MedWorm: Speech-Language Pathology

Instructions for earning continuing education credit from asha.

Topics in Language Disorders — Fri, 16 May 2008 15:14:21 +0100

Page: 189DOI: 10.1097/01.TLD.0000318938.39301.92Authors: AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION (Source: Topics in Language Disorders)

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Narrative transcription accuracy and reliability in two languages.

Topics in Language Disorders — Fri, 16 May 2008 15:14:21 +0100

Page: 178DOI: 10.1097/01.TLD.0000318937.39301.76Authors: Heilmann, John PhD; Miller, Jon F. PhD; Iglesias, Aquiles PhD; Fabiano-Smith, Leah PhD; Nockerts, Ann MS; Andriacchi, Karen Digney MS (Source: Topics in Language Disorders)

Personal narratives: cultural differences and clinical implications.

Topics in Language Disorders — Fri, 16 May 2008 15:14:21 +0100

Page: 162DOI: 10.1097/01.TLD.0000318936.31677.2dAuthors: Bliss, Lynn S. PhD; McCabe, Allyssa PhD (Source: Topics in Language Disorders)

Use of narrative-based language intervention with children who have cochlear implants.

Topics in Language Disorders — Fri, 16 May 2008 15:14:21 +0100

Page: 149DOI: 10.1097/01.TLD.0000318935.54548.36Authors: Justice, Ellie C. MA, CCC-SLP; Swanson, Lori A. PhD; Buehler, Velvet MA, CCC-SLPIA (Source: Topics in Language Disorders)

Assessing story comprehension in preschool children.

Topics in Language Disorders — Fri, 16 May 2008 15:14:21 +0100

Page: 131DOI: 10.1097/01.TLD.0000318934.54548.7fAuthors: Skarakis-Doyle, Elizabeth PhD; Dempsey, Lynn PhD (Source: Topics in Language Disorders)

Emerging procedures in narrative assessment: the index of narrative complexity.

Topics in Language Disorders — Fri, 16 May 2008 15:14:21 +0100

Page: 115DOI: 10.1097/01.TLD.0000318933.46925.86Authors: Petersen, Douglas B. MA, MEd; Gillam, Sandra Laing PhD; Gillam, Ronald B. PhD (Source: Topics in Language Disorders)

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Narrative abilities: advances in research and implications for clinical practice.

Topics in Language Disorders — Fri, 16 May 2008 15:14:21 +0100

Page: 99DOI: 10.1097/01.TLD.0000318932.08807.daAuthors: Boudreau, Donna PhD, CCC-SLP (Source: Topics in Language Disorders)

Narratives: twenty-five years later.

Topics in Language Disorders — Fri, 16 May 2008 15:14:21 +0100

Page: 93DOI: 10.1097/01.TLD.0000318931.08807.01Authors: Johnston, Judith R. PhD (Source: Topics in Language Disorders)

Foreword.

Topics in Language Disorders — Fri, 16 May 2008 15:14:21 +0100

Page: 91DOI: 10.1097/01.TLD.0000318930.01183.f3Authors: Boudreau, Donna PhD, Issue Editor (Source: Topics in Language Disorders)

From the editors.

Topics in Language Disorders — Fri, 16 May 2008 00:09:00 +0100

Page: 89DOI: 10.1097/01.TLD.0000318929.24054.4fAuthors: Nelson, Nickola Wolf PhD, Editor; Butler, Katharine G. PhD, Editor Emerita (Source: Topics in Language Disorders)

Voice production during a weightlifting and support task

Folia Phoniatrica et Logopaedica : Last 20 articles — Fri, 09 May 2008 23:41:26 +0100

Folia Phoniatr Logop 2008;60:188-194 (DOI:10.1159/000128277) (Source: Folia Phoniatrica et Logopaedica : Last 20 articles)

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Smoking, carcinophobia and voice handicap index

Folia Phoniatrica et Logopaedica : Last 20 articles — Fri, 09 May 2008 23:41:26 +0100

Folia Phoniatr Logop 2008;60:195-198 (DOI:10.1159/000131103) (Source: Folia Phoniatrica et Logopaedica : Last 20 articles)

A look at supervision in the 21st century

The ASHA Leader Online — Tue, 06 May 2008 21:32:58 +0100

Whether you are already a supervisor or hoping to become one, you can hone your skills by developing familiarity with the literature and the supervisory process. (Source: The ASHA Leader Online)

Aging and speech communication

The ASHA Leader Online — Tue, 06 May 2008 21:32:58 +0100

Peripheral, central-auditory, and cognitive factors affect speech-understanding problems in older adults. (Source: The ASHA Leader Online)

The need for auditory training

The ASHA Leader Online — Tue, 06 May 2008 21:32:58 +0100

Our professions must evolve to the point where we can inform patients confidently and compellingly that they must actively engage in rehabilitation training in order to achieve maximum potential with hearing technology. (Source: The ASHA Leader Online)

Strategic planning in csd programs: the san francisco state example

The ASHA Leader Online — Tue, 06 May 2008 21:32:58 +0100

At San Francisco State University, the process of strategic planning was difficult, yet the results achieved were inspiring and rewarding. (Source: The ASHA Leader Online)

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Volunteer coalition helps improve literacy

The ASHA Leader Online — Tue, 06 May 2008 21:32:58 +0100

To address the needs of struggling readers, SLP Sherry Comerchero developed a volunteer literacy coalition that sends teams of tutors into the schools. (Source: The ASHA Leader Online)

Regional carrier covers aac devices

The ASHA Leader Online — Tue, 06 May 2008 21:32:58 +0100

ASHA's advocacy successfully reversed a carrier's decision to exclude coverage of speech-generating devices and other augmentative and alternative communication devices for autism spectrum disorders. (Source: The ASHA Leader Online)

The peer in peer review.

