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1.
Acta otorrinolaringol. esp ; 70(5): 251-257, sept.-oct. 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-186367

RESUMEN

Introducción y objetivos: La inadecuada retroalimentación auditiva en los niños con hipoacusia prelocutiva altera la articulación de consonantes y vocales. El propósito de esta investigación es comparar la producción de vocales en niños hipoacúsicos hispanohablantes con implante coclear o adaptación audioprotésica con niños normooyentes por medio del análisis acústico de las frecuencias formánticas y el espacio vocal. Método: Un total de 56 niños con hipoacusia prelocutiva (25 con implante coclear y 31 con audífonos) y 47 niños normooyentes participaron en el estudio. Los 2 primeros formantes (F1 y F2) de las 5 vocales del idioma español se midieron utilizando el programa Praat. Para analizar las diferencias entre los 3 grupos se aplicó el método ANOVA de análisis de la varianza y el test de Scheffé. También se calculó el área del espacio vocal. Resultados: El valor medio del F1 en todas las vocales no mostró diferencias significativas en los 3 grupos de niños. Para las vocales /i/, /o/ y /u/ el valor medio del F2 fue significativamente diferente entre los 2 grupos de niños hipoacúsicos y el grupo de niños normooyentes. Conclusión: Ambos grupos de niños con hipoacusia prelocutiva tienden a presentar sutiles desviaciones en la articulación de las vocales que pueden ser analizadas mediante un programa de análisis acústico


Introduction and objectives: Inadequate auditory feedback in prelingually deaf children alters the articulation of consonants and vowels. The purpose of this investigation was to compare vowel production in Spanish-speaking deaf children with cochlear implantation, and with hearing-aids with normal-hearing children by means of acoustic analysis of formant frequencies and vowel space. Methods: A total of 56 prelingually deaf children (25 with cochlear implants and 31 wearing hearing-aids) and 47 normal-hearing children participated. The first 2 formants (F1 and F2) of the five Spanish vowels were measured using Praat software. One-way analysis of variance (ANOVA) and post hoc Scheffé test were applied to analyze the differences between the 3 groups. The surface area of the vowel space was also calculated. Results: The mean value of F1 in all vowels was not significantly different between the 3 groups. For vowels /i/, /o/ and /u/, the mean value of F2 was significantly different between the 2 groups of deaf children and their normal-hearing peers. Conclusion: Both prelingually hearing-impaired groups tended toward subtle deviations in the articulation of vowels that could be analyzed using an objective acoustic analysis programme


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Trastornos de la Articulación/etiología , Implantes Cocleares , Audífonos , Pérdida Auditiva/complicaciones , Personas con Deficiencia Auditiva , Fonética , Trastornos de la Articulación/fisiopatología , Retroalimentación Sensorial , Pérdida Auditiva/fisiopatología , Pérdida Auditiva/rehabilitación , Acústica del Lenguaje , Medición de la Producción del Habla , Calidad de la Voz
2.
Int J Lang Commun Disord ; 54(5): 767-778, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31045304

RESUMEN

BACKGROUND: Submucous cleft palate (SMCP) has a heterogeneous presentation and is often identified late or misdiagnosed. Diagnosis is prompted by speech, resonance or feeding symptoms associated with velopharyngeal insufficiency. However, the broader impacts of SMCP on communication have rarely been examined and therefore are poorly understood. AIM: To describe the communicative profile of individuals with non-syndromic SMCP by examining speech, language and pragmatics (social language). METHODS & PROCEDURES: Fifteen participants with SMCP aged 5;1-12;8, without a genetic diagnosis, participated in the study. Participants completed standardized assessments examining language, resonance, speech and non-verbal intellect. Parents also completed the Children's Communication Checklist (CCC-2), which provided a measure of overall communicative ability, including pragmatic skills. Formal language outcomes were compared with two cohorts: 36 individuals with overt non-syndromic clefts and 129 individuals with no history of clefting. OUTCOMES & RESULTS: Speech intelligibility was reduced secondary to hypernasality, disordered articulation and/or impaired phonology (n = 7) in children with SMCP. Poorer overall language outcomes were observed for children with SMCP compared with both those with overt clefts and no history of clefting (p < 0.001). Language scores for children with SMCP ranged from impaired (n = 6) to above the standardized mean (n = 4). Receptive and expressive language performance were independently correlated with non-verbal IQ (p < 0.01). Those with severe language impairment (n = 4) also had borderline or impaired non-verbal IQ. Parents reported that speech and semantics were the most affected sub-domains of communication, while scores were the highest for the initiation domain. Speech and language skills were correlated strongly with pragmatics (r = 0.877, p < 0.01). CONCLUSIONS & IMPLICATIONS: Overall, performance was variable within the SMCP group across speech, language and pragmatic assessments. In addition to well-documented speech difficulties, children with SMCP may have language or pragmatic impairments, suggesting that further neurodevelopmental influences may be at play. As such, for individuals with SMCP, additional clinical screening of language and pragmatic abilities may be required to ensure accurate diagnosis and guide both cleft and non-cleft related therapy programmes.


