Head position and its effect on pulmonary function in tetraplegic patients.

To test the influence of head position on pulmonary function in tetraplegic individuals 15 subjects with chronic C4-C7 injuries participated in a one group pre-post test comparing the relationship between orthostatic position of the head (OPH) and standard pulmonary function tests (PFTs). Twelve subjects with habitual forward head posture and three with non-forward head posture performed PFTs in (1) their habitual posture, and (2) an experimental posture imposed by placement of thoracic and/or lumbar rolls behind their back. Results showed that changing head posture did not alter mid-forced expiratory flow or forced inspiratory vital capacity, but significantly affected forced vital capacity (t = 2.83; P < 0.05) and 12 s maximum voluntary ventilation (t = 2.07; P < 0.05). In cases where pulmonary function was altered by head position, the resulting performance was best in the subject's habitual posture, although no differences in resting pulmonary tests were observed between subjects with and without forward head position. These data show that temporary postural alterations affecting OPH, if not allowing sufficient time for muscular adaptation, adversely affect pulmonary function in tetraplegic patients.

Correlates of sophisticated listener judgments of esophageal air intake noise.

Twenty-four laryngectomies, ranging widely in speaking ability, read a standard passage for audio recording. Four experienced voice clinicians rated the acceptability of the speakers' air intake noise. Independently, overall speech proficiency ratings were obtained for 18 of the subjects. Five objective measures of the subjects' esophageal speech were obtained using a real-time intensity display on a storage oscilloscope. Judges' reliability was determined by Pearson Product Moment Correlations. Ratings were submitted to multiple regression analysis. The means of air intake noise acceptability were the criterion variables; the objective measures and speech proficiency scores were the predictor variables. Three predictors were positively correlated (less than .01) with air intake acceptability: the number of syllables per intake, the sound intensity of the intake, and the rate of speech. Syllables per intake provided the largest share of the variance.

Judgments by children and adults regarding communication skills of esophageal speakers.

The intelligibility and acceptability of esophageal speech were judged by a group of children and a group of adults. Eight esophageal speakers demonstrating a range of speech proficiency and differing vocal characteristics were videotaped reading a children's story. These recordings were played to child and adult judges. Data were analyzed to provide information about within-group and between-group comparisons. Findings indicated that children achieved higher intelligibility scores and employed different values than did adults when listening to esophageal speech.

Cognitive loci of impairments in picture naming by aphasic subjects.

In order to identify the process or processes responsible for impaired naming by aphasic patients, ten aphasic adults and ten normal adults performed three independent tasks--picture naming, modified Sternberg picture recognition, and modified Sternberg random shape recognition (Sternberg, 1966). Response times and error percentages were the dependent variables. Independent variables in naming were stimulus codability measured in bits of uncertainty (two levels) and number of naming trials (three trials). Independent variables in the recognition tasks were uncertainty (two levels), number of stimuli to be remembered (two or four stimuli) and response type ("yes" or "no"). The results showed that uncertainty had significant effects on naming but not on recognition performance. The aphasic group produced significantly longer naming response times regardless of uncertainty level. The differences between groups were much greater for high-uncertainty pictures (1100 msec) than for low-uncertainty pictures (270 msec). A comparison of estimates of word retrieval times showed that the two subject groups differed significantly for high-uncertainty but not for low-uncertainty items. It was concluded that (1) use of the term "word retrieval problem" rather than "loss of memory problem" was justified to describe the major component in the aphasic naming impairment for high-uncertainty items, and (2) when naming low-uncertainty items these aphasic subjects did not demonstrate a word retrieval problem. The results indicate that treatment procedures designed to improve naming should be process rather than content oriented.

Short-term memory scan in normal individuals and individuals with aphasia.

Ten matched pairs of normal adults and adults with aphasia participated in a short-term memory, visual recognition paradigm wherein each determined whether or not a probe digit appeared in a subset of digits previously presented. Reaction times, measured in milliseconds from onset of probe digits until completion of visual-motor responses, were analyzed as a function of increasing subset size (two, four, and six digits) and the positive versus the negative response condition. Reaction times were significantly slower for the subjects with aphasia. Both groups of subjects demonstrated linear increases in reaction time across levels of subset size. For both groups, increases in reaction time were similar in the positive vs the negative-response conditions. Resulting parallel slopes suggested that both groups of subjects used a serial exhaustive scan of short-time memory. Results from this study did not support results obtained by others in previous studies which may have been confounded by group differences in visual retention spans.

Patient-controlled delivery of monosyllabic words in a test of auditory discrimination.

Normal- and sensorineural-hearing subjects repeated monosyllabic words under a conventional and subject-controlled method of presentation at 0, 8, 16, and 44 dB SL. Results of the study revealed little difference between discrimination scores obtained with the two methods of presentation. Discussion of clinical relevance was concerned with (1) saving of time, (2) standardization of test, and (3) favorable subjective reports of the new procedure.