apparently related to the conditions of the familiarization procedure, have been previously reported [Borrie et al., Language and Cognitive Processes (2012)]. The current follow-up investigation examined whether this difference was also observed when familiarization stimuli highlighted syllabic strength contrast cues. Forty listeners completed an identical transcription task following familiarization with dysarthric phrases presented under either passive or explicit learning conditions. Lexical boundary error patterns revealed that syllabic strength cues were exploited in both familiarization conditions. Comparisons with data previously reported afford further insight into perceptual learning of dysarthric speech.


Assuntos
Sinais (Psicologia) , Disartria/fisiopatologia , Reconhecimento Psicológico , Acústica da Fala , Inteligibilidade da Fala , Percepção da Fala , Estimulação Acústica , Adulto , Análise de Variância , Audiometria da Fala , Humanos , Aprendizagem , Estimulação Luminosa , Leitura , Adulto Jovem
14.
Am J Speech Lang Pathol ; 31(3): 1354-1367, 2022 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-35394803

RESUMO

PURPOSE: This study investigated the effects of intensive voice treatment on subjective and objective measures of speech production in Mandarin speakers with hypokinetic dysarthria. METHOD: Nine Mandarin speakers with hypokinetic dysarthria due to Parkinson's disease received 4 weeks of intensive voice treatment (4 × 60 min per week). The speakers were recorded reading a passage before treatment (PRE), immediately after treatment (POST), and at 6-month follow-up (FU). Listeners (n = 15) rated relative ease of understanding (EOU) of paired speech samples on a visual analogue scale. Acoustic analyses were performed. Changes in EOU, vocal intensity, global and local fundamental frequency (f o) variation, speech rate, and acoustic vowel space area (VSA) were examined. RESULTS: Increases were found in EOU and vocal intensity from PRE to POST and from PRE to FU, with no change found from POST to FU. Speech rate increased from PRE to POST, with limited evidence of an increase from PRE to FU and no change from POST to FU. No changes in global or local f o variation or in VSA were found. CONCLUSIONS: Intensive voice treatment shows promise for improving speech production in Mandarin speakers with hypokinetic dysarthria. Vocal intensity, speech rate, and, crucially, intelligibility, may improve for up to 6 months posttreatment. In contrast, f o variation and VSA may not increase following the treatment. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19529017.


Assuntos
Disartria , Doença de Parkinson , Acústica , Disartria/diagnóstico , Disartria/etiologia , Disartria/terapia , Humanos , Doença de Parkinson/complicações , Acústica da Fala , Inteligibilidade da Fala , Medida da Produção da Fala
15.
J Speech Lang Hear Res ; 64(6S): 2301-2316, 2021 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-33656916

RESUMO

Purpose Children with dysarthria secondary to cerebral palsy may experience reduced speech intelligibility and diminished communicative participation. However, minimal research has been conducted examining the outcomes of behavioral speech treatments in this population. This study examined the effect of Speech Intelligibility Treatment (SIT), a dual-focus speech treatment targeting increased articulatory excursion and vocal intensity, on intelligibility of narrative speech, speech acoustics, and communicative participation in children with dysarthria. Method American English-speaking children with dysarthria (n = 17) received SIT in a 3-week summer camplike setting at Columbia University. SIT follows motor-learning principles to train the child-friendly, dual-focus strategy, "Speak with your big mouth and strong voice." Children produced a story narrative at baseline, immediate posttreatment (POST), and at 6-week follow-up (FUP). Outcomes were examined via blinded listener ratings of ease of understanding (n = 108 adult listeners), acoustic analyses, and questionnaires focused on communicative participation. Results SIT resulted in significant increases in ease of understanding at POST, that were maintained at FUP. There were no significant changes to vocal intensity, speech rate, or vowel spectral characteristics, with the exception of an increase in second formant difference between vowels following SIT. Significantly enhanced communicative participation was evident at POST and FUP. Considerable variability in response to SIT was observed between children. Conclusions Dual-focus treatment shows promise for improving intelligibility and communicative participation in children with dysarthria, although responses to treatment vary considerably across children. Possible mechanisms underlying the intelligibility gains, enhanced communicative participation, and variability in treatment effects are discussed.