Asunto(s)
Fisura del Paladar/psicología , Trastornos del Desarrollo del Lenguaje/etiología , Trastornos del Habla/etiología , Trastornos de la Articulación/etiología , Trastornos de la Articulación/psicología , Niño , Preescolar , Trastornos de la Comunicación/etiología , Trastornos de la Comunicación/psicología , Femenino , Humanos , Inteligencia , Trastornos del Desarrollo del Lenguaje/psicología , Pruebas del Lenguaje , Masculino , Sistema de Registros , Semántica , Trastornos del Habla/psicología , Inteligibilidad del Habla
3.
J Commun Disord ; 77: 94-113, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30606457

RESUMEN

Foreign Accent Syndrome (FAS) is an intriguing motor speech disorder which has captured the interest of the scientific community and media for decades. At the moment, there is no comprehensive model which can account for the pathophysiology of this disorder. This paper presents a review of 112 FAS cases published between 1907 and October 2016: these were analyzed with respect to demographic characteristics, lesion location, associated neurocognitive symptoms, and comorbid speech and language disorders. The analysis revealed that organic-neurogenic FAS is more frequent in women than in men. In organic-neurogenic FAS over half of the patients acquired the foreign accent after a stroke. Their lesions are typically located in the left supratentorial regions of the brain, and generally involve the primary motor cortex and premotor cortex (BA 4 and 6), and/or the basal ganglia. Although neurocognitive data are not consistently reported, vascular FAS patients regularly suffer frontal executive dysfunctions. On the basis of a careful comparison of the cognitive and theoretical accounts of FAS, AoS and ataxic dysarthria, it is concluded that FAS should be regarded a dual component motor speech disorder in which both planning and motor execution of speech may be affected.


Asunto(s)
Trastornos de la Articulación/etiología , Trastornos de la Articulación/fisiopatología , Fonética , Accidente Cerebrovascular/complicaciones , Ganglios Basales/fisiopatología , Humanos , Corteza Motora/fisiopatología , Factores Sexuales , Acústica del Lenguaje
4.
Rev Neurol ; 68(3): 99-106, 2019 Feb 01.
Artículo en Español | MEDLINE | ID: mdl-30687916

RESUMEN

INTRODUCTION: The 22q11 deletion syndrome (S22q11) is a genetic disorder caused by the loss of a fragment of the chromosome 22. The clinical manifestations associated with the syndrome are diverse, including learning difficulties and alterations in voice, speech and language. However, to date we have not found any study that evaluates these aspects in the Spanish population with S22q11. PATIENTS AND METHODS: We evaluate the voice and speech of a sample of 10 boys and 7 girls, aged 3 years and 3 months to 13 years and 9 months old (mean age: 9,4 ± 3,5 years old) with S22q11, with voice recordings and a phonological and phonetic evaluation. Also, semistructured type interview is administered to parents. RESULTS: Most children of our series, both male and female, with S22q11 have a deeper voice than expected by gender and age, except for male children over 12 years. In terms of intensity, all of them are within the parameters of normality in spontaneous conversation. Almost all of them showed alterations in voice quality, mainly due to hypernasality. Regarding the speech, there are major difficulties in the articulation of fricatives, affricates and vibrant rhotic consonant clusters + /r/. Likewise, children, especially the youngest ones, make use of glottal stops to replace consonants. CONCLUSIONS: In the studied sample, most of the children with S22q11 have specific voice and speech alterations.


