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1.
Codas ; 32(4): e20190152, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32401996

RESUMO

Purpose This study investigated the influence of the cleft type on the appearance of hypernasality after surgical maxillary advancement (MA). Methods Nasality was determined by measurement of nasalance (acoustic correlate of nasality) by nasometry. The study involved analysis of the nasalance scores of 17 individuals with isolated cleft palate (CP), 118 with unilateral cleft lip and palate (UCLP) and 69 with bilateral cleft lip and palate (BCLP), of both sexes, aged 18 to 28 years, after MA. Only individuals with normal nasalance scores indicating balanced resonance before MA were included in this study. Nasometry was performed 3 days before and 15 months after MA, on average. The proportion of patients who presented nasalance scores indicating hypernasality after surgery was calculated by the ANOVA test, and comparison among the different cleft types was evaluated by the chi-square test (p < 0.05). Results No significant difference was found in the proportions of individuals with hypernasality among the cleft types. Conclusion Nasometry showed that the appearance of hypernasality after MA in individuals with cleft palate with or without cleft lip occurred in similar proportions, regardless of the cleft type.


Assuntos
Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Procedimentos Cirúrgicos Ortognáticos/efeitos adversos , Distúrbios da Fala/etiologia , Fala/fisiologia , Insuficiência Velofaríngea/etiologia , Adolescente , Adulto , Fenda Labial/fisiopatologia , Fissura Palatina/fisiopatologia , Feminino , Humanos , Masculino , Maxila/cirurgia , Osteotomia de Le Fort/efeitos adversos , Estudos Retrospectivos , Distúrbios da Fala/fisiopatologia , Medida da Produção da Fala , Insuficiência Velofaríngea/fisiopatologia , Adulto Jovem
2.
J Appl Oral Sci ; 28: e20190399, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32348443

RESUMO

Objectives To evaluate the acoustic properties of the /s/ sound in individuals with different occlusion types and to investigate relationships between these properties and cephalometric measurements. Methodology Sixty patients were divided into three groups based on malocclusion. Group 1 included 20 patients (mean age: 14.85±2.01 years) with Class I skeletal and dental relationships. Group 2 included 20 patients (mean age: 13.49±1.78 years) with Class II skeletal and dental relationships. Group 3 included 20 patients (mean age: 12.46±2.62 years) with Class III skeletal and dental relationships. Cephalometric tracings were obtained from cephalometric radiographs. All included patients were native speakers of Turkish. The /s/ sound was selected for center of gravity analysis. Correlations between cephalometric values and acoustic parameters were also investigated. Results The center of gravity of the /s/ sound had the lowest value in Group 2 (p<0.05). For the /s/ sound in Group 3, moderate positive correlations were found between center of gravity and Sella-Nasion to Gonion-Gnathion angle (p<0.05, r=0.444) Lower incisor to Nasion-B point (p<0.023, r=0.505), and Lower incisor to Nasion-B point angle (p<0.034; r=0.476). No correlation was found in other cephalometric measurements. Conclusions The /s/ sound was affected by malocclusion due to the changing place of articulation. Therefore, referral to an orthodontist for malocclusion treatment especially patients with class III in the early period is suggested for producing acoustically ideal sound.


Assuntos
Cefalometria , Má Oclusão/fisiopatologia , Acústica da Fala , Distúrbios da Fala/fisiopatologia , Adolescente , Criança , Feminino , Humanos , Masculino , Má Oclusão/complicações , Má Oclusão/diagnóstico por imagem , Mandíbula/anatomia & histologia , Mandíbula/fisiopatologia , Maxila/anatomia & histologia , Maxila/fisiopatologia , Estudos Prospectivos , Radiografia , Valores de Referência , Distúrbios da Fala/diagnóstico por imagem , Distúrbios da Fala/etiologia , Estatísticas não Paramétricas , Língua/anatomia & histologia , Língua/fisiopatologia , Turquia
3.
Codas ; 32(4): e20190072, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32049105

RESUMO

PURPOSE: To describe and characterize a finding, i.e., delayed posterior leakage of food residue during swallowing, according to age, gender and food consistency, which occurred in the event. METHODS: Data were collected through the analysis of each functional videonasoendoscopy test of swallowing previously recorded in a specialist outpatient clinic. The study population included 200 patients, both males and females, aged between 46 and 87 years, with and without an underlying pathology for dysphagia. The images were studied individually by the researcher and analyzed by judges in order to identify and select images that would confirm the presence or absence of the study event. RESULTS: Delayed escape was found in 45 out of the 200 analyzed tests. The tests selected for the study showed delayed posterior bolus leakage in at least one consistency. The highest frequency of delayed posterior leakage occurred with fluids. The analysis showed the significance of the study event with the population related to older ages in the sample analyzed. CONCLUSION: Delayed posterior leakage occurs predominantly in the liquid consistency in older populations with no gender predominance.


