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1.
J Voice ; 2022 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-35000836

RESUMO

INTRODUCTION: In recent years cepstral analysis and specific cepstrum-based measures such as smoothed cepstral peak prominence (CPPS) has become increasingly researched and utilized in attempts to determine the extent of overall dysphonia in voice signals. Yet, few studies have extensively examined how specific voice-source parameters affect CPPS values. OBJECTIVE: Using a range of synthesized tones, this exploratory study sought to systematically analyze the effect of fundamental frequency (fo), vibrato extent, source-spectrum tilt, and the amplitude of the voice-source fundamental on CPPS values. MATERIALS AND METHODS: A series of scales were synthesised using the freeware Madde. Fundamental frequency, vibrato extent, source-spectrum tilt, and the amplitude of the voice-source fundamental were systematically and independently varied. The tones were analysed in PRAAT, and statistical analyses were conducted in SPSS. RESULTS: CPPS was significantly affected by both fo and source-spectrum tilt, independently. A nonlinear association was seen between vibrato extent and CPPS, where CPPS values increased from 0 to 0.6 semitones (ST), then rapidly decreased approaching 1.0 ST. No relationship was seen between the amplitude of the voice-source fundamental and CPPS. CONCLUSION: The large effect of fo should be taken into account when analyzing the voice, particularly in singing-voice research, when comparing pre and posttreatment data, and when comparing inter-subject CPPS data.

2.
N Z Med J ; 134(1543): 39-50, 2021 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-34695075

RESUMO

AIM: Childhood visual impairment has a life-long impact that, with early access to eyecare, is largely avoidable. We aimed to understand visual impairment and its correction among Pacific youth in Aotearoa New Zealand. METHOD: The Pacific Islands Families Study is a birth cohort study that tracks an original sample of 1,398 Pacific children born at Middlemore Hospital (Auckland). This analysis focuses on assessed visual acuity (at 9- and 18-years, using 0.3logMAR or 6/12 as the cut-off for visual impairment) and participants' self-reports about accessing eyecare services. RESULTS: Less than a fifth of children (111/729, 15.2%) and teens (86/457, 18.8%) reported having sought eyecare. The percentage of participants with refractive correction was 3.6% (32/887) at 9-years and 14.3% (66/463) at 18-years. At 9-years, 1.9% of children (16/853) had visual impairment in one eye only, and 0.9% (8/853) had visual impairment impacting both eyes. By 18-years these values increased to 7.9% (36/456) and 4.2% (19/456), respectively. Among those with visual impairment, most children (15/24, 62.5%) and teens (32/55, 58.2%) reported they did not have refractive correction. CONCLUSION: Although prevalence of visual impairment is relatively low compared to non-Pacific youth, much of the reported impairment appears to be avoidable with improved eyecare.


Assuntos
Transtornos da Visão/etnologia , Transtornos da Visão/epidemiologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Nova Zelândia/epidemiologia , Prevalência , Acuidade Visual
3.
Clin Neurophysiol ; 132(12): 3025-3034, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34717223

RESUMO

OBJECTIVE: To systematically assess the body of literature using N400 and P600 as they relate to people with aphasia. The primary aim was to reveal patterns in the literature which could be used to direct future research in the development of clinically relevant Event-Related Potentials (ERPs) for language assessment, while also identifying gaps in existing knowledge and highlight areas of further inquiry. METHODS: A literature search was performed on studies published before May 2021. Relevant studies on aphasia and the two ERPs of interest were assessed for quality, and the relationship between aphasia and these ERPs was explored. RESULTS: A total of 721 articles were identified, with 30 meeting inclusion criteria. Although there is significant variation in the literature, this scoping review revealed people with aphasia show reduced amplitude, delayed latency and different distribution compared to controls, and that ERPs are modulated by severity of aphasia. CONCLUSIONS: To develop a relevant clinical tool for the management of aphasia, future research must strive to improve consistency within ERP methodology, with a greater number of diverse aphasia subtypes included in research. SIGNIFICANCE: This scoping review reveals N400 and P600 represent promising potential biomarkers for the diagnosis and ongoing management of aphasia.

