The NeuroBel: A Screening Test for Verbal Language Impairment in Spanish-Speaking Elderly People With Cognitive Decline.

PURPOSE: The NeuroBel is a short test that can detect cognitive decline using language tasks. This study replicated previous research using larger clinical samples from three Spanish-speaking countries. METHOD: Eight tasks were used to analyze verbal language functioning using a psycholinguistic approach. A total of 232 elderly, monolingual Spanish speakers from Spain, Cuba, and Colombia participated in this study. Of these, 76 had Alzheimer's disease (AD) in the initial phase, 75 had mild cognitive impairment (MCI), and 81 did not exhibit cognitive impairment (healthy controls). RESULTS: Significant differences were observed among the three clinical groups. The participants with AD and the participants with MCI had significantly lower NeuroBel scores than the control group on most of the tasks. However, repetition (in AD vs. MCI) and auditory lexical decision (in MCI vs. control) tasks were not significant in Tukey's post hoc tests. Discriminant analysis showed that 80.6% of the participants were correctly classified into the original groups and revealed the tasks that were the best and worst for differentiating among groups. The receiver-operating characteristic curves showed high sensitivity for AD and MCI. The area under the curve was .97 in the contrast of AD versus MCI + controls, .96 in the determination of overall cognitive decline (AD + MCI vs. controls), and .93 in the contrast of MCI and control groups. CONCLUSION: This study confirmed that the NeuroBel is a suitable test for detecting cognitive decline based on language impairment in Spanish-speaking elderly people.

Voice feminization in male-to-female transgendered clients after Wendler's glottoplasty with vs. without voice therapy support.

The objective of this study was to evaluate the medium-term results of Wendler's glottoplasty surgery (WG) and the effects of post-operative voice therapy in a group of male-to-female transsexuals. This is a retrospective study of 18 transsexuals who voluntarily underwent WG between 2010 and 2014 at a single hospital. Ten of the subjects underwent an additional voice therapy training. The group was assessed pre- vs. post-treatments with a limited battery of measures consisting of fundamental frequency (Fo), maximum phonation time, the TSEQ transgender self-assessment questionnaire, and perceptual assessment of the voice (Visual Analog Scale and a simplified version of the classical Hirano-GRBAS scale) by inter-rater agreement. The surgical procedure consisted of a de-epithelialization of the anterior third of both vocal folds; this area was sutured, and the surface of both vocal folds was vaporized with a laser diode. The results showed a significant increase in vocal tone and feminization of voice in all participants, including a significant increase in Fo 12 months after treatment. Significant improvements were also shown in other evaluated measures, such as self-reported satisfaction and the degree of feminization of the voice. However, no improvements in maximum phonation time were observed. The use of voice therapy appears decisive for optimal improvement of this class of patients. WG applied appropriately by well-trained hands is thus a very effective and less traumatic procedure than other techniques that aim for an acceptable feminization of the voice in MtoF transgendered clients.

Specific Language Impairment: Evaluation and detection of differential psycholinguistic markers in phonology and morphosyntax in Spanish-speaking children.

BACKGROUND: The diagnosis of Specific Language Impairment (SLI) is very complex, given the variety of clinical pictures described in this disorder. Knowledge about the linguistic markers of SLI can facilitate its differentiation from the normal profile of language development. These markers can also be used as tools that may improve diagnostic. AIMS: To determine which psycholinguistic markers best discriminate Spanish-speaking children with SLI from children with typical language development. METHOD AND PROCEDURE: The performance of 31 Spanish-speaking children with SLI was analysed using a battery of 13 psycholinguistic tasks organized into two areas: phonology and morphosyntax. The performance of the SLI group was compared to that of two subgroups of controls: aged matched (CA) and linguistically matched (CL). OUTCOMES AND RESULTS: The data show that the SLI group performed worse than the CA subgroup on all 13 verbal tasks. However, the performance of the SLI group did not significantly differ from that of the CL subgroup on most (11/13) of the tasks. Stepwise discriminant analysis established the canonical function of three tasks (morphologic integration, sentence understanding and diadochokinesis) which significantly discriminated SLI from CA, with sensitivity 84% and specificity 90%. CONCLUSIONS AND IMPLICATIONS: These results contribute to determining the psycholinguistic and clinical characteristics of SLI in Spanish-speaking children and provide some methods for screening assessment.