Assuntos
Deglutição/fisiologia , Endoscopia/métodos , Distúrbios da Voz/fisiopatologia , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Transtornos de Deglutição , Feminino , Alimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Distribuição por Sexo , Fatores Sexuais , Distúrbios da Fala/fisiopatologia , Gravação em Vídeo , Distúrbios da Voz/diagnóstico
4.
Neural Netw ; 121: 186-207, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31568896

RESUMO

There is an essential requirement to support people with speech and communication disabilities. A brain-computer interface using electroencephalography (EEG) is applied to satisfy this requirement. A number of research studies to recognize brain signals using machine learning and deep neural networks (DNNs) have been performed to increase the brain signal detection rate, yet there are several defects and limitations in the techniques. Among them is the use in specific circumstances of machine learning. On the one hand, DNNs extract the features well and automatically. On the other hand, their use results in overfitting and vanishing problems. Consequently, in this research, a deep network is designed on the basis of an autoencoder neural Turing machine (DN-AE-NTM) to resolve the problems by the use of NTM external memory. In addition, the DN-AE-NTM copes with all kinds of signals with high detection rates. The data were collected by P300 EEG devices from several individuals under the same conditions. During the test, each individual was requested to skim images with one to six labels and focus on only one of the images. Not to focus on some images is analogous to producing unimportant information in the individual's brain, which provides unfamiliar signals. Besides the main P300 EEG dataset, EEG recordings of individuals with alcoholism and control individuals and the EEGMMIDB, MNIST, and ORL datasets were implemented and tested. The proposed DN-AE-NTM method classifies data with an average detection rate of 97.5%, 95%, 98%, 99.4%, and 99.1%, respectively, in situations where the signals are noisy so that only 20% of the data are reliable and include useful information.


Assuntos
Interfaces Cérebro-Computador , Encéfalo/fisiologia , Aprendizado Profundo , Redes Neurais de Computação , Distúrbios da Fala/fisiopatologia , Interface para o Reconhecimento da Fala , Eletroencefalografia/métodos , Humanos
5.
J Craniomaxillofac Surg ; 47(12): 1868-1874, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31812310

RESUMO

BACKGROUND: Maxillary advancement may affect speech in cleft patients. AIMS: To evaluate whether the amount of maxillary advancement in Le Fort I osteotomy affects velopharyngeal function (VPF) in cleft patients. METHODS: Ninety-three non-syndromic cleft patients (51 females, 42 males) were evaluated retrospectively. All patients had undergone a Le Fort I or bimaxillary (n = 24) osteotomy at Helsinki Cleft Palate and Craniofacial Center. Preoperative and postoperative lateral cephalometric radiographs were digitized to measure the amount of maxillary advancement. Pre- and postoperative speech was assessed perceptually and instrumentally by experienced speech therapists. Student's t-test and Mann-Whitney's U-test were used in the statistical analyses. Kappa statistics were calculated to assess reliability. RESULTS: The mean advancement of A point was 4.0 mm horizontally (range: -2.8-11.3) and 3.9 mm vertically (range -14.2-3.9). Although there was a negative change in VPF, the amount of maxillary horizontal or vertical movement did not significantly influence the VPF. There was no difference between the patients with maxillary and bimaxillary osteotomy. CONCLUSIONS: The amount of maxillary advancement does not affect the velopharyngeal function in cleft patients.


