The Correlation of English Language Proficiency and Indices of Stress and Anxiety in Migrants from Puerto Rico after Hurricane Maria: A Preliminary Study.

OBJECTIVE: Using validated psychological assessment instruments, this study examined the psychological distress associated with potential language barriers experienced by over 135 000 Puerto Rican residents who either temporarily or permanently migrated to the continental United States with the landfall of Hurricane Maria in 2017. METHODS: Participants were Puerto Rican residents (n = 107) who remained in Puerto Rico (control) or left the island for at least 3 months because of Hurricane Maria (migrants). Participants completed an online survey in their preferred language (Spanish or English), which assessed self-reported English language proficiency, Kessler Psychological Distress Scale (K6), Posttraumatic Stress Disorder Checklist for DSM 5, Patient Health Questionnaire 9-item depression scale, and the Generalized Anxiety Disorder 7-item scale. It was hypothesized that migrants with lower self-reported English proficiency would have comparatively higher indices of post-disaster distress than those with a higher proficiency. RESULTS: Dividing the migrant group by preferred language for questionnaire completion, the Fisher's exact test showed significant differences in prevalence of severe mental distress, as defined by K6 scores above 13, between the Spanish-preferring migrants (30.4%), English-preferring migrants (0%), and controls (9.6%). CONCLUSION: Our results support a possible correlation between decreased language proficiency in post-disaster migrants and a higher risk factor for severe mental distress.

SCIRehab Project series: the speech language pathology taxonomy.

INTRODUCTION: Outcomes research for speech language pathology (SLP) interventions for acute traumatic spinal cord injury (SSC) rehabilitation in the US is difficult because of the lack of a treatment classification system (taxonomy). OBJECTIVE: To describe a taxonomy developed by speech language pathologists (SLPs) to examine the effects of SLP interventions on SCI rehabilitation outcomes. METHODS: The SCIRehab study uses practice-based evidence, a rigorous observational methodology that examines treatment processes without specifying or requiring specific therapeutic interventions. Speech language pathology lead clinicians and researchers at 6 US SCI centers developed a detailed SLP taxonomy documentation process that is comprehensive of SLP interventions for patients with SCI. RESULTS: The SLP taxonomy consists of 7 intervention categories that address deficits (speech production for patients with artificial airway, motor speech and voice, swallowing, cognitive-communication, and communication) and the associated exercises and tasks that patients perform. Time is recorded for each category, and supplementary information focuses on cueing needs and family involvement that helps to describe and guide intervention selection. The SCIRehab project is enrolling 1,500 patients with acute traumatic SCI at 6 inpatient rehabilitation facilities. CONCLUSIONS: Speech language pathology taxonomy information is being captured for the SCIRehab patients who are referred for SLP services; this may be the first attempt to document the many details of the SLP rehabilitation process for patients with SCI in the US.

Elements of Phonological Interventions for Children With Speech Sound Disorders: The Development of a Taxonomy.

Purpose: Our aim was to develop a taxonomy of elements comprising phonological interventions for children with speech sound disorders. Method: We conducted a content analysis of 15 empirically supported phonological interventions to identify and describe intervention elements. Measures of element concentration, flexibility, and distinctiveness were used to compare and contrast interventions. Results: Seventy-two intervention elements were identified using a content analysis of intervention descriptions then arranged to form the Phonological Intervention Taxonomy: a hierarchical framework comprising 4 domains, 15 categories, and 9 subcategories. Across interventions, mean element concentration (number of required or optional elements) was 45, with a range of 27 to 59 elements. Mean flexibility of interventions (percentage of elements considered optional out of all elements included in the intervention) was 44%, with a range of 29% to 62%. Distinctiveness of interventions (percentage of an intervention's rare elements and omitted common elements out of all elements included in the intervention [both optional and required]) ranged from 0% to 30%. Conclusions: An understanding of the elements that comprise interventions and a taxonomy that describes their structural relationships can provide insight into similarities and differences between interventions, help in the identification of elements that drive treatment effects, and facilitate faithful implementation or intervention modification. Research is needed to distil active elements and identify strategies that best facilitate replication and implementation.

Perceptual Error Analysis of Human and Synthesized Voices.