American Journal of Speech-Language Pathology — Thu, 01 May 2008 04:00:00 +0100

The peer in peer review.

Am J Speech Lang Pathol. 2008 May;17(2):106

Authors: Justice L

PMID: 18448598 [PubMed - in process]

(Source: American Journal of Speech-Language Pathology)

Assessing the microstructure of written language using a retelling paradigm.

American Journal of Speech-Language Pathology — Thu, 01 May 2008 04:00:00 +0100

Assessing the microstructure of written language using a retelling paradigm.

Am J Speech Lang Pathol. 2008 May;17(2):107-20

Authors: Puranik CS, Lombardino LJ, Altmann LJ

PURPOSE: The primary goal of this study was to document the progression of the microstructural elements of written language in children at 4 grade levels. The secondary purpose was to ascertain whether the variables selected for examination could be classified into valid categories that reflect the multidimensional nature of writing. METHOD: Written language samples were collected and transcribed from 120 children in Grades 3 through 6 using an expository text-retelling paradigm. Nine variables at various levels of language were analyzed. RESULTS: Using a text-retelling paradigm, measures of productivity (e.g., total number of words and ideas) improved steadily with age, whereas measures of complexity (e.g., mean length of T-unit) did not. Results for measures of accuracy (e.g., spelling and writing conventions) were mixed, with some showing improvement across grades. Grade 3 students showed consistently poorer performance than students in Grades 4, 5, and 6. Grade 4 students showed poorer performance than students in Grades 5 and 6. Exploratory factor analysis suggests that writing can be represented by 3 factors: Productivity, Complexity, and Accuracy. CONCLUSIONS: Clinicians can use this multidimensional scheme for examining writing skills using text-retelling formats with children from Grades 3 through 6. This empirically based framework for measuring microstructural variables of writing provides clinicians with a 3-prong conceptual framework for determining children's strengths and weaknesses within the translational stage of writing.

PMID: 18448599 [PubMed - in process]

(Source: American Journal of Speech-Language Pathology)

Expected test scores for preschoolers with a cochlear implant who use spoken language.

American Journal of Speech-Language Pathology — Thu, 01 May 2008 04:00:00 +0100

Expected test scores for preschoolers with a cochlear implant who use spoken language.

Am J Speech Lang Pathol. 2008 May;17(2):121-38

Authors: Nicholas JG, Geers AE

PURPOSE: The major purpose of this study was to provide information about expected spoken language skills of preschool-age children who are deaf and who use a cochlear implant. A goal was to provide "benchmarks" against which those skills could be compared, for a given age at implantation. We also examined whether parent-completed checklists of children's language were correlated with results of standardized language tests and whether scores increased linearly with decreasing age of implantation and increasing duration of cochlear implant use. METHOD: Participants were a nationwide sample of 76 children who were deaf and orally educated and who received an implant by 38 months of age. Formal language tests were administered at age 4.5 years. The MacArthur-Bates Communicative Development Inventories (CDI) instrument was completed by parents when children were ages 3.5 and 4.5 years. RESULTS: Based on regression analyses, expected scores for each age at implant were provided for 2 commonly administered language tests at 4.5 years of age and CDI subscale scores at 3.5 and 4.5 years. Concurrent test scores were significantly correlated on all measures. A linear relation was found that predicted increasing test scores with younger ages at implantation for all scales administered. CONCLUSIONS: While the expected scores reported here should not be considered as normative data, they are benchmarks that may be useful for evaluating spoken language progress of children with cochlear implants who are enrolled in spoken language-based programs.

PMID: 18448600 [PubMed - in process]

(Source: American Journal of Speech-Language Pathology)

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A phase ii trial of telehealth delivery of the lidcombe program of early stuttering intervention.

American Journal of Speech-Language Pathology — Thu, 01 May 2008 04:00:00 +0100

A Phase II Trial of Telehealth Delivery of the Lidcombe Program of Early Stuttering Intervention.

Am J Speech Lang Pathol. 2008 May;17(2):139-49

Authors: Lewis C, Packman A, Onslow M, Simpson JM, Jones M

PURPOSE: The aims of this study were to evaluate the efficacy of telehealth delivery of the Lidcombe Program of Early Stuttering Intervention, compared with a control group, and to determine the number of children who could be regarded as "responders." METHOD: A speech-language pathologist provided telehealth delivery of the Lidcombe Program during telephone consultations with parents in their homes, remote from the clinic. The study design was an open plan, parallel group, randomized controlled trial with blinded outcome assessment. Children in the no-treatment control group who were still stuttering after 9 months then received the same treatment. The primary outcome measure was frequency of stuttering, gathered from audiotape recordings of participants' conversational speech in everyday, nontreatment situations, before and after treatment. RESULTS: Analysis of covariance showed a 73% decrease in frequency of stuttering at 9 months after randomization in the treatment group, as compared with the control group (95% confidence interval = 25%-90%, p = .02). Measures of treatment time showed that telehealth delivery of the Lidcombe Program requires around 3 times more resources than standard presentation. CONCLUSIONS: Telehealth delivery of the Lidcombe Program is an efficacious treatment for preschool children who cannot receive the standard, clinic-based Lidcombe Program. Avenues for improving efficiency are considered.