Assuntos
Disartria , Inteligibilidade da Fala , Acústica , Adulto , Disartria/etiologia , Disartria/terapia , Humanos , Acústica da Fala , Medida da Produção da Fala
16.
Brain Inj ; 24(12): 1408-15, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20858025

RESUMO

PRIMARY OBJECTIVE: This study examined differences in perceived communicative effectiveness between a group of eight participants with chronic dysarthria following TBI and their nominated communication partners (TBIP). The relationship between communicative effectiveness and listener ratings of speech intelligibility was also examined. RESEARCH DESIGN: Group comparison design. METHODS AND PROCEDURES: The Communicative Effectiveness Survey was completed by the participants with TBI and their communication partner. Speech intelligibility of the eight adults with dysarthria was rated by nine naive listeners using direct magnitude estimation. MAIN OUTCOMES AND RESULTS: The participants with TBI tended to rate their communicative effectiveness higher than their TBIP; however, this trend was not significant. No significant differences were noted between the TBI and TBIP groups in ratings of communicative effectiveness in various communication settings. No significant relationship was found between conversation level intelligibility and perceptions of communicative effectiveness, as rated by individuals with TBI and TBIP. CONCLUSIONS: The findings of this study highlight the need for collaborative participation in the therapeutic process by all stakeholders. The lack of correlation between speech intelligibility and perceived communicative effectiveness highlights the need for careful examination of activity and participation during assessment and goal-setting.


Assuntos
Lesões Encefálicas/fisiopatologia , Disartria/fisiopatologia , Inteligibilidade da Fala/fisiologia , Percepção da Fala/fisiologia , Adolescente , Adulto , Lesões Encefálicas/psicologia , Criança , Comunicação , Disartria/psicologia , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Medida da Produção da Fala , Adulto Jovem
17.
J Speech Lang Hear Res ; 63(6): 1752-1761, 2020 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-32459131

RESUMO

Purpose This study examined the relationship between measurements derived from spontaneous speech and participants' scores on the Montreal Cognitive Assessment. Method Participants (N = 521) aged between 64 and 97 years completed the cognitive assessment and were prompted to describe an early childhood memory. A range of acoustic and linguistic measures was extracted from the resulting speech sample. A least absolute shrinkage and selection operator approach was used to model the relationship between acoustic, lexical, and demographic information and participants' scores on the cognitive assessment. Results Using the covariance test statistic, four important variables were identified, which, together, explained 16.52% of the variance in participants' cognitive scores. Conclusions The degree to which cognition can be accurately predicted through spontaneously produced speech samples is limited. Statistically significant relationships were found between specific measurements of lexical variation, participants' speaking rate, and their scores on the Montreal Cognitive Assessment.


Assuntos
Transtornos Cognitivos , Fala , Idoso , Idoso de 80 Anos ou mais , Pré-Escolar , Cognição , Humanos , Idioma , Testes de Estado Mental e Demência , Pessoa de Meia-Idade
18.
Int J Speech Lang Pathol ; 21(6): 537-546, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30322277

RESUMO

Purpose: Research on the prevalence of communication disability among community living older adults is scant, and often suffers from limitations. Using a national database, this study presents an epidemiological profile of communication disability in older community residents within New Zealand and examines whether ethnic populations are disproportionately represented.Method: Since 2012, all New Zealand community care recipients have undergone a standardised needs assessment, which includes questions directed at expressive and receptive language abilities. Those assessed between 1 September 2012 and 31 January 2016, aged ≥65 years, and who provided consent were included. Directly standardised prevalence estimates were calculated and logistic regression used to investigate age, sex and ethnic differences.Result: Overall, 71 859 people were eligible (mean age = 82.7 years, 61% female, 89.2% European/other), with 30.6% and 36.2% exhibiting at least some expression and comprehension communication disability, respectively. Maori, Pasifika and Asian people, males and those who were older were more likely to have at least some communication disability compared to their European/other, female and younger counterparts.Conclusion: Communication disability is common among older adults. With the increased provision of home-based integrated models of care, the impact of communication disability on service seeking and delivery must be recognised and accommodated.