Assuntos
Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Osteotomia Maxilar/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Osteotomia de Le Fort/métodos , Fala/fisiologia , Insuficiência Velofaríngea/fisiopatologia , Adolescente , Adulto , Cefalometria/métodos , Fenda Labial/fisiopatologia , Fissura Palatina/fisiopatologia , Feminino , Finlândia , Humanos , Masculino , Avanço Mandibular/métodos , Maxila/anormalidades , Maxila/cirurgia , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Distúrbios da Fala/fisiopatologia , Distúrbios da Fala/cirurgia , Resultado do Tratamento , Insuficiência Velofaríngea/cirurgia , Adulto Jovem
6.
Am J Speech Lang Pathol ; 28(2S): 857-874, 2019 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-31306605

RESUMO

Purpose The ability of 5- and 6-year-old male children (23 participants) between the chronological ages of 5;0 and 6;11 (years;months) with childhood apraxia of speech (CAS; n = 9) and with typical development (TD; n = 14) to detect differences in vowel duration of syllable pairs is explored. We asked whether the children with CAS show different patterns of performance on the vowel duration difference experimental task than those of their similarly aged peers with TD. Method A male adult audio-recorded the syllable /bɑ/. The /ɑ/ was digitally lengthened and shortened, while maintaining uniform fundamental frequency and amplitude of the vowel and duration of the consonant /b/ at 42 ms. Vowel lengths increased in 40-ms increments, ranging from 208 to 488 ms. Eight pairs of syllables, 1 with equal length and 7 with differing vowel lengths, were randomly presented to the children 10 times in blocks of 16 pairs via a computer application. Results Numerous complementary analyses indicated patterns of performance differed for children with CAS compared to the children with TD. The children with CAS were notably less accurate in their duration discrimination and evidenced greater variability in their performances across duration difference conditions than their peers with TD, signifying they were generally challenged to discriminate the vowel duration differences. Conclusion These results suggest that CAS, which is more generally considered a motor speech disorder, may have a perceptual component of CAS related to vowel duration discrimination. Further research directions and clinical implications are discussed. Supplemental Material https://doi.org/10.23641/asha.8411876.


Assuntos
Apraxias/fisiopatologia , Testes de Discriminação da Fala/métodos , Distúrbios da Fala/fisiopatologia , Percepção da Fala/fisiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Humanos , Masculino
7.
Int J Lang Commun Disord ; 54(6): 902-913, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31338954

RESUMO

BACKGROUND: Acquired apraxia of speech (AOS) involves speech-production deficits on both the segmental and suprasegmental levels. Recent research has identified a non-linear interaction between the metrical structure of bisyllabic words and word-production accuracy in German speakers with AOS, with trochaic words (strong-weak stress) being resistant to errors compared with iambic words (weak-strong). AIMS: To replicate previous findings in English speakers with AOS, to measure the test-retest reliability of the effect, and to examine the potential impact of different methods of word scoring. METHODS & PROCEDURES: Speech samples were collected from 27 speakers with AOS and aphasia. Participants were at least 12 months post-stroke or penetrating brain injury, and represented a large range of AOS and aphasia severities. Productions were elicited via verbal model. Sampling was conducted on three separate occasions: the initial data-collection session and then repeated samplings at 1- and 4-week intervals. Bisyllabic words with a CVCVC segmental structure were selected. The list was divided into sublists representing differing lexical stress patterns: A list of 42 trochees, and one of 37 iambs. All speech samples were phonetically transcribed and then aligned with canonical transcriptions via an edit distance algorithm that followed transcription alignment principles. Phonetic-level errors (distortions) were penalized less severely than phonemic-level errors. Per cent consonants correct and whole-word accuracy were also examined. Trochee and iamb lists were analysed separately. OUTCOMES & RESULTS: Paired samples t-tests indicated that the modified edit distance was significantly lower for the trochee lists than for the iamb lists. There was a lack of a significant effect of time on the absolute difference between modified edit distance for both lists. Intraclass coefficients suggested the list and procedures used are appropriate as an outcome measure for group research. CONCLUSIONS & IMPLICATIONS: The results suggest that in English, as in German, the trochaic structure is more resistant to segmental errors in persons with AOS and aphasia, providing replication of the findings of Aichert et al. in 2016. Further, this effect is stable over repeated sampling occasions. Implications for clinical management of AOS include possible ways to scaffold item difficulty and potentially improve stimulus generalization.


