Efficacy of telepractice, an alternative therapy tool during the coronavirus disease 2019 pandemic, for speech disorders related to congenital anomalies.

Since telepractice regulation does not yet exist in Japan, we assessed telepractice efficacy and the level of satisfaction with telepractice versus that with face-to-face practice (FTFP) in speech therapy to establish effective telepractice in Japan. Changes in the number of therapy sessions and therapy levels were compared between telepractice and FTFP sessions conducted during the study period. Additionally, the patients' parents completed a questionnaire survey regarding telepractice. The mean number of sessions was not significantly different between the two types of therapy; the therapy levels, according to stepwise speech therapy, either increased or remained unchanged. The survey showed satisfaction with telepractice among all parents. Telepractice for cleft palate speech was delivered successfully with complete parental satisfaction.

Living beyond words: post-human reflections on making music with post-verbal people.

Background: This paper draws on a longitudinal ethnographic study of music-making with "post-verbal" people: those with stroke, learning difficulties, acquired brain injury, dementias or autism. Methods: Using embedded observation, arts workshops, interviews with families and carers and focus groups with Music Leaders, the project traced how inclusive music-making happens with "post-verbal" people. It used post-human theory to illuminate and explore processes and benefits. Results: This paper fuses the practical and theoretical aspects of making music with post-verbal people, to understand both how it happens, and, what it signifies. It shows how post-verbal people use music to communicate and demonstrate their capacities, and analyses how those working with them use music to foster a sense of inclusion and belonging. Conclusions: By writing in collaboration across academia and community music practice the paper makes new and important contributions to both post-human thinking and capacities in learning, arts and health.

Protocol for Correcting Residual Errors with Spectral, ULtrasound, Traditional Speech therapy Randomized Controlled Trial (C-RESULTS RCT).

BACKGROUND: Speech sound disorder in childhood poses a barrier to academic and social participation, with potentially lifelong consequences for educational and occupational outcomes. While most speech errors resolve by the late school-age years, between 2 and 5% of speakers exhibit residual speech errors (RSE) that persist through adolescence or even adulthood. Previous findings from small-scale studies suggest that interventions incorporating visual biofeedback can outperform traditional motor-based treatment approaches for children with RSE, but this question has not been investigated in a well-powered randomized controlled trial. METHODS/DESIGN: This project, Correcting Residual Errors with Spectral, ULtrasound, Traditional Speech therapy Randomized Controlled Trial (C-RESULTS RCT), aims to treat 110 children in a parallel randomized controlled clinical trial comparing biofeedback and non-biofeedback interventions for RSE affecting the North American English rhotic sound /ɹ/. Eligible children will be American English speakers, aged 9-15 years, who exhibit RSE affecting /ɹ/ but otherwise show typical cognitive-linguistic and hearing abilities. Participants will be randomized, with stratification by site (Syracuse University or Montclair State University) and pre-treatment speech production ability, to receive either a motor-based treatment consistent with current best practices in speech therapy (40% of participants) or treatment incorporating visual biofeedback (60% of participants). Within the biofeedback condition, participants will be assigned in equal numbers to receive biofeedback in the form of a real-time visual display of the acoustic signal of speech or ultrasound imaging of the tongue during speech. The primary outcome measure will assess changes in the acoustics of children's production of /ɹ/ during treatment, while a secondary outcome measure will use blinded listeners to evaluate changes in the perceived accuracy of /ɹ/ production after the completion of all treatment. These measures will allow the treatment conditions to be compared with respect to both efficacy and efficiency. DISCUSSION: By conducting the first well-powered randomized controlled trial comparing treatment with and without biofeedback, this study aims to provide high-quality evidence to guide treatment decisions for children with RSE. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT03737318, November 9, 2018.