4.
J Allied Health ; 50(3): 242-249, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34495036

RESUMO

BACKGROUND: Patient safety and quality care require learning organizations. For organizations to pivot and progress they need a workforce skilled and confident in voicing ideas and errors. Expressing issues related to patient safety and quality improvement can be defined as voice behavior. METHODS: This scoping review aimed to answer two questions: 1) What is the scope of the study of voice behavior in healthcare? 2) How do new graduates in allied health use their voice? The Joanna Briggs guidelines were used to identify 76 articles that were explored using a descriptive and evaluative approach to map the depth and breadth of this topic and identify research gaps. FINDINGS: The review revealed that nursing and medicine feature in voice behavior studies, but few studies focus on allied health. An exploration of the concepts emerging from these studies revealed eight topics: power, risk, tenure, leadership, intervention, self, climate, and strategies. CONCLUSION: Synthesis of the reviewed studies highlights that we know little about allied health new graduates' voice behavior in healthcare. Exploration of voice behaviors with this group will inform education and workplace settings about ways to grow professionals who are confident and competent in speaking up for patient safety and quality improvement.


Assuntos
Atenção à Saúde , Pessoal de Saúde , Instalações de Saúde , Humanos , Aprendizagem , Recursos Humanos
5.
Nat Aging ; 1(3): 295-308, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33796868

RESUMO

Some humans age faster than others. Variation in biological aging can be measured in midlife, but the implications of this variation are poorly understood. We tested associations between midlife biological aging and indicators of future frailty-risk in the Dunedin cohort of 1037 infants born the same year and followed to age 45. Participants' Pace of Aging was quantified by tracking declining function in 19 biomarkers indexing the cardiovascular, metabolic, renal, immune, dental, and pulmonary systems across ages 26, 32, 38, and 45 years. At age 45 in 2019, participants with faster Pace of Aging had more cognitive difficulties, signs of advanced brain aging, diminished sensory-motor functions, older appearance, and more pessimistic perceptions of aging. People who are aging more rapidly than same-age peers in midlife may prematurely need supports to sustain independence that are usually reserved for older adults. Chronological age does not adequately identify need for such supports.

6.
Brain Sci ; 11(4)2021 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-33917776

RESUMO

Individuals with Autism Spectrum Disorder (ASD) experience challenges with social communication, often involving emotional elements of language. This may stem from underlying auditory processing difficulties, especially when incoming speech is nuanced or complex. This study explored the effects of auditory training on social perception abilities of children with ASD. The training combined use of a remote-microphone hearing system and computerized emotion perception training. At baseline, children with ASD had poorer social communication scores and delayed mismatch negativity (MMN) compared to typically developing children. Behavioral results, measured pre- and post-intervention, revealed increased social perception scores in children with ASD to the extent that they outperformed their typically developing peers post-intervention. Electrophysiology results revealed changes in neural responses to emotional speech stimuli. Post-intervention, mismatch responses of children with ASD more closely resembled their neurotypical peers, with shorter MMN latencies, a significantly heightened P2 wave, and greater differentiation of emotional stimuli, consistent with their improved behavioral results. This study sets the foundation for further investigation into connections between auditory processing difficulties and social perception and communication for individuals with ASD, and provides a promising indication that combining amplified hearing and computer-based targeted social perception training using emotional speech stimuli may have neuro-rehabilitative benefits.