Assuntos
Apraxias/psicologia , Distúrbios da Fala/psicologia , Fala/fisiologia , Adulto , Apraxias/etiologia , Apraxias/fisiopatologia , Feminino , Traumatismos Cranianos Penetrantes/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Variações Dependentes do Observador , Fonética , Reprodutibilidade dos Testes , Acústica da Fala , Distúrbios da Fala/etiologia , Distúrbios da Fala/fisiopatologia , Medida da Produção da Fala/métodos , Acidente Vascular Cerebral/complicações
9.
Neurol Sci ; 40(11): 2391-2397, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31222543

RESUMO

BACKGROUND: Foreign accent syndrome (FAS) is arare syndrome associated with altered speech rhythm and prosody, which listeners perceive as foreign; cerebrovascular accidents, tumors and multiple sclerosis are reported as possible causes of FAS. The pathophysiology of FAS is not yet understood. CASE PRESENTATION: A 68-year-old Italian man was admitted to the EmergencyDepartment for non-fluent aphasia and dysarthria. Computed tomography (CT) scan did not show abnormalities; the patient was treated with systemic thrombolysis. A repeated brain CT and magnetic resonance imaging (MRI) confirmed an infarct in the left primary motor cortex and mild extension to cortico-subcortical frontal regions. In the following days he gradually improved, speaking Italian fluently with a typical German accent. In conclusion, FAS is a rare motor speech disorder, often related to cerebrovascular accidents involving critical regions in the dominant hemisphere. In addition, the present case adds further evidence to the role of the left primary motor cortex in modulation of prosody. In rare cases FAS can be the only sign of stroke or can appear after recovery from post-stroke aphasia.


Assuntos
Infarto Cerebral/complicações , Córtex Motor , Distúrbios da Fala , Idoso , Infarto Cerebral/diagnóstico por imagem , Humanos , Masculino , Córtex Motor/diagnóstico por imagem , Córtex Motor/patologia , Córtex Motor/fisiopatologia , Distúrbios da Fala/etiologia , Distúrbios da Fala/patologia , Distúrbios da Fala/fisiopatologia
10.
Psychol Aging ; 34(3): 362-373, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31070400

RESUMO

Personality traits, such as Neuroticism and Conscientiousness, are associated with cognitive outcomes across the life span, including cognitive function in young adulthood and risk of cognitive impairment and dementia in old age. Research on personality and age-related cognition has focused primarily on memory-related tasks and outcomes. The purpose of this research is to address the relation between Five Factor Model personality traits and another critical marker of cognitive function that has received less attention-verbal fluency. We examine this relation across adulthood in 10 cohorts (11 samples) that totaled more than 90,000 participants (age range 16-101). Participants in all samples reported on their personality traits and completed at least one fluency task (semantic and/or letter). A meta-analysis of semantic fluency (N = 86,044) indicated that participants who scored lower in Neuroticism, and higher in Extraversion, Openness, and Conscientiousness, retrieved more words, independent of age, gender, and education. These associations generally replicated for the letter fluency task (3 samples; N = 11,551). Moderation analysis indicated that the associations between personality and semantic fluency were stronger in older samples (except for Openness) and among individuals with lower education. This pattern suggests that these associations are stronger in groups vulnerable to severe cognitive impairment. Personality traits have pervasive associations with fluency tasks that are replicable across samples and age groups. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Cognição/fisiologia , Personalidade/fisiologia , Distúrbios da Fala/fisiopatologia , Idoso , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
11.
Cogn Neuropsychol ; 36(5-6): 282-299, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31131723

RESUMO

Gestures might serve communicative functions by supplementing spoken expressions or restorative functions by facilitating speech production. Also, speakers with speech deficits use gestures to compensate for their speech impairments. In this study, we examined gesture use in speakers with and without speech impairments and how spoken spatial expressions changed when gestures were restrained. Six patients with speech problems and with left frontal and/or temporal lesions and 20 neurotypical controls described motion events in 3 different conditions (spontaneous gesture, only speech, and only gesture). In addition to the group analyses, we ran case analyses. Results showed that patients used more gestures compared to controls. Gestures served both communicative and restorative functions for patients whereas controls only used gestures for communicative purposes. Case analyses revealed that there were differential patterns among patients. Overall, gesture production is multifunctional and gestures serve different functions for different populations as well as within a population.