Glotoplastia de Wendler y tratamiento logopédico en la feminización de la voz en transexuales: resultados de la valoración pre- vs. poscirugía / Wendler glottoplasty and voice-therapy in male-to-female transsexuals: results in pre and post-surgery assessment

Introducción: Con el avance de las técnicas en otorrinolaringología, buena parte de los transexuales que desean convertirse en mujeres solicitan una intervención que eleve la frecuencia fundamental de su voz (feminización). El médico otorrinolaringólogo y el logopeda abordan interdisciplinariamente esta creciente demanda social. El objetivo de este estudio es presentar los resultados obtenidos en un grupo de pacientes transexuales después de una sinequia anterior de Wendler, con tratamiento logopédico complementario. Métodos: Diez pacientes transexuales que desean convertirse en mujeres intervenidos mediante una glotoplastia de Wendler más terapia logopédica fueron evaluados. El procedimiento quirúrgico consistió en una desepitelización del tercio anterior de ambas cuerdas vocales, sutura de la zona desepitelizada y vaporización de la cara superior de ambas cuerdas con láser diodo. La evaluación de la voz pre- vs. poscirugía consistió en: medición de la Fo, tiempo máximo de fonación, autovaloración mediante el cuestionario TSEQ de valoración específica del paciente transexual y valoración perceptiva interjueces. Resultados: Todas las pacientes aumentaron significativamente su Fo (106 Hz en promedio) tras el tratamiento. Asimismo, se aprecian mejoras significativas en el nivel de satisfacción autoinformado y en el grado de feminización de la voz. No se observaron mejoras en el tiempo máximo de fonación. Conclusiones: La glotosplastia de Wendler es un procedimiento quirúrgico para conseguir la feminización de la voz, con buenos resultados a medio plazo y sin complicaciones médicas mencionables. El aumento de tono vocal se pudo observar mediante diversas medidas de control pre- vs. poscirugía más logopedia (AU)

Introduction: With the development of new ENT techniques, many male transsexuals who wish to become women usually request a surgical procedure to raise the fundamental frequency of the voice (feminization). The ENT specialist and the voice-therapist have to use an interdisciplinary approach to this growing social demand. The aim of this study was to show the results in a group of transsexual patients after Wendler's anterior synechiae, with additional voice-therapy treatment. Methods: Ten male transexulas who wish to become women patients who had Wendler glottoplasty and voice-therapy were assessed. The surgical procedure consisted of a de-epithelialization of the anterior third of both vocal folds; this area was sutured and the surface of both vocal folds was vaporised with laser diode. Pre- and postsurgery voice assessment consisted of measuring fundamental frequency (Fo) and maximum phonation time, administering the transgender self-assessment questionnaire (TSEQ) and obtaining perceptual voice assessment by inter-rater agreement. Results: All the male transsexuals who wish to become women patients significantly increased their Fo (106 Hz on average) after the treatment. Furthermore, significant improvements were shown in self-reported satisfaction and in the degree of voice feminization. No improvements in the maximum phonation time were observed. Conclusions: Wendler glottoplasty is a surgical procedure to contribute to feminising the voice, with good medium-term results and without noteworthy medical complications. The increase in vocal tone was observed using several pre- and post-surgery control measures and voice therap (AU)

Wendler glottoplasty and voice-therapy in male-to-female transsexuals: results in pre and post-surgery assessment.