OBJECTIVE/HYPOTHESIS: To assess the quality of synthesized voices through listeners' skills in discriminating human and synthesized voices. STUDY DESIGN: Prospective study. METHODS: Eighteen human voices with different types and degrees of deviation (roughness, breathiness, and strain, with three degrees of deviation: mild, moderate, and severe) were selected by three voice specialists. Synthesized samples with the same deviations of human voices were produced by the VoiceSim system. The manipulated parameters were vocal frequency perturbation (roughness), additive noise (breathiness), increasing tension, subglottal pressure, and decreasing vocal folds separation (strain). Two hundred sixty-nine listeners were divided in three groups: voice specialist speech language pathologists (V-SLPs), general clinician SLPs (G-SLPs), and naive listeners (NLs). The SLP listeners also indicated the type and degree of deviation. RESULTS: The listeners misclassified 39.3% of the voices, both synthesized (42.3%) and human (36.4%) samples (P = 0.001). V-SLPs presented the lowest error percentage considering the voice nature (34.6%); G-SLPs and NLs identified almost half of the synthesized samples as human (46.9%, 45.6%). The male voices were more susceptible for misidentification. The synthesized breathy samples generated a greater perceptual confusion. The samples with severe deviation seemed to be more susceptible for errors. The synthesized female deviations were correctly classified. The male breathiness and strain were identified as roughness. CONCLUSION: VoiceSim produced stimuli very similar to the voices of patients with dysphonia. V-SLPs had a better ability to classify human and synthesized voices. VoiceSim is better to simulate vocal breathiness and female deviations; the male samples need adjustment.

Therapeutic effects of photobiomodulation in the speech-language-hearing clinic: an integrative literature review / Efeitos terapêuticos da fotobiomodulação na clínica fonoaudiológica: uma revisão integrativa da literatura

ABSTRACT Purpose: to conduct a literature review on the therapeutic effects of photobiomodulation applicable to speech-language-hearing therapy. Methods: the databases searched were the Cochrane Library, Virtual Health Library, Medical Literature Analysis and Retrieval System Online (MEDLINE) via PubMed, and Web of Science/ISI.The selected articles were original ones whose abstracts were available and that evaluated the therapeutic effect of photobiomodulation in situations related to speech-language-hearing practice. Results: the sample comprised 23 articles, most of them being indexed in PubMed. The fields of health with the largest number of publications were Physical Therapy and Medicine. The sample size ranged from1 to 99 people, aged 15 to 77 years, and the most applied wavelength was the infrared one. Most of the studies had positive photobiomodulation application results - although in a few publications the effects of this treatment modality were assessed in a combination with rehabilitation exercises. Conclusion: photobiomodulation benefits different disorders treated by speech-language-hearing therapists, however, there is a broad methodological diversity, lacking specific protocols for the ideal dosimetry for each disorder.

RESUMO Objetivo: realizar revisão de literatura sobre efeitos terapêuticos da fotobiomodulação aplicáveis à Fonoaudiologia. Métodos: foram utilizadas as bases de dados Biblioteca Cochrane, Biblioteca Virtual de Saúde, Medical Literature Analysis and Retrieval Sistem online (Medline) via PuBmed e Web of Science/ISI. Foram selecionados artigos originais e com resumos disponíveis que avaliaram o efeito terapêutico da fotobiomodulação em situações relacionadas à prática fonoaudiológica. Resultados: a amostra consistiu em 23 artigos, a maioria indexada na PubMed. As áreas da Saúde com maior número de publicações foram Fisioterapia e Medicina. O tamanho das amostras variou de 1 a 99 indivíduos, faixas etárias entre 15 e 77 anos e o comprimento de onda mais aplicado foi o infravermelho. A maioria das pesquisas evidenciou resultados positivos da aplicação da fotobiomodulação, embora, em poucas publicações tenham sido avaliados os efeitos dessa modalidade de tratamento associados a exercícios de reabilitação. Conclusão: a fotobiomodulação traz benefícios em diferentes distúrbios tratados por fonoaudiólogos, no entanto, há grande diversidade metodológica e ausência de protocolos específicos da dosimetria ideal para cada distúrbio.

Classification of speech dysfluencies using LPC based parameterization techniques.