Assuntos
Lesões Encefálicas/fisiopatologia , Gestos , Idioma , Comunicação Manual , Lesões Encefálicas/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fala , Distúrbios da Fala/complicações , Distúrbios da Fala/fisiopatologia
12.
Neurorehabil Neural Repair ; 33(6): 453-463, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31081485

RESUMO

Background. Communication impairment is one of the most common symptoms of Parkinson's disease (PD), significantly affecting quality of life. Singing shares many of the neural networks and structural mechanisms used during speech and, thus, has potential for therapeutic application to address speech disorders. Objective. To explore the effects of an interdisciplinary singing-based therapeutic intervention (ParkinSong) on voice and communication in people with PD. Methods. A controlled trial compared the effects of the ParkinSong intervention with an active control condition at 2 dosage levels (weekly vs monthly) over 3 months, on voice, speech, respiratory strength, and voice-related quality-of-life outcomes for 75 people living with PD. The interdisciplinary ParkinSong model comprised high-effort vocal and respiratory tasks, speech exercises, group singing, and social communication opportunities. Results. ParkinSong intervention participants demonstrated significant improvements in vocal intensity (P = .018), maximum expiratory pressure (P = .032), and voice-related quality of life (P = .043) in comparison to controls. Weekly ParkinSong participants increased vocal intensity more than monthly participants (P = .011). Vocal intensity declined in nontreatment control groups. No statistical differences between groups on maximum phonation length or maximum inspiratory pressure were observed at 3 months. Conclusions. ParkinSong is an engaging intervention with the potential to increase loudness and respiratory function in people with mild to moderately severe PD.


Assuntos
Exercícios Respiratórios , Comunicação , Relações Interpessoais , Musicoterapia , Doença de Parkinson/fisiopatologia , Doença de Parkinson/reabilitação , Psicoterapia de Grupo , Canto , Distúrbios da Fala/fisiopatologia , Distúrbios da Fala/reabilitação , Fonoterapia , Idoso , Idoso de 80 Anos ou mais , Exercícios Respiratórios/métodos , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Musicoterapia/métodos , Doença de Parkinson/complicações , Psicoterapia de Grupo/métodos , Índice de Gravidade de Doença , Distúrbios da Fala/etiologia , Inteligibilidade da Fala/fisiologia , Fonoterapia/métodos , Resultado do Tratamento
13.
J Speech Lang Hear Res ; 62(1): 153-168, 2019 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-30950754

RESUMO

Purpose We sought to estimate the prevalence of isolated epileptiform activity (IEA) in children with speech and language impairments and discuss the utility of an electroencephalogram (EEG) in assessing these children. Method We conducted a systematic review and searched for eligible studies in 8 databases. All languages were included, and meta-analyses were performed. Results We found 55 prevalence estimates (8 with control group). The odds of having IEA were 6 times greater for children with speech and language impairments than for typically developing children. The overall pooled prevalence of IEA was 27.3%. A wide variation between the prevalence estimates was, to a certain degree, explained by type of impairment (8.1% in speech impairments, 25.8% in language impairments, and 51.5% in language regression). Sleep EEGs detected a significantly higher prevalence than awake EEGs. Although the presence of epilepsy gave a significantly higher prevalence than if epilepsy was not present, 33.5% of children with language impairment but without epilepsy were found to have IEA in sleep EEGs. Conclusions This systematic review shows that IEA is 6 times more prevalent in children with speech and language impairment than in typically developing children. However, the prevalence rates vary to a great extent. Uncovering IEA will, in addition to information from other clinical assessments, provide a more comprehensive understanding of the child's impairments. We argue that, although EEG is of questionable value when assessing children with speech impairments, sleep EEG could be valuable when assessing children with language impairments and, in particular, children who experience language regression.


Assuntos
Eletroencefalografia , Epilepsia/fisiopatologia , Transtornos do Desenvolvimento da Linguagem/fisiopatologia , Distúrbios da Fala/fisiopatologia , Adolescente , Criança , Epilepsia/epidemiologia , Humanos , Transtornos do Desenvolvimento da Linguagem/complicações , Prevalência , Valores de Referência , Distúrbios da Fala/complicações
14.
BMJ Case Rep ; 12(3)2019 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-30936345

RESUMO

Leber's hereditary optic neuropathy (LHON) is a mitochondrially inherited disorder characterised by bilateral, painless visual loss which leads to severe optic atrophy. It can be associated with other conditions including multiple sclerosis (MS), movement disorders, epilepsy and cardiac arrhythmias. The association of LHON with an MS-like illness is often referred to as Harding's disease (or Harding's syndrome). We report two siblings, who both harbour the 11 778 mitochondrial DNA (mtDNA) mutation, but who manifest markedly different clinical phenotypes; a male with classical LHON and a female with an MS-like illness. LHON affects males four to five times more often than females. By contrast, Harding's disease is seen predominantly in females, in a pattern comparable to that seen in MS. The pathogenic basis behind the variation in penetrance and phenotype between genders and individual family members remains unclear.