INTRODUCTION: With the development of new ENT techniques, many male transsexuals who wish to become women usually request a surgical procedure to raise the fundamental frequency of the voice (feminization). The ENT specialist and the voice-therapist have to use an interdisciplinary approach to this growing social demand. The aim of this study was to show the results in a group of transsexual patients after Wendler's anterior synechiae, with additional voice-therapy treatment. METHODS: Ten male transexulas who wish to become women patients who had Wendler glottoplasty and voice-therapy were assessed. The surgical procedure consisted of a de-epithelialization of the anterior third of both vocal folds; this area was sutured and the surface of both vocal folds was vaporised with laser diode. Pre- and postsurgery voice assessment consisted of measuring fundamental frequency (Fo) and maximum phonation time, administering the transgender self-assessment questionnaire (TSEQ) and obtaining perceptual voice assessment by inter-rater agreement. RESULTS: All the male transsexuals who wish to become women patients significantly increased their Fo (106 Hz on average) after the treatment. Furthermore, significant improvements were shown in self-reported satisfaction and in the degree of voice feminization. No improvements in the maximum phonation time were observed. CONCLUSIONS: Wendler glottoplasty is a surgical procedure to contribute to feminising the voice, with good medium-term results and without noteworthy medical complications. The increase in vocal tone was observed using several pre- and post-surgery control measures and voice therapy.

Trastorno Específico del Lenguaje: Marcadores psicolingüísticos en semántica y pragmática en niños españoles / Specific Language Impairment: Markers into semantic and pragmatic areas in Spanish-speaking children

El objetivo del estudio fue determinar qué marcadores semánticos y pragmáticos sirven para discriminar mejor a niños con Trastorno Específico del Lenguaje (TEL) de niños con desarrollo normal del lenguaje. El estudio analiza los resultados de 31 niños hispanohablantes con TEL en una batería de 9 tareas psicolingüísticas. Sus resultados se compararon con el de dos subgrupos control: uno de niños emparejados en edad cronológica (CE) y otro de niños emparejados en edad lingüística (CL). Los datos mostraron que el grupo TEL realizó peor que el grupo CE la mayoría de las tareas (8/9). Sin embargo, el grupo TEL sólo fue significativamente peor que el CL en una de las tareas. Un primer Análisis Discriminante TEL vs CA estableció una función canónica con una Sensibilidad de 93,5% y una Especificidad de 87.1%. Un segundo Análisis Discriminante TEL vs CL estableció una función canónica con Sensibilidad de 77,4% y Especificidad de sólo 54.8%. Una tarea semántica (Definición de palabras) y una tarea pragmática (Lenguaje contextual) parecen ser las mejores tareas para establecer un perfil del TEL en estas áreas. Estos resultados se discuten a la luz de las implicaciones que pueden tener para el diagnóstico clínico y la psicopatología del lenguaje

The aim of this study is to determine which semantics and pragmatics markers best discriminate Spanish-speaking children with Specific Language Impairment (SLI) from children with typical language development. This study analyzes the performance of 31 Spanish-speaking children with SLI on a battery of 9 psycholinguistic tasks. The performance of the SLI children was compared with that of two subgroups of controls: aged-matched (CA) and linguistically matched (CL). The data show that the SLI group performed more poorly than the CA subgroup on most of the tasks (8/9). However, the SLI group performance only was significantly worse that of the CL subgroup on one of the tasks. A first Discriminant Analysis SLI vs CA established canonical function with Sensitivity 93,5% and Specificity 87,1%. A second Discriminant Analysis SLI vs CL identified a canonical function with Sensitivity 77,4% and Specificity only 54,8%. One semantic task (Definition of words) and another pragmatic task (Scene language) appear to be the best variables for establishing an SLI profile in this psycholinguistics areas. Discuss the implications of these findings for the clinical diagnosis and speech-language pathology

NEUROBEL: Breve batería neuropsicológica de evaluación del lenguaje oral en adultos-mayores. Datos normativos iniciales / NEUROBEL: Brief neuropsychological screening batteryof oral language in older-adults. First normative data