Asunto(s)
Síndrome de Deleción 22q11/fisiopatología , Trastornos de la Articulación/etiología , Calidad de la Voz , Síndrome de Deleción 22q11/complicaciones , Anomalías Múltiples/etiología , Anomalías Múltiples/fisiopatología , Adolescente , Trastornos de la Articulación/fisiopatología , Niño , Preescolar , Femenino , Humanos , Masculino , Paladar (Hueso)/anomalías
5.
Int J Neural Syst ; 29(2): 1850037, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30336711

RESUMEN

Neurodegenerative pathologies as Parkinson's Disease (PD) show important distortions in speech, affecting fluency, prosody, articulation and phonation. Classically, measurements based on articulation gestures altering formant positions, as the Vocal Space Area (VSA) or the Formant Centralization Ratio (FCR) have been proposed to measure speech distortion, but these markers are based mainly on static positions of sustained vowels. The present study introduces a measurement based on the mutual information distance among probability density functions of kinematic correlates derived from formant dynamics. An absolute kinematic velocity associated to the position of the jaw and tongue articulation gestures is estimated and modeled statistically. The distribution of this feature may differentiate PD patients from normative speakers during sustained vowel emission. The study is based on a limited database of 53 male PD patients, contrasted to a very selected and stable set of eight normative speakers. In this sense, distances based on Kullback-Leibler divergence seem to be sensitive to PD articulation instability. Correlation studies show statistically relevant relationship between information contents based on articulation instability to certain motor and nonmotor clinical scores, such as freezing of gait, or sleep disorders. Remarkably, one of the statistically relevant correlations point out to the time interval passed since the first diagnostic. These results stress the need of defining scoring scales specifically designed for speech disability estimation and monitoring methodologies in degenerative diseases of neuromotor origin.


Asunto(s)
Trastornos de la Articulación/fisiopatología , Fenómenos Biomecánicos/fisiología , Enfermedad de Parkinson/diagnóstico , Anciano , Trastornos de la Articulación/etiología , Conjuntos de Datos como Asunto , Disartria/etiología , Disartria/fisiopatología , Humanos , Maxilares/fisiopatología , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/complicaciones , Índice de Severidad de la Enfermedad , Lengua/fisiopatología
6.
Logoped Phoniatr Vocol ; 44(2): 58-66, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29068267

RESUMEN

OBJECTIVES: The aim of this study was to describe speech at 1, 1;6 and 3 years of age in children born with unilateral cleft lip and palate (UCLP) and relate the findings to operation method and amount of early intervention received. METHODS: A prospective trial of children born with UCLP operated with a one-stage (OS) palatal repair at 12 months or a two-stage repair (TS) with soft palate closure at 3-4 months and hard palate closure at 12 months was undertaken (Scandcleft). At 1 and 1;6 years the place and manner of articulation and number of different consonants produced in babbling were reported in 33 children. At three years of age percentage consonants correct adjusted for age (PCC-A) and cleft speech errors were assessed in 26 of the 33 children. Early intervention was not provided as part of the trial but according to the clinical routine and was extracted from patient records. RESULTS: At age 3, the mean PCC-A was 68% and 46% of the children produced articulation errors with no significant difference between the two groups. At one year there was a significantly higher occurrence of oral stops and anterior place consonants in the TS group. There were significant correlations between the consonant production between one and three years of age, but not with amount of early intervention received. CONCLUSIONS: The TS method was beneficial for consonant production at age 1, but not shown at 1;6 or 3 years. Behaviourally based early intervention still needs to be evaluated.


Asunto(s)
Trastornos de la Articulación/etiología , Lenguaje Infantil , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Intervención Médica Temprana , Acústica del Lenguaje , Calidad de la Voz , Factores de Edad , Trastornos de la Articulación/diagnóstico , Trastornos de la Articulación/fisiopatología , Preescolar , Labio Leporino/complicaciones , Labio Leporino/diagnóstico , Labio Leporino/fisiopatología , Fisura del Paladar/complicaciones , Fisura del Paladar/diagnóstico , Fisura del Paladar/fisiopatología , Humanos , Lactante , Ensayos Clínicos Controlados Aleatorios como Asunto , Recuperación de la Función , Medición de la Producción del Habla , Factores de Tiempo , Resultado del Tratamiento
7.
Acta Otorrinolaringol Esp ; 70(5): 251-257, 2019.
Artículo en Inglés, Español | MEDLINE | ID: mdl-30086890