The goal of this paper is to discuss and compare three feature extraction methods: Linear Predictive Coefficients (LPC), Linear Prediction Cepstral Coefficients (LPCC) and Weighted Linear Prediction Cepstral Coefficients (WLPCC) for recognizing the stuttered events. Speech samples from the University College London Archive of Stuttered Speech (UCLASS) were used for our analysis. The stuttered events were identified through manual segmentation and were used for feature extraction. Two simple classifiers namely, k-nearest neighbour (kNN) and Linear Discriminant Analysis (LDA) were employed for speech dysfluencies classification. Conventional validation method was used for testing the reliability of the classifier results. The study on the effect of different frame length, percentage of overlapping, value of ã in a first order pre-emphasizer and different order p were discussed. The speech dysfluencies classification accuracy was found to be improved by applying statistical normalization before feature extraction. The experimental investigation elucidated LPC, LPCC and WLPCC features can be used for identifying the stuttered events and WLPCC features slightly outperforms LPCC features and LPC features.

Looking at the ICF and human communication through the lens of classification theory.

This paper explores the insights that classification theory can provide about the application of the International Classification of Functioning, Disability and Health (ICF) to communication. It first considers the relationship between conceptual models and classification systems, highlighting that classification systems in speech-language pathology (SLP) have not historically been based on conceptual models of human communication. It then overviews the key concepts and criteria of classification theory. Applying classification theory to the ICF and communication raises a number of issues, some previously highlighted through clinical application. Six focus questions from classification theory are used to explore these issues, and to propose the creation of an ICF-related conceptual model of communicating for the field of communication disability, which would address some of the issues raised. Developing a conceptual model of communication for SLP purposes closely articulated with the ICF would foster productive intra-professional discourse, while at the same time allow the profession to continue to use the ICF for purposes in inter-disciplinary discourse. The paper concludes by suggesting the insights of classification theory can assist professionals to apply the ICF to communication with the necessary rigour, and to work further in developing a conceptual model of human communication.

Augmentative and alternative communication: scope and peculiarities of terms and concepts in Brazil.

BACKGROUND: Augmentative and Alternative Communication (AAC) is expanding in our country, however it is still not a widely recognized practice. Although the term 'Augmentative and Alternative Communication' is well defined in the international literature, in our country there is no official and/or accepted version. AIM: To review the terms used in Brazil and to discuss their implications, taking as a reference the policies and recommendations of Isaac--International Society for Augmentative and Alternative Communication. METHOD: A review of national Journals was made, consulting Lilacs and SciELO database, until the year of 2007. RESULTS: The following versions were found: Comunicação Alternativa e Suplementar, Comunicação Alternativa, Comunicação Suplementar e/ou Alternativa, Sistemas Alternativos e Facilitadores de Comunicação, Comunicação Suplementar, Comunicação Alternativa e Ampliada. CONCLUSION: It is important for a given version/term, besides being adopted by its own use, to maintain the original intended sense and to be in consonance with recommendations/policies of the field it belongs, such as those proposed by Isaac. This is a relevant discussion for the consolidation and strengthening of AAC in Brazil and also for the establishment of descriptors in the field of Health Sciences.

Comunicação suplementar e/ou alternativa: abrangência e peculiaridades dos termos e conceitos em uso no Brasil: [revisão] / Augmentative and alternative communication: scope and peculiarities of terms and concepts in Brazil: [review]

TEMA: a Comunicação Suplementar e/ou Alternativa (CSA) vem se expandindo em nosso país, porém, ainda não se constitui em prática de amplo conhecimento. Na literatura internacional situa-se como "Augmentative and Alternative Communication" (AAC), contudo, não existe uma versão oficial e/ou consagrada em nosso meio. OBJETIVO: fazer uma revisão das versões brasileiras em uso e discutir suas implicações, tomando como referência as publicações da International Society for Augmentative and Alternative Communication (Isaac). MÉTODO: foi feito um levantamento dos periódicos nacionais nas bases Lilacs e SciELO até 2007. RESULTADOS: foram encontradas várias versões: Comunicação Alternativa e Suplementar, Comunicação Alternativa, Comunicação Suplementar e/ou Alternativa, Sistemas Alternativos e Facilitadores de Comunicação, Comunicação Suplementar, Comunicação Alternativa e Ampliada. CONCLUSÃO: é importante que uma versão, além da consagração pelo próprio uso, carregue os sentidos originais a que se propõe bem como esteja em consonância com recomendações/políticas da área, como as propostas pela Isaac. Trata-se de discussão relevante para consolidação e fortalecimento da CSA no Brasil bem como para a definição dos descritores em Saúde