7.
JAMA Psychiatry ; 78(5): 530-539, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33595619

RESUMO

Importance: Individuals with mental disorders are at an elevated risk of developing chronic age-related physical diseases. However, it is not clear whether psychopathology is also associated with processes of accelerated aging that precede the onset of age-related disease. Objective: To test the hypothesis that a history of psychopathology is associated with indicators of accelerated aging at midlife. Design, Setting, and Participants: This prospective cohort study was based on the Dunedin Multidisciplinary Health and Development Study, a population-representative birth cohort of 1037 individuals born between April 1, 1972, and March 31, 1973, in Dunedin, New Zealand. Members were followed up to age 45 years (until April 2019). Data were analyzed from January 6 to December 7, 2020. Exposures: Mental disorders were assessed in 6 diagnostic assessments from ages 18 to 45 years and transformed through confirmatory factor analysis into continuous measures of general psychopathology (p-factor) and dimensions of internalizing, externalizing, and thought disorders (all standardized to a mean [SD] of 100 [15]). Main Outcomes and Measures: Signs of aging (biological pace of aging; declines in sensory, motor, and cognitive functioning; and facial age) were assessed up to age 45 years using previously validated measures including biomarkers, clinical tests, and self-reports. Results: Of the original 1037 cohort participants, 997 were still alive at age 45 years, of whom 938 (94%) were assessed (474 men [50.5%]). Participants who had experienced more psychopathology exhibited a faster pace of biological aging (ß, 0.27; 95% CI, 0.21-0.33; P < .01); experienced more difficulties with hearing (ß, 0.18; 95% CI, 0.12-0.24; P < .01), vision (ß, 0.08; 95% CI, 0.01-0.14; P < .05), balance (ß, 0.20; 95% CI, 0.14-0.26; P < .01), and motor functioning (ß, 0.19; 95% CI, 0.12-0.25; P < .01); experienced more cognitive difficulties (ß, 0.24; 95% CI, 0.18-0.31; P < .01); and were rated as looking older (ß, 0.20; 95% CI, 0.14-0.26; P < .01). Associations persisted after controlling for sex, childhood health indicators, maltreatment, and socioeconomic status and after taking into account being overweight, smoking, use of antipsychotic medication, and the presence of physical disease. Tests of diagnostic specificity revealed that associations were generalizable across externalizing, internalizing, and thought disorders. Conclusions and Relevance: In this cohort study, a history of psychopathology was associated with accelerated aging at midlife, years before the typical onset of age-related diseases. This link is not specific to any particular disorder family but generalizes across disorders. Prevention of psychopathology and monitoring of individuals with mental disorders for signs of accelerated aging may have the potential to reduce health inequalities and extend healthy lives.

8.
Auris Nasus Larynx ; 48(1): 65-74, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32736886

RESUMO

OBJECTIVE: To explore the behavioural and functional performance of a group of children with conductive unilateral hearing loss (UHL) due to congenital aural atresia. METHOD: Twelve children aged 7 to 16 years (Mage 10.0, SD 3.1 years) formed the UHL group and 15 age-matched children (Mage 9.5, SD 3.6 years) with normal hearing formed the control group. Auditory skills were assessed using tests of sound localisation, spatial speech perception in noise, and self-ratings of auditory abilities (Listening Inventory for Education; LIFE and Speech, Spatial and Qualities of Hearing scale; SSQ). RESULTS: When speech was directed to the good ear, performance was poorer than for normal hearing controls. Sound localisation abilities were impaired in children with UHL. Children with UHL reported higher levels of difficulties in classroom settings compared to children with normal hearing, particularly for activities involving listening in noise and focused listening activities. Older children self-report and parents report difficulties for their children across all SSQ scales. CONCLUSIONS: Children with UHL showed a wide range of auditory difficulties. As expected, speech recognition in noise differed from controls. Sound localisation abilities were variable; greater variability was seen for right ear hearing losses suggesting that some of these children may have developed compensatory mechanisms. Younger children identified listening difficulties for school situations where focussed auditory attention was needed. Older children and parents reported greatest difficulty for activities requiring perception of the direction, distance, and movement of sound. Higher levels of effort and inability to ignore sounds were reported as major difficulties.


Assuntos
Anormalidades Congênitas , Orelha/anormalidades , Perda Auditiva Condutiva , Perda Auditiva Unilateral , Localização de Som , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Feminino , Perda Auditiva Condutiva/fisiopatologia , Perda Auditiva Unilateral/fisiopatologia , Testes Auditivos , Humanos , Masculino , Pais , Mascaramento Perceptivo , Autorrelato , Percepção da Fala , Inquéritos e Questionários
9.
Clin Linguist Phon ; 35(8): 793-808, 2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-33021121

RESUMO

Public speaking has been described as one of the most daunting tasks one can engage in, even more so for people with aphasia (PWA). Gavel Clubs (affiliated with Toastmasters International) were established over 20 years ago for those who want to engage in public speaking but do not meet the eligibility criteria for Toastmasters membership. This study is the first of its kind to systematically evaluate changes in the speeches of PWA attending a weekly Gavel Club. The aims were to compare Table Topics (TT) and Prepared Speeches (PS) which are two different tasks regularly performed in a Gavel Club; to measure linguistic change over time in the two speech types; and to determine the feasibility of a discourse measure for analysing public speeches. Thirty-six speeches (four each from nine PWA) were audio-recorded, transcribed and analysed using the Linguistic Communication Measure (LCM). The nine participants represented a wide range of aphasia severity. Analysis revealed that engaging in weekly speaking activities in the GC was associated with an improvement in conveying content and in grammaticality through an increase in total number of words and number of correct words produced. The LCM is a comprehensive analysis tool but proved to be challenging in its speed and utility when measuring linguistic change in public speeches of PWA. Regular GC participation appears to facilitate improved language abilities, but we have yet to find the best tool to demonstrate this.