Praxias bucofonatorias con dispositivos bucales y realidad virtual inmersiva: un estudio piloto / Bucco-phonatory training practices with oral devices and immersive virtual reality: a pilot study

El presente trabajo evalúa la efectividad de una intervención utilizando Praxias bucofonatorias con dispositivos bucales en conjunto con realidad virtual inmersiva (RVI), mediante programas diseñados para estimular estados de relajación e interacción en diferentes ambientes virtuales. Para ello, se aplicó la terapia integrada de vibro estimulación bucal palatina, ejercitación lingual y la exposición a imágenes y sonidos empleando RVI en un grupo de 6 niños con el diagnóstico de dislalia. Se comparó los resultados de esta intervención con el de una intervención utilizando únicamente la vibro estimulación bucal palatina en un grupo de 20 niños con diagnóstico de dislalia. Finalmente, se aplicó la terapia integrada de vibro estimulación bucal palatina, ejercitación lingual y RVI en un grupo de niños con autismo. Los resultados observados mostraron que la terapia con dispositivos bucales combinadas con RVI tendía a producir mayores avances que la terapia sin RVI. Además, se observó diferentes grados de avances individuales y grupales en el dominio fonético dependiendo las habilidades de hablainicial, los niños con mejores habilidades presentaban mayores avances. El grupo de niños con autismo presentó menores avances respecto de los otros dos grupos. A pesar de las limitantes del presente estudio (diferente cantidad de sujetos por grupo y distintas edades) puede considerarse esta propuesta como prometedora para futuros estudios.

This study assesses the effectiveness of a therapy using Bucco-phonatory training practices with buccal devices and immersive virtual reality (RVI) through programs designed to stimulate states of relaxation and interaction in different virtual environments. In order to do so, an integrated therapy based on Intra buccal stimulation by means of vibrations in the palatal area, daily lingual exercises with a lingual exerciser device, and exposure to images and sounds using RVI was applied to a group of 6 children diagnosed with dyslalia. The results of this intervention were compared with those obtained in an intervention based only on intra buccal stimulation by means of vibrations in the palatal area (conducted on a a group of 20 children diagnosed with dyslalia). Finally, the integrated therapy of intra buccal stimulation by means of vibrations in the palatal area, lingual exercises, and RVI was applied to a group of children with autism. The results showed that therapy with oral devices combined with RVI tended to produce greater advances than therapy without RVI. In addition, individual differences in group advances in the phonetic domain were observed depending on the initial speech skills, children with better abilities presented greater advances. The group of children with autism progressed less than the other two groups. Even considering the limitations of this study, such as the heterogeneity in terms of group size and age, results can be considered as promising for future studies.

Do Patients With Neurogenic Speech Sound Impairments Benefit From Auditory Priming With a Regular Metrical Pattern?

Purpose Earlier investigations based on word and sentence repetition tasks had revealed that the most prevalent metrical pattern in German (the trochee)-unlike the iambic pattern-facilitates articulation in patients with apraxia of speech (AOS; e.g., Aichert, Späth, & Ziegler, 2016), confirming that segmental and prosodic aspects of speech production interact. In this study, we investigated if articulation in apraxic speakers also benefits from auditory priming by speech with a regular rhythm. Furthermore, we asked if the advantage of regular speech rhythm, if present, is confined to impairments at the motor planning stage of speech production (i.e., AOS) or if it also applies to phonological encoding impairments. Method Twelve patients with AOS, 12 aphasic patients with postlexical phonological impairment (PI), and 36 neurologically healthy speakers were examined. A sequential synchronization paradigm based on a sentence completion task was conducted in conditions where we independently varied the metrical regularity of the prime sentence (regular vs. irregular prime sentence) and the metrical regularity of the target word (trochaic vs. iambic). Results Our data confirmed the facilitating effect of regular (trochaic) word stress on speech accuracy in patients with AOS (target effect). This effect could, for the first time, also be demonstrated in individuals with PI. Moreover, the study also revealed an influence of the metrical regularity of speech input in both patient groups (prime effect). Conclusions Patients with AOS and patients with PI exploited rhythmic cues in the speech of a model speaker for the initiation and the segmental realization of words. There seems to be a robust metrical influence on speech at both the phonological and the phonetic planning stages of speech production.

Introducing the Beatalk technique: using beatbox sounds and rhythms to improve speech characteristics of adults with intellectual disability.