BACKGROUND: Augmentative and Alternative Communication (AAC) is expanding in our country, however it is still not a widely recognized practice. Although the term "Augmentative and Alternative Communication" is well defined in the international literature, in our country there is no official and/or accepted version. AIM: to review the terms used in Brazil and to discuss their implications, taking as a reference the policies and recommendations of Isaac - International Society for Augmentative and Alternative Communication. METHOD: a review of national Journals was made, consulting Lilacs and SciELO database, until the year of 2007. RESULTS: the following versions were found: Comunicação Alternativa e Suplementar, Comunicação Alternativa, Comunicação Suplementar e/ou Alternativa, Sistemas Alternativos e Facilitadores de Comunicação, Comunicação Suplementar, Comunicação Alternativa e Ampliada. CONCLUSION: it is important for a given version/term, besides being adopted by its own use, to maintain the original intended sense and to be in consonance with recommendations/policies of the field it belongs, such as those proposed by Isaac. This is a relevant discussion for the consolidation and strengthening of AAC in Brazil and also for the establishment of descriptors in the field of Health Sciences

Taxonomies in biology, phonetics, phonology, and speech motor control.

This article begins with a review explaining the different purposes of biological taxonomies. Taxonomic units are often dependent on the purpose for which the taxonomy has been constructed. Biological taxonomies provide an analogy that we use to emphasize some of the distinctions among the units of phonetic transcription systems, competence phonologies, and performance phonologies. The units of both phonology and phonetic transcription are considered as possible units of the speech motor system, and some of the difficulties of this assumption are explained. Although phonemic units, like units of phonetic transcription, are useful for many purposes, it is not theoretically necessary to use units derived as part of competence phonologies in systems attempting to explain phonological performance or speech motor performance. In this regard, we challenge the concept of coarticulation, because it is based on assumptions about the role of phonological or phonetic units in speech motor control. We offer an integrated perspective that has implications for research in speech motor control and deficits of the speech motor system. We see speech motor deficits as distinct from, yet possibly interacting with, phonological deficits.

Comunicación aumentativa y alternativa para personas con afasia / Augmentative and alternative communication for individuals with aphasia

La afasia se considera actualmente un trastorno cognitivo multimodal, producido por una lesión cerebral, que tiene lugar generalmente en la edad adulta y afecta, en mayor o menor medida, a la expresión y la comprensión del lenguaje en sus distintas formas (oral, escrita y gestual). Los sistemas aumentativos y alternativos de comunicación, que se definen como las técnicas, estrategias y símbolos para aumentar o sustituir el habla natural o la escritura, han supuesto un avance muy significativo en el tratamiento de las personas con afasia. En este artículo se realiza una revisión de las técnicas y estrategias de comunicación aumentativa y alternativa y se incluyen ejemplos concretos y breves transcripciones de interacciones, pasando también por los productos de apoyo, electrónicos y no electrónicos, que se utilizan para personas con afasia. También se proporcionan ideas clave sobre cómo maximizar las posibilidades de éxito de la intervención, enfatizando aspectos como la implicación y el entrenamiento en estrategias de interacción de los interlocutores habituales del individuo. Por otro lado, se destaca la gran diversidad en la tipología y en las formas de manifestación del trastorno, que hace necesaria una personalización de las ayudas utilizadas en cada caso. Finalmente, se discuten y aportan argumentos referentes a las polémicas asociadas al uso de los sistemas aumentativos y alternativos de comunicación con personas con necesidades complejas de comunicación(AU)

Aphasia is considered to be a multimodal cognitive impairment due to brain injury, usually occurring in adulthood and affecting both the expression and understanding of language in its various forms (oral, written and gestural). Augmentative and alternative communication, which consists of a variety of techniques, strategies and symbol systems aimed at augmenting or replacing natural speech or writing, is a major advance in the treatment of aphasia. The present article reviews augmentative and alternative communication strategies and technical aids, both electronic and non-electronic, aimed at people with aphasia. Specific examples and short transcripts of interactions between people with aphasia and their partners are included. Key ideas on how to maximize the success of interventions are provided, emphasizing issues such as the need for the involvement and training of significant others. The need for aids and strategies to be tailored to the type of aphasia in each individual is also analyzed. Some of the controversies associated with the use of alternative and augmentative communication systems for people with complex communication needs are also discussed(AU)