Assuntos
Transtornos da Comunicação/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Avaliação das Necessidades , Nova Zelândia/epidemiologia , Prevalência
19.
Am J Speech Lang Pathol ; 28(2): 521-535, 2019 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-31136238

RESUMO

Purpose This study investigated the effects of cueing for increased loudness and reduced speech rate on scaled intelligibility and acoustics of speech produced by Mandarin speakers with hypokinetic dysarthria due to Parkinson's disease (PD). Method Eleven speakers with PD read passages in habitual, loud, and slow speaking conditions. Fifteen listeners rated ease of understanding (EOU) of the speech samples on a visual analog scale. Effects of the cues on EOU, vocal loudness, pitch range, pause duration and frequency, articulation rate, and vowel space, as well as relationships between EOU gains and acoustic features, were analyzed. Results EOU increased significantly in the loud condition only. The loud cue resulted in increased intensity, and the slow cue resulted both in reduced articulation rate and increased pause frequency. In the loud condition, EOU increased significantly as intensity increased and vowel centralization decreased. In the slow condition, EOU tended to increase as intensity increased and vowel centralization decreased but did not reach statistical significance. Conclusion Cueing for loud speech may yield greater EOU gains than cueing for slow speech in Mandarin speakers with PD. Theoretical and clinical implications are discussed, although further investigations with more participants and a larger range of dysarthria severity are warranted.


Assuntos
Sinais (Psicologia) , Disartria/psicologia , Doença de Parkinson/psicologia , Acústica da Fala , Inteligibilidade da Fala , Percepção da Fala , Qualidade da Voz , Acústica , Adulto , Idoso , Idoso de 80 Anos ou mais , Disartria/diagnóstico , Disartria/fisiopatologia , Feminino , Humanos , Julgamento , Percepção Sonora , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/diagnóstico , Doença de Parkinson/fisiopatologia , Percepção da Altura Sonora , Medida da Produção da Fala , Fatores de Tempo
20.
Sci Rep ; 9(1): 17272, 2019 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-31754118

RESUMO

Aged residential care (ARC) admission needs are increasing beyond the available capacity in many countries, including New Zealand. Therefore, identifying modifiable factors which may prevent or delay ARC admissions is of international importance. Hearing impairment is common among older adults and thought to be an important predictor, although the current evidence-base is equivocal. Using the largest national database to date, competing-risk regression analysis was undertaken on 34,277 older adults having standardised home care assessments between 1 July 2012 and 31 May 2014, aged ≥65 years, and still living in the community 30 days after that assessment. Minimal hearing difficulty was reported by 10,125 (29.5%) participants, moderate difficulty by 5,046 (14.7%), severe difficulty/no hearing by 1,334 (3.9%), while 17,769 (51.8%) participants reported adequate hearing. By 30 June 2014, the study end-point, 6,389 (18.6%) participants had an ARC admission while 6,082 (17.7%) had died. In unadjusted competing-risk regression analyses, treating death as a competing event, hearing ability was significantly associated with ARC admission (p < 0.001). However, in adjusted analyses, this relationship was completely confounded by other variables (p = 0.67). This finding implies that screening for hearing loss among community-living older adults is unlikely to impact on ARC admission rates.


Assuntos
Audição/fisiologia , Admissão do Paciente/tendências , Instituições Residenciais/tendências , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Pessoas com Deficiência , Feminino , Perda Auditiva/fisiopatologia , Testes Auditivos/métodos , Hospitalização , Humanos , Masculino , Nova Zelândia/epidemiologia , Fatores de Risco
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