Assuntos
Esclerose Múltipla/fisiopatologia , Atrofia Óptica Hereditária de Leber/fisiopatologia , Mutação Puntual/genética , Transtornos da Visão/etiologia , DNA Mitocondrial/genética , Família , Feminino , Transtornos Neurológicos da Marcha/genética , Transtornos Neurológicos da Marcha/fisiopatologia , Aconselhamento Genético , Humanos , Imunoterapia , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Esclerose Múltipla/genética , Atrofia Óptica Hereditária de Leber/diagnóstico , Atrofia Óptica Hereditária de Leber/genética , Encaminhamento e Consulta , Distúrbios da Fala/genética , Distúrbios da Fala/fisiopatologia , Resultado do Tratamento , Transtornos da Visão/genética , Transtornos da Visão/fisiopatologia
15.
Sensors (Basel) ; 19(8)2019 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-31013673

RESUMO

High-tech augmentative and alternative communication (AAC) methods are on a constant rise; however, the interaction between the user and the assistive technology is still challenged for an optimal user experience centered around the desired activity. This review presents a range of signal sensing and acquisition methods utilized in conjunction with the existing high-tech AAC platforms for individuals with a speech disability, including imaging methods, touch-enabled systems, mechanical and electro-mechanical access, breath-activated methods, and brain-computer interfaces (BCI). The listed AAC sensing modalities are compared in terms of ease of access, affordability, complexity, portability, and typical conversational speeds. A revelation of the associated AAC signal processing, encoding, and retrieval highlights the roles of machine learning (ML) and deep learning (DL) in the development of intelligent AAC solutions. The demands and the affordability of most systems hinder the scale of usage of high-tech AAC. Further research is indeed needed for the development of intelligent AAC applications reducing the associated costs and enhancing the portability of the solutions for a real user's environment. The consolidation of natural language processing with current solutions also needs to be further explored for the amelioration of the conversational speeds. The recommendations for prospective advances in coming high-tech AAC are addressed in terms of developments to support mobile health communicative applications.


Assuntos
Auxiliares de Comunicação para Pessoas com Deficiência/tendências , Distúrbios da Fala/reabilitação , Fala/fisiologia , Telemedicina , Interfaces Cérebro-Computador , Humanos , Equipamentos de Autoajuda , Distúrbios da Fala/fisiopatologia
16.
Artigo em Chinês | MEDLINE | ID: mdl-30776863

RESUMO

Objective: To investigate the hearing loss and speech disorders in the elderly, to analyze the risk factors of the elderly deafness, as well as to provide reference for the clinical research of the elderly deafness. Methods: From March 2016 to March 2018, 913 elderly people, who were tested for hearing and speech disorders, were examined by a unified questionnaire to investigate the demographic data of the subjects and the related factors of deafness, and the hearing and speech recognition tests were carried out. According to the hearing loss, the hearing impaired group was divided into the hearing impaired group (500, 1 000, 2 000 and 4 000 Hz, the average hearing threshold>25 dBHL) and the non hearing impaired group (the average hearing threshold of the four frequencies ≤25 dBHL), and then the single factor analysis and the unconditional Logistic regression analysis were used. Finally, the risk factors of senile deafness were analyzed. Results: Of the 913 elderly subjects in the survey, 389 (42.61%, 389/913) had no hearing impaired, 345 (37.79%, 345/913) were mild hearing impaired, and 149 (16.32%, 149/913) had moderate hearing loss. Twenty-six patients were severe hearing loss (2.85%, 26/913); 4 patients had severe hearing loss (0.44%, 4/913). Among the 524 hearing-impaired elderly, there were 244 speech-recognition disorders (46.56%, 244/524), of whom 106 were mild hearing-impaired, accounting for 30.72% (106/345), 108 were moderate hearing loss, accounting for 72.48% (108/149), 26 were severe hearing loss, accounting for 100% (26/26), and 4 were the profound hearing loss, accounting for 100% (4/4). Statistical analysis showed that the age, job status, history of hypertension, history of hyperglycemia, and smoking history were independent risk factors for senile hearing loss (P<0.05). Conclusions: High incidences of hearing and speech recognition obstacle are found in health examination for the elderly patients. Noise exposure, age, history of hypertension, high blood sugar, and smoking history are high-risk factors for senile deafness, therefore, prevention and rehabilitation programs are urgent to be developed.