RESUMEN

INTRODUCTION AND OBJECTIVES: Inadequate auditory feedback in prelingually deaf children alters the articulation of consonants and vowels. The purpose of this investigation was to compare vowel production in Spanish-speaking deaf children with cochlear implantation, and with hearing-aids with normal-hearing children by means of acoustic analysis of formant frequencies and vowel space. METHODS: A total of 56 prelingually deaf children (25 with cochlear implants and 31 wearing hearing-aids) and 47 normal-hearing children participated. The first 2 formants (F1 and F2) of the five Spanish vowels were measured using Praat software. One-way analysis of variance (ANOVA) and post hoc Scheffé test were applied to analyze the differences between the 3 groups. The surface area of the vowel space was also calculated. RESULTS: The mean value of F1 in all vowels was not significantly different between the 3 groups. For vowels /i/, /o/ and /u/, the mean value of F2 was significantly different between the 2 groups of deaf children and their normal-hearing peers. CONCLUSION: Both prelingually hearing-impaired groups tended toward subtle deviations in the articulation of vowels that could be analyzed using an objective acoustic analysis programme.


Asunto(s)
Trastornos de la Articulación/etiología , Implantes Cocleares , Audífonos , Pérdida Auditiva/complicaciones , Personas con Deficiencia Auditiva , Fonética , Trastornos de la Articulación/fisiopatología , Niño , Preescolar , Retroalimentación Sensorial , Femenino , Pérdida Auditiva/fisiopatología , Pérdida Auditiva/rehabilitación , Humanos , Masculino , Acústica del Lenguaje , Medición de la Producción del Habla , Calidad de la Voz
8.
Folia Phoniatr Logop ; 70(3-4): 165-173, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30184536

RESUMEN

AIMS: The aim of this study was to describe the nutritive and non-nutritive oral sucking habits (breastfeeding, bottle use, pacifier/dummy/soother use, thumb/finger sucking) of preschoolers with and without phonological impairment, and to determine whether oral sucking habits are associated with the presence and severity of phonological impairment. METHODS: We conducted a cross-sectional study of 199 Australian English-speaking preschoolers with and without phonological impairment. Preschoolers' speech was directly assessed, and parents/caregivers completed a questionnaire. Chi-square (χ2) tests were used to examine relationships between oral sucking habits and the presence and severity of phonological impairment. RESULTS: Based on caregiver reports, 79.9% of participants had been breastfed (33.3% for >12 months), 58.3% had used a pacifier (74.2% for ≥12 months), 83.9% had used a bottle (73.4% for > 12 months), and 15.1% sucked their thumb/fingers. There was no association between a history of oral sucking and the presence and severity of phonological impairment. CONCLUSION: The majority of preschoolers had been breastfed and bottle-fed, and more than half had used a pacifier. The findings support an understanding that phonological impairment is not associated with a history of nutritive and non-nutritive sucking habits. Research is needed to examine the association between oral sucking habits and other types of speech sound disorders.


Asunto(s)
Trastornos de la Articulación/etiología , Alimentación Artificial , Lactancia Materna , Chupetes , Conducta en la Lactancia , Alimentación Artificial/efectos adversos , Lactancia Materna/efectos adversos , Lactancia Materna/estadística & datos numéricos , Preescolar , Estudios Transversales , Femenino , Succión del Dedo/efectos adversos , Humanos , Lactante , Masculino , Tamizaje Masivo , Chupetes/efectos adversos , Chupetes/estadística & datos numéricos , Utilización de Procedimientos y Técnicas , Encuestas y Cuestionarios
9.
Folia Phoniatr Logop ; 70(3-4): 138-148, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30138930

RESUMEN

BACKGROUND/AIMS: Speech impairment during the initial phase of removable partial denture (RPD) treatment can prevent patient adaptation to RPDs. This study was undertaken to investigate the influence of oral morphology on speech production in subjects wearing RPDs with major connectors. METHODS: Two types of connectors were fabricated for 17 subjects with normal dentitions: covering the middle palate (M-bar) and the anterior/posterior palate (AP-bar). Four target sounds ([∫i], [t∫i], [çi], and [ki]) were evaluated under 3 recording conditions: no connector, M-bar, and AP-bar. The mean appearance ratios of correct labels (MARCs) were calculated as parameters representing speech production accuracy with the speech evaluation system. Subgroup analysis was conducted based on palate height, dental arch width, and front space volume of the oral cavity. RESULTS: Based on the multiple linear regression test, a significant association was found between the MARCs of [∫i] with M-bar and front space (p = 0.036). In the subgroup analysis, the AP-bar had a significant effect on the MARCs of [∫i] among subjects with high palate (p = 0.026), narrow arch (p = 0.004), and small front space (p = 0.014). CONCLUSION: RPDs with major connectors could disturb speech production among patients with high palates, narrow arches, and small front spaces.