BACKGROUND: Individuals with intellectual disability (ID) often demonstrate speech impairments and reduced intelligibility. However, traditional treatment methods, which involve using repetitive verbal and non-verbal exercises, may not be fully suitable for this population. As adults with ID tend to lose interest and motivation facing the demands of a typical speech therapy session, other intervention methods are needed. The current study tested a novel intervention technique, Beatalk, based on practising vocally produced sounds and rhythms, imitating the sounds produced by rhythm machines in an a cappella musical context (i.e., human beatboxing). Human beatboxing may be a particularly effective tool since it involves intense production of speech sounds (phonemes) that can be misarticulated in the presence of speech disorders; it is relatively easy to learn and practice, and is also considered 'fun'. AIMS: As many of the features of beatboxing make it a promising method for speech therapy, this pioneering study aimed to examine its effectiveness in comparison with a traditional speech therapy. METHODS & PROCEDURES: Twelve adults with moderate ID and low speech intelligibility (age 24-48 years) participated in a speech therapy group for 6 weeks. Six participants were assigned to the Beatalk (study) group and six to a traditional (control) therapy group. Pre- to post-treatment changes in speech intelligibility and voice measures were assessed. OUTCOMES & RESULTS: The preliminary data demonstrate that both types of therapy groups resulted in improved performance in articulation accuracy and voice measures, yet the Beatalk technique yielded larger gains. CONCLUSIONS & IMPLICATIONS: The results present initial evidence for the beneficial effect of the Beatalk technique as an intervention tool for adults with ID. It is an easy-to-use technique in the context of speech therapy, and may enhance verbal communication skills in this population.

Use of electropalatography in the treatment of speech disorders in children with Down syndrome: a randomized controlled trial.

BACKGROUND: Electropalatography (EPG) records details of the location and timing of tongue contacts with the hard palate during speech. It has been effective in treating articulation disorders that have failed to respond to conventional therapy approaches but, until now, its use with children and adolescents with intellectual/learning disabilities and speech disorders has been limited. AIMS: To evaluate the usefulness of EPG in the treatment of speech production difficulties in children and adolescents with Down syndrome (DS) aged 8-18 years. METHODS & PROCEDURES: A total of 27 children with DS were assessed on a range of cognitive and speech and language measures and underwent additional EPG assessment. Participants were randomly allocated to one of three age-matched groups receiving either EPG therapy, EPG-informed conventional therapy or 'treatment as usual' over a 12-week period. The speech of all children was assessed before therapy using the Diagnostic Evaluation of Articulation and Phonology (DEAP) and reassessed immediately post- and 3 and 6 months post-intervention to measure percentage consonants correct (PCC). EPG recordings were made of the DEAP assessment items at all time points. Per cent intelligibility was also calculated using the Children's Speech Intelligibility Measure (CSIM). OUTCOMES & RESULTS: Gains in accuracy of production immediately post-therapy, as measured by PCC, were seen for all groups. Reassessment at 3 and 6 months post-therapy revealed that those who had received therapy based directly on EPG visual feedback were more likely to maintain and improve on these gains compared with the other groups. Statistical testing showed significant differences between groups in DEAP scores across time points, although the majority did not survive post-hoc evaluation. Intelligibility across time points, as measured by CSIM, was also highly variable within and between the three groups, but despite significant correlations between DEAP and CSIM at all time points, no statistically significant group differences emerged. CONCLUSIONS & IMPLICATIONS: EPG was an effective intervention tool for improving speech production in many participants. This may be because it capitalizes on the relative strength of visual over auditory processing in this client group. The findings would seem to warrant an increased focus on addressing speech production difficulties in current therapy.

[Epilepsy, Mozart and his sonata K.448: is the «Mozart effect¼ therapeutic?] / Epilepsia, Mozart y su sonata K.448: es terapeutico el «efecto Mozart¼?

AIMS: To present a review of the so-called «Mozart effect¼, to explain why Mozart and his sonata K.448 were chosen, and to review the available literature on the treatment of epilepsy with that sonata. DEVELOPMENT: Profuse literature exists on the cerebral mechanisms that allow us to perceive, process and respond to the musical stimulus. Cerebral plasticity, especially in people with musical training, has also been demonstrated. The «Mozart effect¼ arose from the finding that hearing the sonata K.448 improved cognitive abilities, but the fact that these results may be due not to the music itself but to the listener increasing arousal or enjoyment generated controversy. In this context of debate, a large number of papers about the «Mozart effect¼ in the field of epilepsy were published, and are reviewed in this work. CONCLUSIONS: The «Mozart effect¼ has a scientific basis but its nature limits the methodological quality of the research. The music of Mozart, chosen for its exquisite structure, has been able to increase even more the controversy because also it is of the taste of a great majority. It is still far from being consolidated as a non-pharmacological antiepileptic treatment, but it could increase the scientific evidence with studies whose design minimizes the cited confounding factors.