Assuntos
Afasia , Fala , Comunicação , Humanos , Linguística
10.
Int J Pediatr Otorhinolaryngol ; 141: 110510, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33248714

RESUMO

OBJECTIVES: In New Zealand (NZ), permanent hearing loss is associated with higher levels of socioeconomic deprivation, and is more prevalent amongst Maori and Pacific than NZ European children. Many of these hearing losses are detected through newborn hearing screening, however there is a need to screen children again later, to look for childhood hearing losses that are either late-onset, progressive, or acquired. This study evaluated the feasibility of implementing an objective screening protocol that includes otoscopy, distortion product otoacoustic emission screening (DPOAEs), and tympanometry. It also evaluated the feasibility of using Early Learning Centres (ELCs) to contact families, recruit, and test 3-year-old children from an area of high socioeconomic deprivation in Auckland, New Zealand. METHODS: Sixty-one 3-year-old children were recruited from ELCs within the Counties Manukau District Health Board (CMDHB) region which services the geographical area of South Auckland. The first part of the screening protocol consisted of otoscopy, DPOAEs, and tympanometry. Children identified with hearing loss and/or middle ear problems were either referred directly to Otolaryngology/Audiology at the local hospital or invited back for a re-screen 4-8 weeks later. Children who were referred from the screening were followed up to track and document their subsequent clinical pathway through the public health system. RESULTS: Mean overall time for the screening protocol was 4.1 minutes. The combination of otoscopy, DPOAEs, and tympanometry was well accepted by the 3-year-old children. DPOAE amplitude and signal-to-noise ratio results significantly differentiated between different tympanometry results, providing support for this combination of measures to accurately screen for hearing loss and/or middle ear disease. Thirty-eight of the 61 children (62%) passed the screening protocol. Of the remaining 23 children, five were referred to the hospital after not passing the screening, but following more in-depth audiological testing, were discharged with normal hearing. Six children referred to the hospital were diagnosed with varying degrees of conductive hearing loss, and two of the six received grommet insertion surgery. The remaining 12 children who were referred to the hospital were lost to follow-up, highlighting challenges for the families to successfully navigate the current public health system. CONCLUSION: This study demonstrates that identifying hearing loss and ear disease in 3-year-old children in the pre-school setting is feasible. A number of barriers were identified in the current health system that contribute to a large proportion of children referred with suspected hearing loss and ear disease being unsuccessful in accessing Otolaryngology/Audiology clinical care through the local hospital.


Assuntos
Testes de Impedância Acústica , Emissões Otoacústicas Espontâneas , Pré-Escolar , Estudos de Viabilidade , Humanos , Nova Zelândia/epidemiologia , Otoscopia
11.
J Health Organ Manag ; 31(2): 709-724, 2020 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-32979045

RESUMO

PURPOSE: Highly-experienced allied health professionals have the opportunity to perform at the expert-level by sharing knowledge and skills with more junior staff, with the aim of upskilling the workforce. The study explored the current motivators, aspirations and the role of work in the life of highly-experienced practitioners, revealing factors that hinder or support them to further develop their own expertise and be inspiring role-models and mentors for less experienced staff. DESIGN/METHODOLOGY/APPROACH: Taking a grounded theoretical research design, we report on interviews with 45 allied health practitioners with at least seven years of professional experience from different professions and across organisational sectors. Transcripts were coded iteratively in conjunction with reviewing the literature, and cases were categorised to form a conceptual typology of work orientation. FINDINGS: Four work orientations are characterised capturing the diversity of the allied health workforce, particularly in relation to two dimensions of personal fulfilment and future ambition. The relationship between the types and expert-level performance is discussed, leading to recommendations for support that can be implemented to develop and sustain expert-level performance within a community. ORIGINALITY/VALUE: A new view of work orientation is introduced that relates expert-level performance with meaningful work. The findings highlight a diversity of work orientation for highly-experienced allied health professionals, that all require managerial awareness. Once recognised, the four types would benefit from different supports that could develop and maintain expert-level performance in those that seek it. Alternatives are also available for those that do not. Implications for workforce policy are discussed.