PMID: 18448601 [PubMed - in process]

(Source: American Journal of Speech-Language Pathology)

Oral and written language development of children adopted from china.

American Journal of Speech-Language Pathology — Thu, 01 May 2008 04:00:00 +0100

Oral and written language development of children adopted from china.

Am J Speech Lang Pathol. 2008 May;17(2):150-60

Authors: Scott KA, Roberts JA, Krakow R

PURPOSE: The sharp increase in the number of international adoptions in the United States has prompted a heightened interest in the language development of internationally adopted children. Although recent studies have investigated the early language development of adoptees, little is known about the school-age language and literacy skills of internationally adopted children. The focus of this study was the oral and written language skills of school-age adoptees from China. METHOD: The participants were 24 children between the ages of 7;0 (years;months) and 8;8. Oral and written language skills were assessed using standardized measures and a narrative retell task. RESULTS: As a group, the majority of children exhibited scores in the average to above average range for all oral and written standardized language measures. Narrative analysis indicated that an increase in the number of grammatical errors was moderately correlated with lower reading comprehension scores. Age at adoption was negatively correlated with several measures, including a narrative measure of grammatical errors per T-unit. CONCLUSION: These findings provide an encouraging outlook on the oral and written language outcomes of internationally adopted children from China through the early elementary grades. Moreover, these findings support earlier research that speaks to the resiliency and robustness of language acquisition abilities in children.

PMID: 18448602 [PubMed - in process]

(Source: American Journal of Speech-Language Pathology)

Using semantic feature analysis to improve contextual discourse in adults with aphasia.

American Journal of Speech-Language Pathology — Thu, 01 May 2008 04:00:00 +0100

Using semantic feature analysis to improve contextual discourse in adults with aphasia.

Am J Speech Lang Pathol. 2008 May;17(2):161-72

Authors: Rider JD, Wright HH, Marshall RC, Page JL

PURPOSE: Semantic feature analysis (SFA) was used to determine whether training contextually related words would improve the discourse of individuals with nonfluent aphasia in preselected contexts. METHOD: A modified multiple-probes-across-behaviors design was used to train target words using SFA in 3 adults with nonfluent aphasia. Pretreatment, posttreatment, and follow-up sessions obtained language samples for the preselected contexts. Contexts included 4 story retellings and 4 procedure explanations. RESULTS: All participants improved naming ability for treated words. No generalization to untrained items was found. Within discourse samples, participants increased number of target words produced from pretreatment to posttreatment sessions but did not increase lexical diversity across samples. Participants maintained performance on standardized measures from the beginning to the end of the study. CONCLUSIONS: Results support and extend previous research by indicating that SFA improves confrontational naming ability and may benefit word retrieval in discourse production of closed-set contexts.

PMID: 18448603 [PubMed - in process]

(Source: American Journal of Speech-Language Pathology)

Comparisons of audio and audiovisual measures of stuttering frequency and severity in preschool-age children.

American Journal of Speech-Language Pathology — Thu, 01 May 2008 04:00:00 +0100

Comparisons of audio and audiovisual measures of stuttering frequency and severity in preschool-age children.

Am J Speech Lang Pathol. 2008 May;17(2):173-8

Authors: Rousseau I, Onslow M, Packman A, Jones M

PURPOSE: To determine whether measures of stuttering frequency and measures of overall stuttering severity in preschoolers differ when made from audio-only recordings compared with audiovisual recordings. METHOD: Four blinded speech-language pathologists who had extensive experience with preschoolers who stutter measured stuttering frequency and rated overall severity from audio-only and audiovisual recordings of 36 preschool children who were stuttering. Stuttering frequency (percentage of syllables stuttered [%SS]) was based on counts of perceptually unambiguous stutterings, made in real time, and overall severity was measured using a 9-point rating scale. RESULTS: Stuttering frequency was statistically significantly lower by around 20% when made from audio-only recordings. This was found to be directly attributable to differences in the counts of stuttered syllables, rather than to differences in the total numbers of syllables spoken. No significant differences were found between recording modalities for the ratings of overall severity. Correlations between %SS scores in the 2 modalities and severity rating scores in the 2 modalities were high, indicating that observers agreed on data trends across speech samples. CONCLUSIONS: Measures of %SS made from audio-only recordings may underestimate stuttering frequency in preschoolers. Although audio-only %SS measures may underestimate stuttering frequency at the start of a clinical trial to a clinically significant extent, posttreatment scores at or below 1.0%SS are likely to underestimate by 0.2%SS or less, which is clinically insignificant.

PMID: 18448604 [PubMed - in process]

(Source: American Journal of Speech-Language Pathology)

The role of color cues in facilitating accurate and rapid location of aided symbols by children with and without down syndrome.

American Journal of Speech-Language Pathology — Thu, 01 May 2008 04:00:00 +0100

The role of color cues in facilitating accurate and rapid location of aided symbols by children with and without down syndrome.