Assuntos
Limiar Auditivo/fisiologia , Surdez/diagnóstico , Distúrbios da Fala/diagnóstico , Percepção da Fala/fisiologia , Idoso , Surdez/epidemiologia , Surdez/fisiopatologia , Humanos , Análise de Regressão , Fatores de Risco , Testes de Discriminação da Fala , Distúrbios da Fala/epidemiologia , Distúrbios da Fala/fisiopatologia
17.
Brain ; 142(4): 966-977, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30796815

RESUMO

Speech disorders are highly prevalent in the preschool years, but frequently resolve. The neurobiological basis of the most persistent and severe form, apraxia of speech, remains elusive. Current neuroanatomical models of speech processing in adults propose two parallel streams. The dorsal stream is involved in sound to motor speech transformations, while the ventral stream supports sound/letter to meaning. Data-driven theories on the role of these streams during atypical speech and language development are lacking. Here we provide comprehensive behavioural and neuroimaging data on a large novel family where one parent and 11 children presented with features of childhood apraxia of speech (the same speech disorder associated with FOXP2 variants). The genetic cause of the disorder in this family remains to be identified. Importantly, in this family the speech disorder is not systematically associated with language or literacy impairment. Brain MRI scanning in seven children revealed large grey matter reductions over the left temporoparietal region, but not in the basal ganglia, relative to typically-developing matched peers. In addition, we detected white matter reductions in the arcuate fasciculus (dorsal language stream) bilaterally, but not in the inferior fronto-occipital fasciculus (ventral language stream) nor in primary motor pathways. Our findings identify disruption of the dorsal language stream as a novel neural phenotype of developmental speech disorders, distinct from that reported in speech disorders associated with FOXP2 variants. Overall, our data confirm the early role of this stream in auditory-to-articulation transformations. 10.1093/brain/awz018_video1 awz018media1 6018582401001.


Assuntos
Distúrbios da Fala/genética , Distúrbios da Fala/fisiopatologia , Percepção da Fala/genética , Adolescente , Adulto , Encéfalo/fisiologia , Mapeamento Encefálico/métodos , Criança , Pré-Escolar , Família , Feminino , Humanos , Idioma , Imagem por Ressonância Magnética , Masculino , Rede Nervosa , Vias Neurais , Neuroimagem , Linhagem , Fala/fisiologia , Percepção da Fala/fisiologia
18.
Codas ; 31(1): e20170212, 2019 Feb 11.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30758395

RESUMO

PURPOSE: To verify and correlate the spelling errors present in the written productions to the performance in phonological awareness skills of children in different school years, with typical and atypical phonological development. METHODS: The sample consisted of 50 children divided into two groups: with typical phonological development (TPD) and with atypical phonological development (APD); students from the early years (1st to 5th grades) of schooling and ages between 6:0 and 10:0 years old. The children were submitted to speech-language and audiological evaluations. Data were tabulated and statistical analyzes were performed using the Spearman Correlation Coefficient. RESULTS: In relation to the number of spelling errors in writing, these were similar in the TPD and APD groups, except for the contextual-arbitrary errors that were greater for the APD. Still, it was observed that the number of written spelling errors decreased with the increase in schooling. Concerning the average performance in phonological awareness, the TPD performed better than the APD in syllabic and phonemic awareness. The children of 4th and 5th grades presented better performance in phonological awareness than those in grades 1st to 3rd. CONCLUSION: The correlation was inversely proportional between the phonological awareness performance and the number of spelling errors (those that alter the syllabic structure) for both groups, demonstrating that the more errors of this type, the lower the performance in syllabic, phonemic and total phonological awareness.