TITLE: Epilepsia, Mozart y su sonata K.448: es terapeutico el «efecto Mozart¼?Objetivos. Presentar una revision del denominado «efecto Mozart¼, explicar por que se eligio a Mozart y su sonata K.448, y repasar la bibliografia disponible sobre el tratamiento de la epilepsia con la citada sonata. Desarrollo. Existe abundante bibliografia sobre los mecanismos cerebrales que nos permiten percibir, procesar y responder al estimulo musical. Tambien se ha demostrado la plasticidad cerebral que, en especial el adiestramiento musical, desencadena. El «efecto Mozart¼ se planteo a raiz de la comprobacion de que la audicion de la sonata K.448 mejoraba habilidades cognitivas, pero el hecho de que esos resultados se puedan deber no a la musica en si, sino a que el oyente aumente su nivel de alerta o disfrute con ella, genero controversia. En este contexto de debate se publico un volumen importante de estudios sobre el «efecto Mozart¼ en el campo de la epilepsia, que se repasan en este trabajo. Conclusiones. El «efecto Mozart¼ tiene base cientifica, pero su propia naturaleza limita la calidad metodologica de los estudios. La musica de Mozart, elegida por su exquisita estructura, ha podido aumentar aun mas la polemica porque tambien resulta del gusto de una gran mayoria. Aun esta lejos de consolidarse como tratamiento antiepileptico no farmacologico, pero podria aumentar la evidencia cientifica con estudios cuyo diseño minimice los factores de confusion citados.

The Impact of Expiratory Muscle Strength Training on Speech Breathing in Individuals With Parkinson's Disease: A Preliminary Study.

PURPOSE: The purpose of this study was to examine the impact of expiratory muscle strength training on speech breathing and functional speech outcomes in individuals with Parkinson's disease (PD). METHOD: Twelve individuals with PD were seen once a week for 8 weeks: 4 pretraining (baseline) sessions followed by a 4-week training period. Posttraining data were collected at the end of the 4th week of training. Maximum expiratory pressure, an indicator of expiratory muscle strength, and lung volume at speech initiation were the primary outcome measures. Secondary outcomes included lung volume at speech termination, lung volume excursion, utterance length, and vocal intensity. Data were collected during a spontaneous speech sample. Individual effect sizes > 1 were considered significant. RESULTS: Maximum expiratory pressure increased in a majority of participants after training. Training resulted in 2 main respiratory patterns: increasing or decreasing lung volume initiation. Lung volume termination and excursion, utterance length, and vocal loudness were not consistently altered by training. CONCLUSIONS: Preliminary evidence suggests that the direct physiologic intervention of the respiratory system via expiratory muscle strength training improves speech breathing in individuals with PD, with participants using more typical lung volumes for speech following treatment.

Acquired Apraxia of Speech: The Relationship Between Awareness of Errors in Word Productions and Treatment Outcomes.

PURPOSE: Awareness of errors has been considered a clinical feature of acquired apraxia of speech (AOS). However, there is limited research examining error awareness in speakers with AOS. The purpose of this investigation was to examine awareness of errors and explore the relationship between awareness of errors and treatment outcomes in speakers with AOS. METHOD: Twenty speakers with AOS and aphasia produced mono- and multisyllabic words in a repetition task. Following each production, speakers were asked to judge the accuracy of their production (i.e., correct or incorrect). Then, speakers received Sound Production Treatment. RESULTS: Judgment accuracy of productions for the group ranged from 20% to 96%. There was a weak relationship between judgment accuracy and probe performance at posttreatment (r = .47) and a moderate relationship between judgment accuracy and probe performance at follow-up (r = .53). CONCLUSION: Findings indicate that speakers with AOS varied in their ability to judge the accuracy of their productions. For some speakers, the ability to judge the accuracy of their productions did not coincide with their production accuracy of treatment stimuli at posttreatment and at follow-up. Further research is needed to explore the relationship between error awareness and treatment outcomes.