Am J Speech Lang Pathol. 2008 May;17(2):179-93

Authors: Wilkinson K, Carlin M, Thistle J

PURPOSE: This research examined how the color distribution of symbols within a visual aided augmentative and alternative communication array influenced the speed and accuracy with which participants with and without Down syndrome located a target picture symbol. METHOD: Eight typically developing children below the age of 4 years, 8 typically developing children over the age of 4 years, and 10 children with Down syndrome participated. Participants were asked to find a target line drawing among an array of 12. Line drawings represented either foods (e.g., grapes, cherries), clothing (e.g., a red shirt, a yellow shirt), or activities (e.g., soccer, swimming). In one condition, symbols that shared a color were clustered together, creating a subgroup within which to search. In another condition, symbols that shared a color were distributed across the display, allowing each to appear individually. Dependent measures were accuracy and speed of finding the target symbol. RESULTS: Clustering same-color symbols facilitated the speed of locating the target for all participants, and facilitated search accuracy in the younger preschool children and participants with Down syndrome. These effects held when targets were foods, clothing, or activities. CONCLUSION: Clinicians should consider the internal color of visual symbols when constructing aided symbol displays, at least for children with Down syndrome. Further research is needed on a number of dimensions, however, including visual processing in other etiological categories, the role of background color, and the relation of color to other stimulus dimensions.

PMID: 18448605 [PubMed - in process]

(Source: American Journal of Speech-Language Pathology)

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Comparison of personal versus fictional narratives of children with language impairment.

American Journal of Speech-Language Pathology — Thu, 01 May 2008 04:00:00 +0100

Comparison of personal versus fictional narratives of children with language impairment.

Am J Speech Lang Pathol. 2008 May;17(2):194-206

Authors: McCabe A, Bliss L, Barra G, Bennett M

PURPOSE: Personal narratives are common in children's conversations, recommended as the appropriate genre for early writing by educators, and part of many high-stakes tests, possibly because they tend to be better formed than fictional narratives. However, current practice in the field of speech-language pathology employs fictional narratives in assessment, intervention, and study of children with impaired language development. This article explored performance on personal versus fictional narratives by children with language impairment (LI), hypothesizing that performance on the former would be better and a minimal relationship between performances in the 2 genres. METHOD: Twenty-seven children age 7;0-9;9 (years;months) with LI orally produced personal and fictional narratives (responses to a wordless picture book). Narratives were analyzed by raters blind to experimental hypotheses using high-point analysis and an analysis derived from scoring of a high-stakes composition for 4th grade. RESULTS: High-point ratings of personal significantly exceeded those of fictional narratives. Disproportionate fictional stories did not meet minimal narrative criteria. However, more personal narratives than would be expected by chance did. The analyses were significantly correlated. Quality of a child's performance of personal was minimally related to that of fictional narratives. CONCLUSIONS: Clinicians may want to consider functional aspects of personal narratives.

PMID: 18448606 [PubMed - in process]

(Source: American Journal of Speech-Language Pathology)

Economic aspects of a therapy and support service for people with long-term stroke and aphasia.

International Journal of Language and Communication Disorders — Thu, 01 May 2008 04:00:00 +0100

Economic aspects of a therapy and support service for people with long-term stroke and aphasia.

Int J Lang Commun Disord. 2008 May-Jun;43(3):233-44

Authors: van der Gaag A, Brooks R

Backgound: This paper considers some economic aspects of a therapy and support service for people with stroke and aphasia. This material was part of a broader evaluation of the service, which is reported elsewhere (van der Gaag et al. 2005, van der Gaag and Mowles 2005). Aims: The purpose of this part of the study was to investigate the feasibility of undertaking economic appraisal in a voluntary sector service providing therapy for people with aphasia and their families. Methods & Procedures: The costs of delivering therapy and support services were calculated. These costs were compared with the costs of equivalent services in the National Health Service (NHS). The EQ-5D health-related quality of life instrument was used to calculate quality-adjusted life years (QALYs). Outcomes & Results: The cost of delivering therapy was lower than expected for a customized service of this nature. The study generated cost data for delivering therapy services, allowing some comparisons to be made with equivalent services in NHS settings. QALY data were generated for a sample of 25 clients on one of the programmes. Conclusions: The economics of speech and language therapy service delivery have received scant attention in the published literature. The paper argues that decision-making about methods of service delivery can be aided by the explicit consideration of the costs and consequences of different programmes.

PMID: 18446573 [PubMed - in process]

(Source: International Journal of Language and Communication Disorders)

Corrigendum.

International Journal of Language and Communication Disorders — Thu, 01 May 2008 04:00:00 +0100

Corrigendum.

Int J Lang Commun Disord. 2008 May-Jun;43(3):264

Authors:

PMID: 18446574 [PubMed - in process]

(Source: International Journal of Language and Communication Disorders)

Investigating factors related to the effects of time-out on stuttering in adults.

International Journal of Language and Communication Disorders — Thu, 01 May 2008 04:00:00 +0100

Investigating factors related to the effects of time-out on stuttering in adults.