Assuntos
Conscientização , Fonética , Leitura , Distúrbios da Fala/fisiopatologia , Percepção da Fala , Brasil , Estudos de Casos e Controles , Criança , Deficiências do Desenvolvimento , Escolaridade , Feminino , Humanos , Desenvolvimento da Linguagem , Masculino , Estudantes , Redação
19.
Neurology ; 92(9): e957-e963, 2019 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-30804066

RESUMO

OBJECTIVE: This study explores the use of quantitative data on strength and fatigability of orofacial muscles in patients with facioscapulohumeral muscular dystrophy (FSHD) and assesses the frequency of swallowing and communication difficulties and their relationship to orofacial muscle involvement. METHODS: We included 43 patients with FSHD and 35 healthy controls and used the Iowa Oral Performance Instrument (IOPI) to obtain quantitative measurements of strength and endurance of lip compression, cheek (buccodental) compression, and tongue elevation. For the assessment of swallowing and communication difficulties, we used the dysphagia-specific quality of life (SWAL-QOL) and Communicative Participation Item Bank questionnaires. RESULTS: Cheek compression strength was reduced in patients with FSHD compared to healthy controls. Dysphagia and difficulty with verbal communication were reported by 25% and 35% of patients, respectively, and correlated to cheek compression strength and endurance and to anterior tongue elevation endurance. Prolonged cheek compression or anterior tongue elevation endurance (decreased fatigability) made swallowing or speech problems less likely to occur. CONCLUSION: Cheek compression strength is the most sensitive IOPI measure for orofacial weakness in FSHD. Orofacial weakness contributes to dysphagia and speech difficulties in FSHD, which are both common, though generally mild. Higher endurance of orofacial muscles was associated with a lower chance of dysphagia or speech problems. More research is required for further refinement of the pattern of facial muscle involvement in FSHD and to provide new insights for improvement of speech and language therapy.


Assuntos
Transtornos de Deglutição/fisiopatologia , Músculos Faciais/fisiopatologia , Debilidade Muscular/fisiopatologia , Distrofia Muscular Facioescapuloumeral/fisiopatologia , Distúrbios da Fala/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Comunicação , Deglutição , Transtornos de Deglutição/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/etiologia , Distrofia Muscular Facioescapuloumeral/complicações , Qualidade de Vida , Fala , Distúrbios da Fala/etiologia , Fonoterapia , Adulto Jovem
20.
BMJ Open ; 9(1): e024236, 2019 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-30670516

RESUMO

OBJECTIVES: The prevalence of restless legs syndrome (RLS) in functional movement disorders (FMD) is not known. Patients with FMD often present with multiple motor and sensory symptoms. Some of these symptoms might be due to comorbid RLS. Therefore, our objective was to evaluate possible association between FMD and RLS. DESIGN: Case-control study. SETTING: Movement Disorders Center, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic. PARTICIPANTS: 96 consecutive patients with clinically established FMD (80 females, mean age (SD) 45.0 (13) years), and 76 matched controls. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was prevalence of RLS based on updated International RLS Study Group criteria. Secondary outcome measures included prevalence of periodic limb movements (PLM) using actigraphy; pain, motor and sensory symptoms in lower limbs; organic comorbidities and medication affecting RLS. RESULTS: RLS criteria were fulfilled in 43.8% of patients (95% CI 34 to 54) and in 7.9% of controls (95% CI 3 to 17, p<0.00001). Both RLS and PLM indices (PLMi) ≥22.5/hour were found in 21.2% of patients with FMD and 2.6% of controls. Patients with FMD with RLS had a higher mean PLMi (p<0.001) and a higher proportion of PLMi ≥22.5/hour (p<0.01) than RLS-negative patients. Patients with RLS had higher prevalence of pain and sensory symptoms in lower limbs, no difference was found in medication and prevalence of organic comorbidities in patients with FMD with and without RLS. CONCLUSIONS: We found an increased prevalence of RLS in patients with FMD. Clinical diagnosis of RLS was supported by actigraphic measurement of clinically relevant PLM in a significant proportion of patients with FMD. Although functional motor and sensory symptoms may mimic RLS, RLS may be unrecognised in patients with FMD. This finding may have clinical implications in management of FMD, and it raises the possibility of common pathophysiological mechanisms of FMD and RLS/PLM.


Assuntos
Transtorno Conversivo/epidemiologia , Transtornos dos Movimentos/epidemiologia , Síndrome das Pernas Inquietas/epidemiologia , Adulto , Estudos de Casos e Controles , Transtorno Conversivo/fisiopatologia , República Tcheca/epidemiologia , Distonia/fisiopatologia , Feminino , Transtornos Neurológicos da Marcha/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos dos Movimentos/fisiopatologia , Debilidade Muscular/fisiopatologia , Mioclonia/fisiopatologia , Transtornos da Motilidade Ocular/fisiopatologia , Prevalência , Distúrbios da Fala/fisiopatologia , Tremor/fisiopatologia
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