Efficacy of Visual-Acoustic Biofeedback Intervention for Residual Rhotic Errors: A Single-Subject Randomization Study.

Purpose: This study documented the efficacy of visual-acoustic biofeedback intervention for residual rhotic errors, relative to a comparison condition involving traditional articulatory treatment. All participants received both treatments in a single-subject experimental design featuring alternating treatments with blocked randomization of sessions to treatment conditions. Method: Seven child and adolescent participants received 20 half-hour sessions of individual treatment over 10 weeks. Within each week, sessions were randomly assigned to feature traditional or biofeedback intervention. Perceptual accuracy of rhotic production was assessed in a blinded, randomized fashion. Each participant's response to the combined treatment package was evaluated by using effect sizes and visual inspection. Differences in the magnitude of response to traditional versus biofeedback intervention were measured with individual randomization tests. Results: Four of 7 participants demonstrated a clinically meaningful response to the combined treatment package. Three of 7 participants showed a statistically significant difference between treatment conditions. In all 3 cases, the magnitude of within-session gains associated with biofeedback exceeded the gains associated with traditional treatment. Conclusions: These results suggest that the inclusion of visual-acoustic biofeedback can enhance the efficacy of intervention for some individuals with residual rhotic errors. Further research is needed to understand which participants represent better or poorer candidates for biofeedback treatment.

Music-based training for pediatric CI recipients: A systematic analysis of published studies.

In recent years, there has been growing interest in the use of music-based training to enhance speech and language development in children with normal hearing and some forms of communication disorders, including pediatric CI users. The use of music training for CI users may initially seem incongruous given that signal processing for CIs presents a degraded version of pitch and timbre, both key elements in music. Furthermore, empirical data of systematic studies of music training, particularly in relation to transfer to speech skills are limited. This study describes the rationale for music training of CI users, describes key features of published studies of music training with CI users, and highlights some developmental and logistical issues that should be taken into account when interpreting or planning studies of music training and speech outcomes with pediatric CI recipients.

Biofeedback eletromiográfico no tratamento das disfunções orofaciais neurogênicas: revisão sistemática de literatura / Electromyography biofeedback in the treatment of neurogenic orofacial disorders: systematic review of the literature

RESUMO Objetivo Investigar se o uso do biofeedback eletromiográfico na terapia voltada às funções orofaciais (expressão facial, mastigação, deglutição, fonação e fala) produz efeitos benéficos para os indivíduos com doenças neurológicas. Estratégia de pesquisa Foi realizada busca nas bases de dados MEDLINE, LILACS e SciELO, por meio dos descritores "electromyographic biofeedback", "swallowing", "speech" "chewing", "phonation", e "facial expression". A busca nas bases de dados e a seleção dos artigos foram realizadas independentemente, por duas pesquisadoras e, nos casos de não concordância, houve discussão fundamentada nos critérios de inclusão e exclusão para que chegassem a um consenso. Critérios de seleção Foram incluídos estudos experimentais em seres humanos, em inglês e português, que descreveram e discutiram a utilização do biofeedback eletromiográfico no tratamento das alterações das funções orofaciais provenientes de doenças neurológicas. Resultados Foram encontrados 175 artigos, sendo que somente 10 se adequaram aos critérios de inclusão. A maioria dos trabalhos relacionou-se a estudo de caso, seguido por estudos de série de casos, caso controle e ensaio clínico randomizado. A maior parte dos artigos abordou a aplicação da terapia com biofeedback eletromiográfico na função da deglutição, seguida da função da fala e apenas um artigo utilizou esta modalidade de tratamento na terapia para melhora da expressão facial. Não foram encontrados estudos que abordassem o tratamento fonoaudiológico utilizando o biofeedback eletromiográfico em pacientes com doenças neurológicas, nas funções de fonação e mastigação. Conclusão O uso do biofeedback eletromiográfico na terapia voltada às funções orofaciais pode produzir efeitos benéficos para os indivíduos com doenças neurológicas, nas funções de deglutição, fala e expressão facial.