Int J Lang Commun Disord. 2008 May-Jun;43(3):283-99

Authors: Franklin DE, Taylor CL, Hennessey NW, Beilby JM

Background: Response-contingent time-out has been shown to be an effective technique for enhancing fluency in people who stutter. However, the factors that determine individual responsiveness to time-out are not well understood. Aims: The study investigated the effectiveness of using response-contingent time-out to reduce stuttering frequency in adults who stutter. In addition, it investigated the predictive value of participants' stutter severity, age, previous treatment history, and type of stutter on the responsiveness to time-out conditioning. Methods & Procedures: Sixty people who stutter participated in the study. Half were exposed to time-out following each moment of stuttering over a 40-min period, the remaining participants acted as controls. Outcomes & Results: Results showed that individuals who stutter are highly responsive to time-out, and that the participants with a more severe stutter responded better than those with a mild stutter. To a lesser degree, previous treatment and speech rate also influenced treatment success. Age and type of stutter did not, although the proportion of repetition types of stutters increased over the experiment conditions, with prolongations and blocks decreasing, for the treatment group. Conclusions: This simple operant conditioning treatment method is effective in reducing stuttering. Individuals respond to time-out regardless of their age, type of stutter, stuttering severity or treatment history, thus it is a treatment methodology potentially suitable for all clients. This study investigated initial responsiveness to time-out; therefore, further research is necessary to determine the durability of fluency over time.

PMID: 18446575 [PubMed - in process]

(Source: International Journal of Language and Communication Disorders)

Grammaticality judgements in adolescents with and without language impairment.

International Journal of Language and Communication Disorders — Thu, 01 May 2008 04:00:00 +0100

Grammaticality judgements in adolescents with and without language impairment.

Int J Lang Commun Disord. 2008 May-Jun;43(3):346-60

Authors: Miller CA, Leonard LB, Finneran D

Background: Existing evidence suggests that young children with specific language impairment have unusual difficulty in detecting omissions of obligatory tense-marking morphemes, but little is known about adolescents' sensitivity to such violations. Aims: The study investigated whether limitations in receptive morphosyntax (as measured by grammaticality judgements) were present at age 16 years, and, if so, whether participants' profiles showed less sensitivity to omissions of tense and agreement morphemes than to (1) inappropriate uses (intrusions) of these same morphemes, and (2) omissions of morphemes that do not encode tense and agreement. The study also compared adolescents with language impairment and non-verbal IQ more than 1 standard deviation (SD) below the mean (non-specific language impairment) to adolescents with specific language impairment. Methods & Procedures: Adolescents with specific language impairment (n = 48), adolescents with non-specific language impairment (n = 25), and adolescents with normal language development (n = 108) performed speeded grammaticality judgements of sentences presented over headphones. Half the sentences were ungrammatical. They included omissions of non-tense morphemes (-ing and possessive -s), omissions of tense morphemes (-ed and third-person singular present -s), and intrusions of the same tense morphemes. The A' statistic was used as the dependent variable for comparisons across groups and item types. Outcomes & Results: Overall, the normal language development group was more sensitive to grammatical violations than the specific language impairment and non-specific language impairment groups, and there was no significant interaction of group and item type. Post-hoc analyses showed that the specific language impairment group was less sensitive to violations than the normal language development group on each item type, and the specific language impairment and non-specific language impairment groups did not differ. Across groups, performance on omission of past tense -ed was lowest, and properties of the items that may have contributed to this difference were explored. Conclusions: The adolescents with language impairment in this study showed evidence of reduced sensitivity to morphological errors, including both tense-marking and non-tense-marking morphemes, but no evidence of any extraordinary difficulty in detecting the omission of tense-marking morphemes, in contrast to results from other research on younger children with specific language impairment. Participants whose non-verbal IQ score was too low to meet the criteria for specific language impairment performed similarly to their peers with specific language impairment. Grammatical competence is compromised in these adolescents with specific language impairment and non-specific language impairment. Neither researchers nor clinicians can assume that adolescents with language impairment have fully mastered grammatical morphology.

PMID: 18446576 [PubMed - in process]

(Source: International Journal of Language and Communication Disorders)

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Hearing aid low frequency cut: effect on mandarin tone and vowel perception in normal-hearing listeners

Folia Phoniatrica et Logopaedica : Last 20 articles — Mon, 28 Apr 2008 13:55:15 +0100

Folia Phoniatr Logop 2008;60:179-187 (DOI:10.1159/000128276) (Source: Folia Phoniatrica et Logopaedica : Last 20 articles)

A pilot study exploring the factors that influence the decision to have peg feeding in patients with progressive conditions

Dysphagia — Fri, 25 Apr 2008 10:46:52 +0100

Abstract This original pilot study was conducted to explore and understand the factors that influence a patient’s decision-making when considering percutaneous endoscopic gastrostomy placement for nonoral nutrition and hydration supplementation. Seven patients living with progressive dysphagic symptoms who had made a decision about percutaneous endoscopic gastrostomy placement were interviewed and their responses analyzed using the constant comparison method. All participants felt they had no option other than to accept the percutaneous endoscopic gastrostomy. The impact of visible physical deterioration and medical opinion were the most powerful influences on patients’ decisions. Patients’ perception of their involvement in the decision varied. This was linked to the amount and timing of information supplied and support they felt they received. Few patients have prior knowledge of tube feeding and rely heavily on medical advice. Effective communication by healthcare professionals can promote an environment that is supportive of patients’ involvement in decisions. Adequate preparation time is vital if patients are to stop feeling uninvolved or peripheral to the decision-making process. Multidisciplinary teams need to address their working practices so that they do not intimidate patients, but rather empower patients in their decision-making. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00455-008-9149-0Authors Siobhan Vesey, Trafford PCT, Trafford General Hospital Speech and Language Therapy Department Moorside Road Davyhulme Manchester M41 5SL UKPaula Leslie, University of Pittsburgh Department of Communication Science and Disorders 4033 Forbes Tower Pittsburgh PA 15260 USACatherine Exley, University of Newcastle upon Tyne Institute of Health and Society 21, Claremont Place Newcastle upon Tyne NE2 4AA England Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)