Assuntos
Pessoal Técnico de Saúde , Competência Clínica , Satisfação no Emprego , Adulto , Idoso , Pessoal Técnico de Saúde/psicologia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Pesquisa Qualitativa , Adulto Jovem
12.
Lang Speech Hear Serv Sch ; 51(4): 1049-1070, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-32755504

RESUMO

Purpose The current study was designed to investigate the differences in language input related to family factors (maternal level of education [MLE] and socioeconomic level of deprivation [SLD]) and their association with language outcomes in preschoolers. Method This study used New Zealand SLD and MLE classification systems to examine differences in language input related to these factors among 20 typically developing preschool children aged 2-5 years. The quantity of children's language input (adult words [AWs], conversational turns [CTs]) was calculated using the Language ENvironment Analysis audiotaping technology for two typical weekend days. Four 5-min Language ENvironment Analysis recording segments were transcribed and coded, and parental language strategies were classified as optimal language strategy, moderate language strategy, or sub-optimal language strategy (S-OLS) for child language outcomes. The receptive and expressive language of each child was assessed using the Preschool Language Scales-Fifth Edition. Results Mann-Whitney U tests showed significant differences between the quantity of language input (AWs/hr, CTs/hr) for high and low MLE and high and low SLD groups. Consistent with the literature, the use of S-OLSs was significantly lower for families with high MLE (Mdn = .25, IQR = .14) and low SLD (Mdn = .22, IQR = .13) than for families with low MLE (Mdn = .41, IQR = .24) and high SLD (Mdn = .41, IQR = .26). Spearman correlation coefficients indicated significant associations between language input (AWs/hr, CTs/hr, S-OLSs) and language outcomes. Conclusions Reduced language input and the frequent use of S-OLSs associated with low maternal education and high deprivation and low language outcomes for these children highlight the importance for all parents/families to learn optimal language strategies to support the development of strong language skills in their children in young age.


Assuntos
Comunicação , Escolaridade , Desenvolvimento da Linguagem , Classe Social , Aptidão , Linguagem Infantil , Pré-Escolar , Feminino , Humanos , Idioma , Aprendizagem , Masculino , Nova Zelândia , Pais , Pobreza
13.
Int J Speech Lang Pathol ; 22(3): 281-289, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32686594

RESUMO

Purpose: Te whare tapa wha represents a Maori view of health and wellness in four dimensions: taha wairua (spiritual health), taha hinengaro (mental health), taha tinana (physical health) and taha whanau (family health). This model of health focuses on indigenous Maori in Aotearoa/New Zealand but has relevance for all people. Speech-language pathologists, including those not familiar with this model, recognise that all four dimensions are needed to support health and wellbeing. Taha wairua includes the importance of culture and heritage to personal identity, an area that speech-language pathology (SLP) recognises as key to clinical competency. Taha hinengaro includes the need to express thoughts and feelings, another area particularly salient to SLP. The other two dimensions taha tinana (physical health) and taha whanau (family health) are arguably more familiar in the day-to-day work of speech-language pathologists.Method: Two broad strands of research are examined within this model of health exploring the challenges faced by vulnerable populations namely: (1) two community based groups (a Choir and a Gavel Club) for people with acquired neurological conditions such as stroke and Parkinson's disease, and (2) diagnosis and management of hearing loss and auditory processing disorder.Result: Community based groups, explored through the CeleBRation Choir and the Gavel Club, highlighted the application of all aspects of te whare tapa wha to the experiences of people with neurological conditions participating in these community therapies. In the area of hearing loss and auditory processing disorder, gaps across all four dimensions of taha wairua, taha hinengaro, taha tinana and taha whanau were identified in the available literature and in examination of clinical provision for participants.Conclusion: Te whare tapa wha provides a framework to consider all the elements that contribute to people living well while experiencing communication challenges within their whanau (extended family). This approach relies on strong partnerships between clinicians, extended family, researchers, communities, organisations and other professionals. Clinicians and researchers are encouraged to consider how their beliefs, practices and impact could improve through consideration of Indigenous health models such as te whare tapa wha.