ABSTRACT Purpose To determine whether the use of electromyographic biofeedback in the therapy of orofacial functions (facial expression, chewing, swallowing, phonation and speech) will result in beneficial effects for individuals with neurological diseases. Research strategy A keyword search was conducted in the MEDLINE, LILACS and SciELO databases, using the terms "electromyographic biofeedback", "swallowing", "speech", "chewing", "phonation", and "facial expression". The database search and the selection of papers were conducted independently by two researchers. In case of any disagreement, there was a discussion based on the inclusion and exclusion criteria, so that they could reach a common ground. Selection criteria This work has included experimental studies in humans, in English and Portuguese, which described and discussed the use of electromyographic biofeedback in the treatment of orofacial function diseases resulting from neurological illness. Results A total of 175 papers were found, wherein only 10 fitted the inclusion criteria. Most works were case studies, followed by case series, case control, and only one randomized controlled trial. Most of studies addressed the therapy with electromyographic biofeedback in the swallowing function, followed by speech function, and only one study addressed the use of electromyographic biofeedback in therapy to improve facial expression. No studies addressing speech therapy using electromyographic biofeedback in patients with neurological diseases in the functions of phonation and chewing were found. Conclusion The use of electromyographic biofeedback in the therapy for orofacial functions can result in beneficial effects for individuals with neurological diseases in the swallowing, speech, and facial expression functions.

[Clinical study of post-stroke speech apraxia treated with scalp electric acupuncture under anatomic orientation and rehabilitation training].

OBJECTIVE: To compare the differences in the clinical efficacy on post-stroke speech disorder between scalp electric acupuncture (EA) under anatomic orientation combined with rehabilitation training and simple rehabilitation training. METHODS: Sixty patients of post-stroke speech apraxia were randomized into an observation group and a control group, 30 cases in each one. In the observation group, under anatomic orientation, the scalp EA was adopted to the dominant hemisphere Broca area on the left cerebrum. Additionally, the speech rehabilitation training was combined. In the control group, the speech rehabilitation training was simply,used. The treatment lasted for 4 weeks totally. The speech movement program module in the psychological language assessment and treatment system of Chinese aphasia was used for the evident of efficacy assessment. The scores of counting, singing scale, repeating phonetic alphabet, repeating monosyllable and repeating disyllable were observed in the patients of the two groups. The assessment was done separately on the day of grouping and 4 weeks after treatment. RESULTS: In 4 weeks of treatment, the scores of counting, singing scale, repeating phonetic alphabet, repeating monosyllable and repeating disyllable were all improved as compared with those before treatment in the two groups (all P<0. 001). The results in the observation group were better than those in the control group (all P< 0. 05). The total effective rate was 100. 0% (30/30) in the observation group, superior apparently to 53. 3% (16/30) in the control group (P<0. 001). CONCLUSION: The scalp EA under anatomic orientation combined with' speech rehabilitation training obviously improves speech apraxia in stroke patients so that the speech disorder cani be relieved. The efficacy is better than that in simple rehabilitation training.

The use of non-speech oral-motor exercises among Indian speech-language pathologists to treat speech disorders: An online survey.

OBJECTIVE: Previous surveys in the United States of America (USA), the United Kingdom (UK), and Canada have indicated that most of the speech-language pathologists (SLPs) tend to use non-speech oral-motor exercises (NSOMEs) on a regular basis to treat speech disorders.At present, there is considerable debate regarding the clinical effectiveness of NSOMEs. The current study aimed to investigate the pattern and extent of usage of NSOMEs among Indian SLPs. METHOD: An online survey intended to elicit information regarding the use of NSOMEs was sent to 505 members of the Indian Speech and Hearing Association. The questionnaire consisted of three sections. The first section solicited demographic information, the second and third sections solicited information from participants who did and did not prefer to use NSOMEs, respectively. Descriptive statistics were employed to analyse the responses that were clinically relevant. RESULTS: A total of 127 participants responded to the survey. Ninety-one percent of the participants who responded to the survey indicated that they used NSOMEs. CONCLUSION: The results suggested that the percentage of SLPs preferring to use NSOMEsis similar to the findings of surveys conducted in the USA, the UK, and Canada. The Indian SLPs continue to use NSOMEs based on a multitude of beliefs. It is important for SLPs to incorporate the principles of evidence-based practice while using NSOMEs to provide high quality clinical care.

Pairing Speech Sounds With Vagus Nerve Stimulation Drives Stimulus-specific Cortical Plasticity.