Dysphagia after emergency intubation: case report and literature review

Dysphagia — Fri, 25 Apr 2008 10:46:52 +0100

Abstract The authors present the case of a 62-year-old male who presented with dysphagia for 1 month after emergency intubation after sustaining a myocardial infarction. Subsequent clinical evaluation discovered an impacted partial denture as the source of this dysphagia. This case highlights clinically relevant issues regarding the multidisciplinary management of emergency intubation with subsequent dysphagia, the nature of dentures and their relevance to developmentally delayed individuals and an aging population. The diagnosis and management of impacted dentures involves valuable input from surgeons, physicians, radiologists and speech pathologists. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00455-008-9154-3Authors Ronald Y. Chin, The Alfred Hospital Department of Otolaryngology Head and Neck Surgery Melbourne Victoria AustraliaSimon Ellul, The Alfred Hospital Department of Otolaryngology Head and Neck Surgery Melbourne Victoria Australia Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)

Does an exercise aimed at improving swallow function have an effect on vocal function in the healthy elderly?

Dysphagia — Fri, 25 Apr 2008 10:46:51 +0100

Abstract Age-related sarcopenia or muscle wasting contributes to changes in the ability to perform activities of daily living, changes in deglutition, and changes in vocal function. The Shaker Exercise, an isometric and isokinetic exercise, has been shown to strengthen suprahyoid muscles and increase deglutitive anteroposterior (AP) upper esophageal sphincter (UES) opening diameter. The aim of this study was to determine if this exercise has an effect on the age-related changes in vocal function and deglutition in healthy older adults. Eleven females and 10 males, aged 65–78 years (mean = 70 ± 4 years) and with a negative history for dysphagia and voice disorders, participated by exercising three times per day for 6 weeks. Five age-matched controls did not perform the exercise. Acoustic analysis of voice and biomechanical analysis of deglutition were performed before and after 6 weeks of exercise. Controls participated in voice analysis only. Dysphonia Severity Index (DSI), a multivariate voice index, was used to compare voice production initially and after 6 weeks. Deglutitive biomechanical measures increased and DSI scores improved in 10 of 21 participants following 6 weeks of the exercise. DSI for controls did not change over the 6-week period. Ten of 21 exercise participants experienced improved deglutitive biomechanics and DSI scores. Accuracy of exercise performance, compliance, and/or disclosed alterations in health status may contribute to the lack of deglutitive and DSI change in the participants who did not experience change in function. A large randomized control study, including periodic monitoring of health status, exercise performance accuracy, and compliance, is warranted to evaluate the affect of this exercise on deglutition as well as voice. The Shaker Exercise could be recommended as a preventative measure to diminish the effect of sarcopenia on the muscles used in deglutition and voice and alter the progression of the characteristic senescent voice and swallow changes. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00455-008-9158-zAuthors Caryn Easterling, University of Wisconsin-Milwaukee Department of Communication Sciences and Disorders P.O. Box 413 Milwaukee WI 53201-0413 USA Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)

Botulinum toxin a treatment of cricopharyngeal dysphagia after subarachnoid hemorrhage

Dysphagia — Fri, 25 Apr 2008 10:46:49 +0100

Abstract Elevated muscular tone associated with spastic syndromes can cause excessive contractility at the upper esophageal sphincter and impede swallowing. A 47-year-old male patient with spasticity predominantly of the lower extremities after a subarachnoid hemorrhage suffered from severe dysphagia and chronic salivary aspiration. He was dependent on a cuffed tracheostomy tube and a percutaneous enterogastric feeding tube. Barium swallow and esophageal manometry revealed cricopharyngeal spasm, while laryngeal elevation and pharyngeal contractility were well preserved. We endoscopically injected 180 MU botulinum toxin A into the cricopharyngeus muscle. Two days post injection, swallowing function had improved and oral nutrition was possible. This improvement lasted for six weeks. After another injection 8 weeks later, an undesired diffusion into the hypopharynx occurred and manometry showed diminished contractility without amelioration of dysphagia. Botulinum toxin therapy of cricopharyngeal spasm improves swallowing function in a subgroup of patients with spastic syndromes. The therapeutic effect is of limited duration. Toxin diffusion into the pharynx should be avoided. Manometry is useful in planning and monitoring the therapy. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00455-007-9132-1Authors Eike Krause, Ludwig-Maximilians-University Department of Otorhinolaryngology Munich GermanyJörg Schirra, Ludwig-Maximilians-University Department of Medicine II Marchioninistaße 15 81377 Munich GermanyRobert Gürkov, Ludwig-Maximilians-University Department of Otorhinolaryngology Munich Germany Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)

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Neuromuscular electrical stimulation (nmes) in stroke patients with oral and pharyngeal dysfunction