Assuntos
Patologia da Fala e Linguagem/métodos , Humanos , Pesquisa Qualitativa
14.
Disabil Rehabil ; : 1-8, 2020 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-32721200

RESUMO

PURPOSE: Because of the limited number of Spanish validated questionnaires available to assess auditory functionality in daily life situations in adults, the purpose of this study was to investigate the validity and the reliability of the Spanish version of the Speech, Spatial and Qualities of Hearing 12 items scale (sp-SSQ12), adapted from the published Spanish SSQ49, and to provide reference data for normal and hearing-impaired populations. METHODS: The SSQ12 is a self-report questionnaire, consisting of 12 items assessing a range of daily life listening situations. One hundred fifty adults (101 female) with a mean age of 53.9 years (SD 20.3; range 20-88 years) took part in the study. Internal consistency, test-retest reliability, validity, and floor and ceiling effects were investigated. RESULTS: The sp-SSQ12 questionnaire had high internal consistency (Cronbach's alpha = 0.95) and test-retest scores were highly correlated (ICC = 0.79). There was minimal evidence of floor and ceiling effects in our sample. Significant differences were observed overall and for the three subscales between normal and hearing-impaired groups. Although some significant differences in SSQ12 scores between groups of participants from different countries, these differences were minimal. CONCLUSIONS: The sp-SSQ12 questionnaire is a valid and reliable tool that is easy to administer and requires a short time to answer. We recommend the use of this tool for the assessment of functional hearing in the Spanish-speaking population.Implication for rehabilitationHearing loss impacts people's lives in a number of ways that are captured in the SSQ.The sp-SSQ12 is a valid and reliable tool for assessing everyday listening abilities and limitations experienced by Spanish-speaking adults with hearing loss.The sp-SSQ12 can be incorporated in the hearing rehabilitation process as a tool for evaluating and improving hearing assessment and rehabilitation programs.The sp-SSQ12 can help to identify adults who require a comprehensive hearing assessment.

15.
Data Brief ; 30: 105372, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32215300

RESUMO

This article describes the data regarding the calculations of language input from the natural language environments of children with hearing loss, taken from four full typical days in a week using a LENA (Language ENvironment Analysis) digital recorder. Calculations were based on 14 children with hearing loss from 24 to 60 months as they interacted with their family. Participants were recruited from the Hearing House, the Speech Clinic at the University of Auckland, and Early Childcare Centers (ECC) in Auckland, New Zealand. All families were interacting with their children orally without using sign language. Data were collected from natural language environments from May 2018 to May 2019. Language environments were examined in terms of daily quantity of language input and styles of oral interaction children were exposed to when interacting with their parent/primary caregiver. To determine quantity of language input, two kinds of observations were taken from the LENA automatic calculation of the number of adult words and number of conversational turns. Segments of the recordings were manually transcribed and coded onto 17 styles of oral interaction, which were further classified into three categories (optimal, moderate, and sub-optimal).

16.
Ear Hear ; 41(3): 539-548, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31567496

RESUMO

OBJECTIVES: Hearing impairment in childhood is a serious disability that can impose a heavy social and economic burden on individuals and families. It was hypothesized that hearing loss or middle ear disease in 11-year-old Pacific children living in New Zealand would be associated with higher levels of engagement in (1) delinquent behaviors, and (2) clinical level internalizing and externalizing problem behaviors than Pacific children with no hearing loss or middle ear disease. Based on earlier findings, peer pressure, self-perception, physical punishment (slapping), sex, and ethnicity were controlled for in the association between hearing difficulties and behavioral outcomes. DESIGN: In the school setting, pure-tone audiometry and immittance audiometry assessments were used to establish the hearing level in 11-year-old Pacific children (n = 920). These children also completed multidisciplinary questionnaires, which included questions about involvement in delinquent behaviors, peer pressure, and self-perception. In the home setting, maternal reports were gathered on internalizing and externalizing problem behaviors in their offspring, their parenting style, and sociodemographic details. RESULTS: A significant effect of hearing level was detected for the odds of reporting mild delinquency versus no delinquency (odds ratio: 1.02, 95% CI: 1.00 to 1.05), and odds of moderate delinquency versus no delinquency (odds ratio: 0.97, 95% CI: 0.94 to 1.00). No significant effect was detected for hearing level and severe delinquency or internalizing or externalizing behavioral problems in the clinical range. Middle ear disease (abnormal tympanogram in the worse ear) was not significantly associated with delinquency at any level or with internalizing behaviors in the clinical range. However, children with middle ear disease were significantly less likely than all other participants to exhibit disruptive externalizing behavior in the clinical range. CONCLUSIONS: Relatively young children with hearing loss reported engagement in moderate levels of delinquency that represent serious antisocial and potentially violent acts. This finding provides evidence of the significant effect that hearing loss has on child behavior. This association between hearing loss and moderate delinquency requires ethnic-specific interventions that are targeted for maximum benefit at appropriate times in childhood to mitigate potentially long-term health, educational, and behavioral risks.