Asunto(s)
Trastornos de la Articulación/etiología , Arco Dental/anatomía & histología , Diseño de Dentadura , Dentadura Parcial Removible , Paladar (Hueso)/anatomía & histología , Adulto , Antropometría , Dentadura Parcial Removible/efectos adversos , Femenino , Humanos , Masculino , Maxilar , Persona de Mediana Edad , Espectrografía del Sonido , Pruebas de Articulación del Habla/métodos , Adulto Joven
10.
Neurol Sci ; 39(10): 1683-1689, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29938340

RESUMEN

INTRODUCTION: Parkinson's disease (PD) is the second most frequent progressive neuro-degenerative disorder. In addition to motor symptoms, nonmotor symptoms and voice and speech disorders can also develop in 90% of PD patients. The aim of our study was to investigate the effects of DBS and different DBS frequencies on speech acoustics of vowels in PD patients. METHODS: The study included 16 patients who underwent STN-DBS surgery due to PD. The voice recordings for the vowels including [a], [e], [i], and [o] were performed at frequencies including 230, 130, 90, and 60 Hz and off-stimulation. The voice recordings were gathered and evaluated by the Praat software, and the effects on the first (F1), second (F2), and third formant (F3) frequencies were analyzed. RESULTS: A significant difference was found for the F1 value of the vowel [a] at 130 Hz compared to off-stimulation. However, no significant difference was found between the three formant frequencies with regard to the stimulation frequencies and off-stimulation. In addition, though not statistically significant, stimulation at 60 and 230 Hz led to several differences in the formant frequencies of other three vowels. CONCLUSION: Our results indicated that STN-DBS stimulation at 130 Hz had a significant positive effect on articulation of [a] compared to off-stimulation. Although there is not any statistical significant stimulation at 60 and 230 Hz may also have an effect on the articulation of [e], [i], and [o] but this effect needs to be investigated in future studies with higher numbers of participants.


Asunto(s)
Trastornos de la Articulación/terapia , Estimulación Encefálica Profunda , Enfermedad de Parkinson/terapia , Fonética , Acústica del Lenguaje , Núcleo Subtalámico , Adulto , Anciano , Trastornos de la Articulación/etiología , Trastornos de la Articulación/fisiopatología , Estimulación Encefálica Profunda/métodos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/fisiopatología , Núcleo Subtalámico/fisiopatología , Resultado del Tratamiento
11.
J Craniofac Surg ; 29(6): 1490-1494, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29916979

RESUMEN

Children with cleft palate frequently show speech and language disorders. In the related scientific literature, several reports have described the use of different strategies for treating speech disorders in children with cleft palate. However, only a few studies have addressed the use of these strategies within a meaningful linguistic context.Deliberate practice is a procedure or strategy, which proposes that the key for achieving high levels of expert performance is dedicating long time for practice. Deliberate practice has been studied mainly in the areas of sports and intellectual games. The purpose of this article is to study whether the use of a strategy originally designed for achieving expert performance in sports and intellectual games, can be useful for the speech intervention of children with cleft palate.For this project, 32 children with cleft palate were studied. The children were randomly assigned to 2 independent groups. Both groups received speech therapy based on the principles of the Whole Language Model. In addition, deliberate practice was used in the children included in the active group.After a speech intervention, although both groups of children demonstrated significant improvement in articulation placement, the active group demonstrated a significantly higher improvement as compared with the control group.In conclusion, these preliminary results seem to suggest that the use of deliberate practice can be effective for enhancing articulation in children with cleft palate.