Dysphagia — Fri, 25 Apr 2008 10:46:47 +0100

Abstract Neuromuscular electrical stimulation (NMES) technique is a dual-channel electrotherapy system designed specifically for the treatment of pharyngeal dysfunction. The purpose of this study was to evaluate and compare the outcome of NMES versus traditional swallowing therapy (TT) in stroke patients. Three European swallowing centers participated in this randomized trial. Twenty-five patients (16 men and 9 women) were included. Twelve patients were randomized for NMES and 13 for TT. Mean age was 70 years for the NMES group and 71 years for the TT group. Inclusion criteria were (1) patients 50–80 years old with cerebrovascular disease (stroke) for more than 3 months before the study, (2) only patients with hemispheric stroke, (3) no brainstem involvement, (4) ability to swallow, and (5) ability to communicate. Pre- and post-trial measurements were videoradiographic swallowing evaluation, nutritional status, oral motor function test, and a visual analog scale (VAS) for self-evaluation of complaints. All subjects received 15 therapy sessions. Statistically significant positive therapy effects for both NMES and TT combined were found, but there was no statistically significant difference in therapy effect between the groups. The correlations between measurements were low. The patient’s subjective experience of improvement had low correlation with the outcome from the objective evaluation. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00455-007-9145-9Authors Margareta Bülow, Malmö University Hospital Diagnostic Centre of Imaging and Functional Medicine Malmö SwedenReneé Speyer, University Hospital Maastricht Audiology/ENT Department Maastricht The NetherlandsLaura Baijens, University Hospital Maastricht Audiology/ENT Department Maastricht The NetherlandsVirginie Woisard, Service ORL, Hôpital Larrey Unité de la voix et de la déglutition Toulouse FranceOlle Ekberg, Malmö University Hospital Diagnostic Centre of Imaging and Functional Medicine Malmö Sweden Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)

An in vitro model for studying neuromuscular transmission in the mouse pharynx

Dysphagia — Fri, 25 Apr 2008 10:46:46 +0100

Abstract The muscles of the pharynx are controlled by networks of neurons under the control of specific regions in the brain stem, which have been fairly well studied. However, the transmission between these neurons and the pharyngeal muscles, at the motor end plates, is less well understood. Therefore, an in vitro model for the study of neuromuscular transmission in the pharyngeal muscle of the mouse was developed. Ring preparations from the inferior constrictor and the cricopharyngeus muscles were isolated and mounted for isometric force recording at physiologic temperature. Preparations from the diaphragm and the soleus muscles were examined in parallel. The muscles were stimulated at supramaximal voltage with short tetani at 100 Hz. Following direct stimulation of the muscle fibers, using a longer pulse duration, the rate of force development of the pharyngeal muscles was similar to that of the diaphragm and faster than that of the soleus muscle. By varying the duration of the stimulation pulses, conditions where the nerve-mediated activation contributed to a major extent of the contractile responses were identified. Gallamine completely inhibited the nerve-mediated responses. In separate experiments the dose dependence of gallamine inhibition was examined, showing similar sensitivity in the inferior pharyngeal constrictor compared to the diaphragm and soleus muscles. We conclude that reproducible contractile responses with an identifiable nerve-induced component can be obtained from the mouse inferior pharyngeal constrictor. The pharyngeal muscles have contractile characteristics similar to those of the faster diaphragm. The sensitivity to the neuromuscular blocking agent gallamine of the inferior pharyngeal constrictor was in the same concentration range as that of the diaphragm and soleus muscles. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00455-008-9168-xAuthors Olle Ekberg, Department of Clinical Sciences, Malmö/Medical Radiology Malmo SwedenM. Ekman, Lund University Department of Experimental Medical Science Lund SwedenL. I. Eriksson, Karolinska Hospital Department of Anaesthesiology and Intensive Care Medicine Stockholm SwedenR. Malm, Lund University Department of Experimental Medical Science Lund SwedenE. Sundman, Karolinska Hospital Department of Anaesthesiology and Intensive Care Medicine Stockholm SwedenA. Arner, Lund University Department of Experimental Medical Science Lund Sweden Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)

Contact your senators regarding slp private practice

ASHA Action Alerts — Fri, 25 Apr 2008 04:00:00 +0100

U.S. Senate To Consider Medicare Legislation In May (Source: ASHA Action Alerts)

Contact your senators regarding slp private practice

ASHA Action Alerts — Fri, 25 Apr 2008 04:00:00 +0100

U.S. Senate To Consider Medicare Legislation In May (Source: ASHA Action Alerts)

Comments on selected recent dysphagia literature

Dysphagia — Tue, 22 Apr 2008 14:20:40 +0100

Comments on Selected Recent Dysphagia Literature Content Type Journal ArticleCategory CommentsDOI 10.1007/s00455-007-9147-7Authors Clarence T. Sasaki, Yale University School of Medicine Department of Surgery, Section of Otolaryngology P.O. Box 208041 New Haven Connecticut 06520-8041 USASteven B. Leder, Yale University School of Medicine Department of Surgery, Section of Otolaryngology P.O. Box 208041 New Haven Connecticut 06520-8041 USA Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)

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Anatomical variations in stylopharyngeus muscle insertions suggest interindividual and left/right differences in pharyngeal clearance function of elderly patients: a cadaveric study