La batería NEUROBEL (Evaluación neuropsicológica del lenguaje en adultos) es una prueba breve que permite una valoración de sondeo de los procesos básicos de comprensión y producción del lenguaje. Consta de 8 tareas, que analizan el correcto funcionamiento del lenguaje oral desde el modelo teórico propuesto por la neuropsicología cognitiva. El objetivo de este trabajo ha consistido en realizar un estudio piloto de los valores de referencia normativos iniciales de esta batería en adultos y mayores. Para ello, se ha estudiado una muestra de 30 participantes sin deterioro cognitivo (MMSE ≥ 25), de ambos sexos y de más de 50 años. La batería NEUROBEL fue administrada a toda la muestra dividida en 2 grupos de edad: «adultos» (50-64) y «adultos-mayores» (> 65). Estos últimos analizados también según su lugar habitual de residencia (domicilio particular o centros de mayores). En el apartado Resultados se presentan las puntuaciones, tiempos de referencia y percentiles principales obtenidos en la batería. NEUROBEL se muestra como una herramienta válida y fiable, con altas correlaciones bivariadas entre las tareas. ANOVA univariantes muestran efectos de grupo y escolaridad en puntuación, a favor de los participantes más jóvenes y escolarizados. Por el contrario, el sexo no influye en los resultados alcanzados, aunque sí se muestra como un factor significativo en el tiempo de ejecución de la batería, a favor de las mujeres. Ciertas diferencias observadas en los resultados entre los participantes del grupo de mayores de 65 años, dependiendo de su lugar habitual de residencia y sexo, se debaten en el apartado Discusión (AU)

NEUROBEL (Neuropsychological assessment of language in adults) is a brief battery that allows a screening of the basic processes of language comprehension and production. It consists of 8 tasks, assessing oral-language processing from the theoretical model of cognitive neuropsychology. The aim has been to carry out a pilot study of initial normative data for NEUROBEL battery in older-adults. This in mind, we studied a sample of 30 male and female healthy participants aged over 50 without cognitive impairment (MMSE ≥ 25). The NEUROBEL battery was administered to all the participants, which were split into 2 groups: 'adults' (50-64) and 'older-adults' (> 65). The latter group was also analyzed according to their usual residence (private home or nursing home). In the Results section, it is shown the scores and time performances of the participants in the battery, as well as main percentiles. NEUROBEL is shown as a valid and reliable battery, including high Pearson's correlations among the tasks. Univariate ANOVAs show group and schooling effects in the scores of the battery for younger and more schooled participants. Conversely, sex factor does not influence the results achieved, although it is shown as significant variable in favor of the women for time execution of the tasks. Some differences among participants over 65 years old, depending on their usual place of residence and sex are debated in the Discussion (AU)

Evaluación del tratamiento logopédico en la rehabilitación de la disfonía en adultos: seguimiento de los efectos grupales y de las variaciones individuales / Evaluation of voice therapy for dysphonia in adults: follow-up of group effects and individual variability

Este estudio analiza las diferencias grupales e individuales en los resultados obtenidos tras la reeducación vocal de un grupo de pacientes disfónicos con diferentes diagnósticos, utilizando un protocolo multidimensional breve de evaluación. Las voces de 21 participantes con disfonía y 21 controles se evalúan y comparan en pretratamiento vs. postratamiento logopédico. El funcionamiento de la voz fue valorado antes y después del tratamiento mediante un conjunto de pruebas que incluían la videolaringostroboscopia, la valoración aerodinámica y tests de autoevaluación mediante cuestionarios de autoinforme. El grupo de tratamiento logopédico (TL) recibió 2 sesiones de terapia de la voz a la semana durante 3 meses. Tres reevaluaciones de seguimiento se llevaron también a cabo después de terminado el tratamiento para valorar la eficacia y la latencia del mismo. Un MANOVA con la prueba de la traza de Pillai mostró un efecto significativo de grupo del tratamiento logopédico en todas las variables evaluadas. Un T-test pretratamiento vs. postratamiento de los cambios individuales resultó también significativo en la mayoría de los participantes con disfonía, a pesar del amplio rango de puntuaciones mostrado (alta varianza) por las diferentes medidas utilizadas para valorar el programa de tratamiento logopédico aplicado. Los resultados corroboran la eficacia de la reeducación vocal con logopedia tanto en los análisis grupales como individuales en al menos algunos tipos de patologías de la voz. Sin embargo, ciertas características y antecedentes de los participantes se destacan como las más favorables para beneficiarse del tratamiento logopédico de la voz (AU)