Asunto(s)
Trastornos de la Articulación , Fisura del Paladar , Logoterapia , Trastornos de la Articulación/etiología , Trastornos de la Articulación/terapia , Niño , Fisura del Paladar/complicaciones , Fisura del Paladar/cirugía , Humanos
12.
PLoS One ; 13(6): e0198146, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29879142

RESUMEN

Developmental dyslexia is presumed to arise from phonological impairments. Accordingly, people with dyslexia show speech perception deficits taken as indication of impoverished phonological representations. However, the nature of speech perception deficits in those with dyslexia remains elusive. Specifically, there is no agreement as to whether speech perception deficits arise from speech-specific processing impairments, or from general auditory impairments that might be either specific to temporal processing or more general. Recent studies show that general auditory referents such as Long Term Average Spectrum (LTAS, the distribution of acoustic energy across the duration of a sound sequence) affect speech perception. Here we examine the impact of preceding target sounds' LTAS on phoneme categorization to assess the nature of putative general auditory impairments associated with dyslexia. Dyslexic and typical listeners categorized speech targets varying perceptually from /ga/-/da/ preceded by speech and nonspeech tone contexts varying. Results revealed a spectrally contrastive influence of the preceding context LTAS on speech categorization, with a larger magnitude effect for nonspeech compared to speech precursors. Importantly, there was no difference in the presence or magnitude of the effects across dyslexia and control groups. These results demonstrate an aspect of general auditory processing that is spared in dyslexia, available to support phonemic processing when speech is presented in context.


Asunto(s)
Adaptación Fisiológica/fisiología , Percepción Auditiva/fisiología , Dislexia/psicología , Sonido , Percepción del Habla/fisiología , Estimulación Acústica , Adolescente , Adulto , Trastornos de la Articulación/epidemiología , Trastornos de la Articulación/etiología , Estudios de Casos y Controles , Dislexia/complicaciones , Dislexia/fisiopatología , Femenino , Humanos , Masculino , Fonética , Factores de Tiempo , Adulto Joven
13.
Cleft Palate Craniofac J ; 55(9): 1225-1235, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-29620917

RESUMEN

OBJECTIVE: The objective of this study was to investigate the impact of international adoption (IA), age at palatoplasty (PR age), and velopharyngeal sufficiency (VPS) on articulation outcomes. DESIGN: This was a cross-sectional, prospective, observational study. SETTING: Outpatient hospital clinic. PARTICIPANTS: Fifty-one IA and 65 not-adopted (NA) children between the ages of 3 and 9 with nonsyndromic cleft palate with or without cleft lip. MAIN OUTCOME MEASURE(S): The Goldman-Fristoe Test of Articulation-2nd Edition (GFTA-2) standard score and cleft-related articulation errors (CREs). RESULTS: Articulation impairment was observed for 40% to 76% of NA children and 71% to 92% IA children, depending on age. PR age mean IA = 2.07 (0.86) years; NA = 1.23 (0.71) years. Children who were IA had poorer performance on the GFTA-2 ( B = -13.82, P = .015). Children who were IA were not significantly more likely to make CRE; rather, age at the time of assessment ( B = -.10, P = .002) and VPS ( B = .24, P = .021) were associated with CRE. CONCLUSIONS: Children who were IA demonstrated poorer articulation skills. Although primary palatoplasty was accomplished later among children who were IA, age at assessment and VP status (not PR age) were significantly correlated with articulation outcomes. Implications for timing of surgical intervention are discussed.


Asunto(s)
Trastornos de la Articulación/etiología , Niño Adoptado , Fisura del Paladar/complicaciones , Fisura del Paladar/cirugía , Insuficiencia Velofaríngea/etiología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Estudios Prospectivos , Medición de la Producción del Habla
14.
Codas ; 30(1): e20170123, 2018 Mar 01.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-29513872

RESUMEN

PURPOSE: Describe the prevalence of communication, swallowing and orofacial myofunctional disorders in a group of children and adolescents at the time of registration at a cancer hospital. METHODS: A cross-sectional study conducted with children aged ≥2 and adolescents, of both genders, admitted to the Pediatric Oncology Section of the Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA) from March 2014 to April 2015 for investigation and/or treatment of solid tumors. A protocol was used to record the sociodemographic and clinical information and findings of the speech-language pathology clinical evaluation, which included aspects of the oral sensorimotor system, swallowing, speech, language, voice, and hearing. RESULTS: Eighty-eight children/adolescents (41.3%) presented some type of speech-language disorder. The most frequent speech-language disorders were orofacial myofunctional disorder, dysphonia, and language impairments, whereas the less frequent ones were dysacusis, tongue paralysis, and trismus. Site of the lesion was the clinical variable that presented statistically significant correlation with presence of speech-language disorders. CONCLUSION: High prevalence of speech-language disorders was observed in children and adolescents at the time of admission at a cancer hospital. Occurrence of speech-language disorders was higher in participants with lesions in the central nervous system and in the head and neck region.