Assuntos
Transtornos do Comportamento Infantil , Perda Auditiva , Comportamento Problema , Criança , Transtornos do Comportamento Infantil/epidemiologia , Pré-Escolar , Perda Auditiva/epidemiologia , Humanos , Nova Zelândia/epidemiologia , Poder Familiar
17.
Ear Hear ; 41(3): 630-639, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31633599

RESUMO

OBJECTIVES: With the advent of newborn hearing screening and early intervention, there is a growing interest in using supra-threshold obligatory cortical auditory evoked potentials (CAEPs) to complement established pediatric clinical test procedures. The aim of this study was to assess the feasibility, and parent acceptability, of recording infant CAEPs. DESIGN: Typically developing infants (n = 104) who had passed newborn hearing screening and whose parents expressed no hearing concerns were recruited. Testing was not possible in 6 infants, leaving 98, age range 5 to 39 weeks (mean age = 21.9, SD = 9.4). Three short duration speech-like stimuli (/m/, /g/, /t/) were presented at 65 dB SPL via a loudspeaker at 0° azimuth. Three criteria were used to assess clinical feasibility: (i) median test duration <30 min, (ii) >90% completion rate in a single test session, and (iii) >90% response detection for each stimulus. We also recorded response amplitude, latency, and CAEP signal to noise ratio. Response amplitudes and residual noise levels were compared for Fpz (n = 56) and Cz (n = 42) noninverting electrode locations. Parental acceptability was based on an 8-item questionnaire (7-point scale, 1 being best). In addition, we explored the patient experience in semistructured telephone interviews with seven families. RESULTS: The median time taken to complete 2 runs for 3 stimuli, including preparation, was 27 min (range 17 to 59 min). Of the 104 infants, 98 (94%) were in an appropriate behavioral state for testing. A further 7 became restless during testing and their results were classified as "inconclusive." In the remaining 91 infants, CAEPs were detected in every case with normal bilateral tympanograms. Detection of CAEPs in response to /m/, /g/, and /t/ in these individuals was 86%, 100%, and 92%, respectively. Residual noise levels and CAEP amplitudes were higher for Cz electrode recordings. Mean scores on the acceptability questionnaire ranged from 1.1 to 2.6. Analysis of interviews indicated that parents found CAEP testing to be a positive experience and recognized the benefit of having an assessment procedure that uses conversational level speech stimuli. CONCLUSIONS: Test duration, completion rates, and response detection rates met (or were close to) our feasibility targets, and parent acceptability was high. CAEPs have the potential to supplement existing practice in 3- to 9-month olds.


Assuntos
Percepção da Fala , Estimulação Acústica , Criança , Potenciais Evocados Auditivos , Estudos de Viabilidade , Humanos , Lactente , Recém-Nascido , Pais , Fala
18.
Front Psychol ; 10: 2481, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31803088