BACKGROUND: Individuals with communication disorders, such as aphasia, exhibit weak auditory cortex responses to speech sounds and language impairments. Previous studies have demonstrated that pairing vagus nerve stimulation (VNS) with tones or tone trains can enhance both the spectral and temporal processing of sounds in auditory cortex, and can be used to reverse pathological primary auditory cortex (A1) plasticity in a rodent model of chronic tinnitus. OBJECTIVE/HYPOTHESIS: We predicted that pairing VNS with speech sounds would strengthen the A1 response to the paired speech sounds. METHODS: The speech sounds 'rad' and 'lad' were paired with VNS three hundred times per day for twenty days. A1 responses to both paired and novel speech sounds were recorded 24 h after the last VNS pairing session in anesthetized rats. Response strength, latency and neurometric decoding were compared between VNS speech paired and control rats. RESULTS: Our results show that VNS paired with speech sounds strengthened the auditory cortex response to the paired sounds, but did not strengthen the amplitude of the response to novel speech sounds. Responses to the paired sounds were faster and less variable in VNS speech paired rats compared to control rats. Neural plasticity that was specific to the frequency, intensity, and temporal characteristics of the paired speech sounds resulted in enhanced neural detection. CONCLUSION: VNS speech sound pairing provides a novel method to enhance speech sound processing in the central auditory system. Delivery of VNS during speech therapy could improve outcomes in individuals with receptive language deficits.

Religion, Spirituality and Speech-Language Pathology: A Viewpoint for Ensuring Patient-Centred Holistic Care.

This paper presents a viewpoint concerning the largely neglected clinical relevance of spirituality and religious belief in speech-language pathology (SLP) assessments, interventions and outcomes across the lifespan. An overview of the refereed SLP literature is presented with regard to religion and spirituality. It was found that while there is increasing research with regard to spirituality, health and well-being, there is very little specific to SLP. What is available and clinically relevant, generally relates to holistic care and/or cultural and linguistic diversity. Amidst the health care literature, however, there is a growing number of recommended instruments (for religious/spiritual screening) sensitive to intercultural and interfaith issues that are currently available to medical, nursing, allied health and chaplaincy practitioners. These instruments can also be of value to SLPs to ensure holistic assessments and interventions. It would seem timely for SLPs (and other allied health practitioners) to consider including spiritual screenings/assessments as part of their clinical practice so as to ensure appropriate holistic care. This would also mean undertaking research and including relevant education within tertiary institutions and professional development programs.

Teaching mindfulness meditation to adults with severe speech and physical impairments: An exploratory study.

People with severe speech and physical impairments may benefit from mindfulness meditation training because it has the potential to enhance their ability to cope with anxiety, depression and pain and improve their attentional capacity to use brain-computer interface systems. Seven adults with severe speech and physical impairments (SSPI) - defined as speech that is understood less than 25% of the time and/or severely reduced hand function for writing/typing - participated in this exploratory, uncontrolled intervention study. The objectives were to describe the development and implementation of a six-week mindfulness meditation intervention and to identify feasible outcome measures in this population. The weekly intervention was delivered by an instructor in the participant's home, and participants were encouraged to practise daily using audio recordings. The objective adherence to home practice was 10.2 minutes per day. Exploratory outcome measures were an n-back working memory task, the Attention Process Training-II Attention Questionnaire, the Pittsburgh Sleep Quality Index, the Perceived Stress Scale, the Positive and Negative Affect Schedule, and a qualitative feedback survey. There were no statistically significant pre-post results in this small sample, yet administration of the measures proved feasible, and qualitative reports were overall positive. Obstacles to teaching mindfulness meditation to persons with SSPI are reported, and solutions are proposed.

A model for interprofessional health care: lessons learned from craniofacial teams.

Seventy-six years ago, Herbert K. Cooper, DDS, DSc, LHD, FACD, created the first interprofessional health care team in response to the frequency of craniofacial anomalies and related speech and hearing deficits in Lancaster, Pa. His experiences and those from subsequent "medical-dental-nursing-pharmacy allied health professions" craniofacial teams inform and provide "best practices" for the future of interprofessional education. This paper revisits the genesis of craniofacial teams and highlights successes, challenges and cost benefits applicable today.