Asunto(s)
Trastornos de la Articulación/epidemiología , Trastornos de Deglución/epidemiología , Trastornos del Lenguaje/epidemiología , Neoplasias/complicaciones , Trastornos del Habla/epidemiología , Adolescente , Trastornos de la Articulación/etiología , Brasil/epidemiología , Instituciones Oncológicas , Niño , Estudios Transversales , Trastornos de Deglución/etiología , Femenino , Humanos , Trastornos del Lenguaje/etiología , Masculino , Neoplasias/epidemiología , Prevalencia , Factores Socioeconómicos , Trastornos del Habla/etiología
16.
PLoS One ; 13(1): e0191359, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29360867

RESUMEN

Acoustic studies have revealed that patients with Essential Tremor treated with thalamic Deep Brain Stimulation (DBS) may suffer from speech deterioration in terms of imprecise oral articulation and reduced voicing control. Based on the acoustic signal one cannot infer, however, whether this deterioration is due to a general slowing down of the speech motor system (e.g., a target undershoot of a desired articulatory goal resulting from being too slow) or disturbed coordination (e.g., a target undershoot caused by problems with the relative phasing of articulatory movements). To elucidate this issue further, we here investigated both acoustics and articulatory patterns of the labial and lingual system using Electromagnetic Articulography (EMA) in twelve Essential Tremor patients treated with thalamic DBS and twelve age- and sex-matched controls. By comparing patients with activated (DBS-ON) and inactivated stimulation (DBS-OFF) with control speakers, we show that critical changes in speech dynamics occur on two levels: With inactivated stimulation (DBS-OFF), patients showed coordination problems of the labial and lingual system in terms of articulatory imprecision and slowness. These effects of articulatory discoordination worsened under activated stimulation, accompanied by an additional overall slowing down of the speech motor system. This leads to a poor performance of syllables on the acoustic surface, reflecting an aggravation either of pre-existing cerebellar deficits and/or the affection of the upper motor fibers of the internal capsule.


Asunto(s)
Trastornos de la Articulación/etiología , Estimulación Encefálica Profunda/efectos adversos , Temblor Esencial/terapia , Tálamo/fisiopatología , Adulto , Anciano , Trastornos de la Articulación/fisiopatología , Trastornos de la Articulación/psicología , Estudios de Casos y Controles , Temblor Esencial/fisiopatología , Temblor Esencial/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Habla/fisiología , Acústica del Lenguaje , Pruebas de Articulación del Habla
17.
Cleft Palate Craniofac J ; 55(6): 876-882, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-28033025

RESUMEN

Many speakers with cleft palate develop atypical consonant productions, especially for pressure consonants such as plosives, fricatives, and affricates. The present study investigated the nature of nasal sound errors. The participants were eight female and three male speakers with cleft palate between the ages of 6 to 20. Speakers were audio-recorded, and midsagittal tongue movement was captured with ultrasound. The speakers repeated vowel-consonant-vowel with the vowels /α/, /i/, and /u/ and the alveolar and velar nasal consonants /n/ and /η/. The productions were reviewed by three listeners. The participants showed a variety of different placement errors and insertions of plosives, as well as liquid productions. There was considerable error variability between and within speakers, often related to the different vowel contexts. Three speakers co-produced click sounds. The study demonstrated the wide variety of sound errors that some speakers with cleft palate may demonstrate for nasal sounds. Nasal sounds, ideally in different vowel contexts, should be included in articulation screenings for speakers with cleft palate, perhaps more than is currently the case.


Asunto(s)
Trastornos de la Articulación/fisiopatología , Labio Leporino/fisiopatología , Fisura del Paladar/fisiopatología , Medición de la Producción del Habla/métodos , Lengua/diagnóstico por imagen , Lengua/fisiopatología , Ultrasonografía , Adolescente , Trastornos de la Articulación/etiología , Niño , Labio Leporino/complicaciones , Fisura del Paladar/complicaciones , Femenino , Humanos , Masculino , Adulto Joven
18.
Dev Sci ; 21(3): e12588, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-28880490