This study analyzed group and individual differences in the results of vocal rehabilitation in a group of dysphonic patients with different diagnoses, using a brief multidimensional assessment protocol. The voices of 21 participants with dysphonia and 21 controls were evaluated and compared in a pre- vs. post-speech therapy treatment. Voice performance was assessed before and after treatment by a set of tests that included videolaryngostroboscopy, aerodynamic tasks, and self-rating questionnaires. The speech-therapy treatment group received two sessions of speech therapy a week for 3 months. Three follow-up reevaluations of group effects and individual variability were also carried out to assess the latency period after the end of treatment. MANOVA with Pillai's trace test showed a significant group effect of the vocal treatment on all of the variables assessed. A pre- vs. post- treatment T-test of individual changes was also significant in most of the dysphonic participants, despite the wide range of scores (high variance) in the different measures used after the voice therapy program. The results of both group and individual analyses support the effectiveness of vocal rehabilitation with speech therapy in at least some types of voice disorders. However, voice therapy was more effective in participants with certain characteristics and antecedents (AU)

Comparing voice-therapy and vocal-hygiene treatments in dysphonia using a limited multidimensional evaluation protocol.

PURPOSE: This study evaluates the effectiveness of two different programs of voice-treatment on a heterogeneous group of dysphonic speakers and the stability of therapeutic progress for longterm follow-up post-treatment period, using a limited multidimensional protocol of evaluation. METHOD: Forty-two participants with voice disorders were randomly assigned to one of two groups. Participants in group 1 received voice-therapy and participants in group 2 received a vocal-hygiene program. Vocal function was assessed before and after treatment. RESULTS: MANOVA analysis Pillai's trace test shows significant pre-post immediate differences between treatments in favor of direct-intervention. Repeated-measures ANOVAs display significant within subjects main effect for follow-up period in the 8 measures considered. Interaction effects of group×time are also found in five out of the eight continuous variables analyzed (3 aerodynamics-acoustic and 2 self-rating), indicating differences between both treatments. Qualitative dimensions (perceptual, laryngoscopic and spectrographic assessments) also support voice-therapy superiority. CONCLUSIONS: Results of this study suggest superiority of a voice-therapy (direct treatment) approach over a vocal-hygiene program (indirect treatment). This advantage is on the majority of the 8 continuous variables analyzed (aerodynamics, acoustic, and self-rating), including qualitative perceptual, laryngoscopic and spectrographic voice-dimensions. The stability of changes is extended during a post-treatment follow-up period. LEARNING OUTCOMES: (1) The reader should distinguish the advantage using one type of treatment or another in clinical contexts. (2) The reader must know the most important direct techniques used in clinical treatment of voice disorders.

Extending the use of Spanish Computer-assisted Anomia Rehabilitation Program (CARP-2) in people with aphasia.

PURPOSE: To extend the use of the Spanish Computer-assisted Anomia Rehabilitation Program (CARP-2) for anomia from a single case to a group of 15 people with aphasia. To evaluate whether the treatment is active (Phase 1) for this group (Robey & Schultz, 1998), providing potential explanations as to why. METHODS: Fifteen participants with chronic aphasia (with a range from moderate to mild anomia) were recruited to 15 weeks of computer-assisted therapy for anomia. A single treatment period with pre- and post-treatment assessments evaluated participants' ability to name 200 words using the multiple cues provided by the computer. Pre- and post-naming measures of all items examined the effect of treatment. Background linguistic and cognitive skills were measured before and after the therapy to investigate whether the improvements in naming were therapy specific. RESULTS: All 15 participants showed significant benefits in their naming skills after the therapy. There were no changes to cognitive and linguistic skills unrelated to anomia. There was evidence of some carry-over effects in naming. CONCLUSION: The Spanish Computer-assisted Anomia Rehabilitation Program (CARP-2) for anomia is an active treatment for a range of people who have anomia as part of their aphasia profile. LEARNING OUTCOMES: By the end of the paper you will be able to answer the CEU questions and consider whether to use computer assisted therapy on a wide range of clients with anomia difficulties.