RESUMO

Background: Some children appear to not hear well in class despite normal hearing sensitivity. These children may be referred for auditory processing disorder (APD) assessment but can also have attention, language, and/or reading disorders. Despite presenting with similar concerns regarding hearing difficulties in difficult listening conditions, the overall profile of deficits can vary in children with suspected or confirmed APD. The current study used cluster analysis to determine whether subprofiles of difficulties could be identified within a cohort of children presenting for auditory processing assessment. Methods: Ninety school-aged children (7-13 years old) with suspected APDs were included in a cluster analysis. All children had their reading, language, cognition and auditory processing assessed. Parents also completed the Children's Auditory Performance Scale (CHAPS). Cluster analysis was based on tasks where age-norms were available, including word reading (Castles and Coltheart irregular and non-words test), phonological awareness (Queensland University Inventory of Literacy), language [Comprehensive Language of Assessment-4, Comprehensive Assessment of Spoken Language (CASL)], sustained attention (Continuous Performance Test), working memory (digits forward and backward), and auditory processing [Frequency Pattern Test (FPT), Dichotic Digits Test (DDT)]. Hierarchical cluster analysis was undertaken to determine the optimal number of clusters for the data, followed by a k-means cluster analysis. Results: Hierarchical cluster analysis suggested a four-group solution. The four subgroups can be summarized as follows: children with (1) global deficits, n = 35; (2) poor auditory processing with good word reading and phonological awareness skills, n = 22; (3) poor auditory processing with poor attention and memory but good language skills, n = 15; and (4) poor auditory processing and attention with good memory skills, n = 18. Conclusion: The cluster analysis identified distinct subgroups of children. These subgroups display the variation in areas of difficulty observed across different studies in the literature (e.g., not every child with APD has an attention deficit), highlighting the heterogeneous nature of APD and the need to assess a range of skills in children with suspected APD. It would be valuable for future studies to independently verify these subgroups and to determine whether interventions can be optimized based on these subgroups.

19.
J Allied Health ; 48(3): 226-232, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31487363

RESUMO

BACKGROUND: Although experienced and expert practitioners are valuable resources for the continuing professional development of other healthcare staff, there is not always a desire to take on this role. Sharing expertise benefits other practitioners, the profession, and healthcare overall. When professionals are unwilling to share, it is a missed opportunity to achieve the best outcomes for patients. METHODS: A narrative review of the literature in relation to professional confidence and expertise across allied health disciplines revealed a number of potential threats to professional confidence and consequently willingness to share information in an 'expert' role. FINDINGS: There is limited literature addressing development of professional confidence post-qualification, particularly after the first year of practice. Role ambiguity, unclear scope of practice, low professional status, and role conflict all threaten the confidence of practitioners. The importance of reflection as a practice to develop and maintain confidence is highlighted in both the student and practitioner literature. CONCLUSION: Training organisations and health workforce employers should consider how professional confidence can be developed and maintained across the career span, with subsequent benefits for development of expertise and knowledge sharing. Recommendations for reflexive thinking and conversations are included.


Assuntos
Pessoal Técnico de Saúde , Competência Clínica/normas , Autoeficácia , Pessoal Técnico de Saúde/educação , Humanos
20.
J Speech Lang Hear Res ; 62(9): 3470-3492, 2019 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-31479621

RESUMO

Purpose This systematic review summarizes the evidence for differences in the amount of language input between children with and without hearing loss (HL). Of interest to this review is evaluating the associations between language input and language outcomes (receptive and expressive) in children with HL in order to enhance insight regarding what oral language input is associated with good communication outcomes. Method A systematic review was conducted using keywords in 3 electronic databases: Scopus, PubMed, and Google Scholar. Keywords were related to language input, language outcomes, and HL. Titles and abstracts were screened independently, and full-text manuscripts meeting inclusion criteria were extracted. An appraisal checklist was used to evaluate the methodological quality of studies as poor, good, or excellent. Results After removing duplicates, 1,545 study results were extracted, with 27 eligible for full-text review. After the appraisal, 8 studies were included in this systematic review. Differences in the amount of language input between children with and without HL were noted. Conversational exchanges, open-ended questions, expansions, recast, and parallel talk were positively associated with stronger receptive and expressive language scores. The quality of evidence was not assessed as excellent for any of the included studies. Conclusions This systematic review reveals low-level evidence from 8 studies that specific language inputs (amount and style) are optimal for oral language outcomes in children with HL. Limitations were identified as sample selection bias, lack of information on control of confounders and assessment protocols, and limited duration of observation/recordings. Future research should address these limitations.


Assuntos
Linguagem Infantil , Comunicação , Perda Auditiva , Criança , Perda Auditiva/fisiopatologia , Humanos , Fala
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