RESUMEN

Children with reading difficulties and children with a history of repeated ear infections (Otitis Media, OM) are both thought to have phonological impairments, but for quite different reasons. This paper examines the profile of phonological and morphological awareness in poor readers and children with OM. Thirty-three poor readers were compared to individually matched chronological age and reading age controls. Their phonological awareness and morphological awareness skills were consistently at the level of reading age matched controls. Unexpectedly, a significant minority (25%) of the poor readers had some degree of undiagnosed mild or very mild hearing loss. Twenty-nine children with a history of OM and their matched controls completed the same battery of tasks. They showed relatively small delays in their literacy and showed no impairment in morphological awareness but had phonological awareness scores below the level of reading age matched controls. Further analysis suggested that this weakness in phonological awareness was carried by a specific weakness in segmenting and blending phonemes, with relatively good performance on phoneme manipulation tasks. Results suggest that children with OM show a circumscribed deficit in phoneme segmentation and blending, while poor readers show a broader metalinguistic impairment which is more closely associated with reading difficulties.


Asunto(s)
Trastornos de la Articulación/etiología , Dislexia/diagnóstico , Otitis Media/diagnóstico , Trastornos de la Articulación/diagnóstico , Concienciación , Niño , Preescolar , Cognición , Femenino , Humanos , Alfabetización , Masculino
19.
Int J Lang Commun Disord ; 53(1): 130-143, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-28741729

RESUMEN

BACKGROUND: Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. AIMS: To assess the influence of different timing of hard palate closure in a two-stage procedure on articulation skills in 3-year-olds born with unilateral cleft lip and palate (UCLP). Secondary aims were to compare results with peers without CP, and to investigate if there are gender differences in articulation skills. Furthermore, burden of treatment was to be estimated in terms of secondary surgery, hearing and speech therapy. METHODS & PROCEDURES: A randomized controlled trial (RCT). Early hard palate closure (EHPC) at 12 months versus late hard palate closure (LHPC) at 36 months in a two-stage procedure was tested in a cohort of 126 Danish-speaking children born with non-syndromic UCLP. All participants had the lip and soft palate closed around 4 months of age. Audio and video recordings of a naming test were available from 113 children (32 girls and 81 boys) and were transcribed phonetically. Recordings were obtained prior to hard palate closure in the LHPC group. The main outcome measures were percentage consonants correct adjusted (PCC-A) and consonant errors from blinded assessments. Results from 36 Danish-speaking children without CP obtained previously by Willadsen in 2012 were used for comparison. OUTCOMES & RESULTS: Children with EHPC produced significantly more target consonants correctly (83%) than children with LHPC (48%; p < .001). In addition, children with LHPC produced significantly more active cleft speech characteristics than children with EHPC (p < .001). Boys achieved significantly lower PCC-A scores than girls (p = .04) and produced significantly more consonant errors than girls (p = .02). No significant differences were found between groups regarding burden of treatment. The control group performed significantly better than the EHPC and LHPC groups on all compared variables.


Asunto(s)
Trastornos de la Articulación/cirugía , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Paladar Duro/cirugía , Trastornos de la Articulación/etiología , Trastornos de la Articulación/terapia , Lenguaje Infantil , Preescolar , Labio Leporino/complicaciones , Fisura del Paladar/complicaciones , Dinamarca , Femenino , Humanos , Masculino , Logoterapia , Factores de Tiempo , Resultado del Tratamiento
20.
BMJ Case Rep ; 20172017 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-29018013

RESUMEN

Isolated pulmonary arteriovenous malformations (PAVM) are rare, but can be responsible for paradoxical embolic events. It is important to recognise these situations early and intervene quickly to attain the best outcome. We describe the case of a 45-year-old woman with a long-standing history of migraines with aura who presented to the emergency department with left-sided weakness and slurred speech. Work-up was unclear and she was diagnosed with cryptogenic stroke. Follow-up transoesophageal echocardiogram was suggestive of an atrial septal defect, though no clear defect was evident. Pulmonary angiography revealed an isolated PAVM arising from the right lower lung segmental artery with a 2 mm feeding artery leading into 3-4 mm of dysplastic vessel that connects to the vein. The vessel was embolised successfully using a combination of a 4 mm Amplatzer Vascular Plug in the distal feeding artery and a 4 mm Nester coil proximally.


Asunto(s)
Fístula Arteriovenosa/complicaciones , Trastornos de la Articulación/etiología , Debilidad Muscular/etiología , Arteria Pulmonar/anomalías , Venas Pulmonares/anomalías , Accidente Cerebrovascular/etiología , Femenino , Humanos , Persona de Mediana Edad
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