Dysphagia — Tue, 22 Apr 2008 14:20:34 +0100

Abstract The stylopharyngeus plays a critical role in the clearance of the piriform recess. We dissected 78 sides of the pharynx from 55 donated cadavers and observed histology of another seven sides of the pharynx from seven cadavers. The stylopharyngeus consistently comprised (1) a descending muscle bundle surrounding the piriform recess and (2) an additional short sheet inserting into the tonsillar bed. Histologically, the former bundle connected to a thick fascia providing the lateral glossoepiglottic fold, extending along the submucosa of the piriform recess, and covering the thyroid cartilage, whereas the latter sheet intermingled with other pharyngeal wall muscles at and near the tonsillar bed. Notably, in 44.4% of female specimens, the additional sheet occupied a greater proportion in cross section than the descending muscle bundle. Given the different directions, the additional sheet seemed to check clearance function of the descending bundle for the piriform recess. Thus, particularly in women, interindividual differences in pharyngeal clearance were likely to depend on whether the additional sheet is strong or weak. Chin down in combination with tilting and rotating the head may represent effective exercises of the stylopharyngeus that could compensate for the disadvantages of additional insertion. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00455-007-9131-2Authors Han Meng, Bunkyo University School of Human Science Department of Physiotherapy 196-1 Kogane-cho Eniwa Hokkaido 061-1408 JapanGen Murakami, Iwamizawa Kojinkai Hospital Division of Internal Medicine and Rehabilitation 297-13 Shibunncho Iwamizawa Hokkaido 068–0833 JapanDaisuke Suzuki, Sapporo Medical University, School of Medicine Department of Anatomy South 1 West 17, Chuo-ku Sapporo Hokkaido 060–8557 JapanShigenori Miyamoto, Bunkyo University School of Human Science Department of Physiotherapy 196-1 Kogane-cho Eniwa Hokkaido 061-1408 Japan Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)

Variability in the production of words containing consonant clusters by typical 2- and 3-year-old children

Folia Phoniatrica et Logopaedica : Last 20 articles — Tue, 22 Apr 2008 14:01:42 +0100

Folia Phoniatr Logop 2008;60:163-172 (DOI:10.1159/000127835) (Source: Folia Phoniatrica et Logopaedica : Last 20 articles)

Validation of the voice handicap index by assessing equivalence of european translations

Folia Phoniatrica et Logopaedica : Last 20 articles — Tue, 22 Apr 2008 07:55:20 +0100

Folia Phoniatr Logop 2008;60:173-178 (DOI:10.1159/000127836) (Source: Folia Phoniatrica et Logopaedica : Last 20 articles)

Annual better hearing and speech month (bhsm) observance to be promoted on npr programs

American Speech-Language-Hearing Association (ASHA) Press Releases — Fri, 18 Apr 2008 16:00:00 +0100

For the second consecutive year, the American Speech-Language-Hearing Association (ASHA) has become a sponsor of National Public Radio (NPR) programming to help brand the May is Better Hearing and Speech Month (BHSM) observance and to educate the public about our professions and communication disorders. (Source: American Speech-Language-Hearing Association (ASHA) Press Releases)

Hearing health bills move forward

The ASHA Leader Online — Tue, 15 Apr 2008 16:00:00 +0100

Two critical hearing health bills?the Early Hearing Detection and Intervention Act of 2008 and the reauthorization of the Traumatic Brain Injury Act?have cleared the U.S. House and key committees. (Source: The ASHA Leader Online)

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Asha receives associations advance america award of excellence

American Speech-Language-Hearing Association (ASHA) Press Releases — Mon, 14 Apr 2008 16:00:00 +0100

The American Speech-Language-Hearing Association (ASHA) has won the 2008 Associations Advance America (AAA) Award of Excellence from the American Society of Association Executives (ASAE) and The Center for Association Leadership. (Source: American Speech-Language-Hearing Association (ASHA) Press Releases)

More than 500 speech-language pathologists attend asha's annual health care conference/business institute

American Speech-Language-Hearing Association (ASHA) Press Releases — Fri, 11 Apr 2008 16:00:00 +0100

The American Speech-Language-Hearing Association held its annual Health Care conference/Business Institute in St. Louis, Missouri on April 5-6, 2008. (Source: American Speech-Language-Hearing Association (ASHA) Press Releases)

Talking literacy with acclaimed author david baldacci

American Speech-Language-Hearing Association (ASHA) Press Releases — Thu, 10 Apr 2008 16:00:00 +0100

Literacy is the focus of a new podcast produced by the American Speech-Language-Hearing Association (ASHA). In this 18-minute podcast award-winning author David Baldacci discusses literacy, one of our most fundamental life skills. (Source: American Speech-Language-Hearing Association (ASHA) Press Releases)

Gestures accompanying speech in specifically language-impaired children and their timing with speech

First Language — Thu, 10 Apr 2008 04:00:00 +0100

The repertoire and timing of gestures accompanying speech were compared in children with specific language impairment (SLI), aged 5—10 years, in typically developing peers (CA), individually matched on age and nonverbal IQ, and in younger language-matched (LM) children. They were videotaped in two tasks, recounting a cartoon and describing their classroom. Three types of gestures were coded — iconics, deictics and beats — and the synchrony of these gestures with speech was examined in terms of number of words encompassed, grammatical speech category at gesture onset, and relationship of iconic gestures to the concept expressed in speech. All groups used more deictic gestures in the classroom description task. SLI children differed from the comparison children only in their use of iconic gestures. They produced somewhat more of these, used them more often to replace words, and began them more often on a noun phrase object. Otherwise, language proficiency, at least as measured by standardized tests, did not appear to impact the gestural system. The fact that, for all groups, most iconic and deictic gestures began on the noun phrase subject indicates a close synchrony between gesture and speech onset. (Source: First Language)